GPOs cannot catch the crooks, but how about a DOTmed-like blacklisting of members, employees or vendors caught in the act? For example, what if Johnson & Johnson is guilty of paying "tens of millions of dollars in kickbacks" to middleman Omnicare to push J&J medicines to its nursing home customers? The jury is still out on this case, filed in federal court on January 15, but even the threat of Justice Department action doesn't seem to eliminate such activities. Perhaps GPOs should weigh in, even with a behemoth like a J&J.

Even a warning flag, a cautionary alert (if these accusations prove true), attached to every J&J contract could be useful exposure, informing and updating buyers everywhere.


Another area GPOs could attack might be those products proven to lack efficacy. A 2007 study found that implanting expensive stents in cardiac patients to unclog arteries was often unnecessary and yielded no additional benefit. A typical GPO reaction to the stent market would be an attempt to contract with the makers and then offer members a token discount. But what if GPOs not only refused to contract with such products, but actively identified such waste?

On a lesser scale, SCDs or continuous compression sleeves used to prevent DVTs on hospital patients have gained wide adoption. But studies have shown that the thigh-length sleeves are no more effective than the knee-length, which cost less. Perhaps GPOs can remove that SKU from its contract, with an explanation as to why.

GPOs taking an active role in at least identifying waste or abuse would not only reduce costs, but also reclaim some higher moral ground - and perhaps a louder voice- in the ongoing debate in health care.

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