With the impact of Physician Preference Items (PPI) on total supply chain costs ranging anywhere from 40-60 percent, independent, community-based hospitals have begun working with physicians to dramatically change the way that these items are evaluated and purchased. Achieving system value without sacrificing quality of care requires a mixture of standardization and utilization with pricing strategies that optimize both financial and operational performance. One of the most exciting ways to achieve these goals is through standardization of medical device contracts.