How to save money by trimming waste disposal costs

Managing your trash may prevent waste -- of money. Savings will not be huge, but at a time of declining reimbursements, some practices find it worthwhile to negotiate a bit harder with companies providing such services, pay attention to additional fees and train staff to dispose of waste as cheaply as possible.

Leslie Strouse, MD, an internist with a solo practice in New Albany, Ind., saves $5 per pickup of the hazardous waste produced by the practice by going with a company that does not have a gas surcharge. The base rate per pickup is the same as a competing vendor.

Dr. Strouse also saves money by training staff to put only certain trash in the "red bag" hazardous material bins and keeping these receptacles out of patients' sight. The containers are less likely to be used for coffee cups and other detritus that belong in the office trash can. She has cut hazardous waste pickups to once every six weeks. Ordinary office waste and recycling is provided by the city and paid for through taxes.

"It's worth it," Dr. Strouse said. "In today's markets, particularly in primary care, you just don't have the luxury of wasting money, and five bucks is five bucks."

Those in the hazardous waste disposal business might offer other tips. Their costs vary widely by location, the type of medical practice and its size. How much actually can be saved depends on the practice.

"Medical practices traditionally have not focused on this area, but there are more and more ways to save money and get the best value for these services," said Linda Lee, DrPH, director of operations for Waste Management in Houston.

The first step is to identify what belongs in the hazardous waste bins and what does not. This varies by state. Waste disposal companies should be able to provide information, but generally, sharps contaminated with blood and other body fluids should be disposed of as hazardous medical waste. Exam table papers and disposable towels usually can go into the office waste stream.

"A lot of waste can go in the regular trash," Lee said. "Practices need to know what is medical waste and what is not."

Minimizing the number of red bins to only those locations that really need them may help with this effort. This is less of an issue with sharps containers, which often need to be plentiful but rarely attract other rubbish because of their design.

"You're not going to stuff paper or anything else into that," Lee said.

In addition to minimizing the hazardous waste stream, you can haggle for a better price with waste disposal companies.

You usually can find vendors through an Internet search, and bids from two or three can be used as ammunition during negotiations.

"The most common-sense thing is to price-shop," said Pete Lindemulder, owner of Bio-safe Medical Waste in Chicago. "I think that a lot of people who are under contract really don't think about it. They just let their contract continue to roll over and have 5% or 10% increases every year. ... Practices need to find a few local companies and get some competitive quotes."

But experts caution that all parts of the bill need to be considered, not just the pickup price. Will there be surcharges for fuel? What about an environmental impact charge or one for documentation? Small practices, in particular, need to be aware of being stuck with fees for not hitting certain minimums.

"You want to make sure up-front what the fees are and that they are not greater than what you expect," Lindemulder said.

Medical practices may want to consider other factors besides price, such as the quality of service and the availability of educational sessions for staff. Before you sign with a firm, experts advise asking for references from similar types of medical practices and checking them out.