|Cardiac, orthopedic, and spinal implants are among the most important medical innovations of the era. These implants are just some of the items collectively referred to as Physician Preferred Items (PPIs), making light of the central role that physicians play in selecting these implants, and by extension, the vendors who manufacture and market these implants.While the manufacturers of PPI are national or international in nature and scope, there is one inescapable fact, healthcare is, indeed, a local business. It is influenced by unique processes and relationships, which, in turn, reflect local differences in infrastructures, business strategies and utilization patterns. For buyers and sellers, these differences provide opportunities and frustrations as the same item will cost different amounts in different parts of the country, state, or region.How can PPI be purchased in a manner that accommodates these clinical and financial influences, yet still satisfies responsible supply-side economics? Contracting plays a key role. Local discounts routinely reflect the vendor’s local market share, the depth of the vendor’s exposure within the facility, the vendor’s relationships with clinicians and the facility’s commitment if they are big enough, to national or regional contracts. The inconsistency of these discounts has frustrated purchasing professionals and broadened the gulf between them and the vendors.Health Future understands this. Working with the PPI Task Force, whose job is to identify the PPI, Health Future leverages the combined buying power of our members, enabling us to negotiate larger discounts on those PPIs.