More than two years into a prolonged economic slump that depressed capital equipment sales and weakened stock prices, manufacturers of diagnostic imaging equipment appear to have reason to smile again as hospitals restart the process of acquiring new equipment to replace aging technology.

The single-use device reprocessing and remanufacturing market is an estimated $200+ million business and growing fast thanks to cost containment pressures and the waning of early controversy surrounding the practice. By nearly any measure--including the number of facilities, number of approved products, and dollars both spent and saved--the SUD reprocessing industry is making a noteworthy impact on health care delivery in the US.

For the past year, hospital purchasing groups have been under a spotlight, as Senate investigators and major media investigate charges that groups have done more harm than good in favoring large product companies. One of two groups at the center of the crisis, Premier, says it is cleaning up its act-and even hired an ethicist to help-but its take on necessary reforms embraces a broad, big-picture view of hospital/GPO relationships. MedAssets is taking more of a back-to-basics approach that stresses flexibility and choice in contracting options while helping members address the escalating costs of physician preferred products. The challenge for GPOs: the pressure to reform comes at a time when competition for hospital customers is fierce, in part because the financial pressure on hospitals has never been greater.

Facing unprecedented scrutiny from major media and the US Senate, leading GPOs are beginning to revamp their policies to address concerns on the part of small suppliers that the current system unfairly excludes them. But given the animosity between the two sides, will there ever be a meeting of the minds on GPO reform?