JHC-April.25

April 2025 Vol. 21 • No. 2

Rising Leaders in Supply Chain How these emerging supply chain leaders are helping reshape the U.S. healthcare industry.

Mariem Ruiz Martinez, MBA, Manager of Strategic Sourcing, Rush University System for Health

Real-World Expertise Real-World Results Everything we do starts from the perspective of a hospital operator. Our Performance Solutions team members bring decades of senior-level experience to solve challenges for providers and deliver sustainable results in key performance areas: Value Analysis Purchased Services Labor Medical Device Spend Pharmacy Services Lab Operations Supply Chain Services Surgery Services

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CONTENTS APRIL 2025

The Journal of Healthcare Contracting is published bi-monthly

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Senior Editor Daniel Beaird dbeaird@sharemovingmedia.com

Art Director Brent Cashman bcashman@sharemovingmedia.com

Publisher John Pritchard

Feature

jpritchard@sharemovingmedia.com

Rising Leaders in Supply Chain

Circulation Laura Gantert lgantert@sharemovingmedia.com

How these emerging supply chain leaders are helping reshape the U.S. healthcare industry.

 pg 16 The Journal of Healthcare Contracting (ISSN 1548-4165) is published monthly by Share Moving Media, 350 Town Center Ave, Ste 201, Suwanee, GA 30024-6914. Copyright 2025

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Please note: The acceptance of advertising or products mentioned by contributing authors does not constitute endorsement by the

2 Publisher’s Letter: Why is it so hard for Suppliers to get in to see you?

4 Finding Value in Trust

McLeod Health’s BJ McCluskey believes effective collaboration with clinical stakeholders in supply chain starts with transparency.

12 The Times Are A-Changing Adapting to new regulatory norms.

37 Clinical Integration: Can You Define It?

Success sees beyond ‘Resistance is futile … you will be integrated.’

44 Private Equity Firm to Acquire Walgreens Boots Alliance Companies say the deal will leverage WBA’s healthcare expertise and Sycamore’s established leadership in retail and consumer services..

46 Supply Chain By the Numbers 49 Provider Perspective

How University of Miami uses distribution.

50 Shedding and Shredding the Cloak of Invisibility 52 Industry News

publisher. Publisher cannot accept responsibility for the correctness of an opinion expressed by contributing authors.

The Journal of Healthcare Contracting | April 2025

Subscribe/renew @ www.jhconline.com : click subscribe

1



PUBLISHER’S LETTER

Why is it so hard for Suppliers to get in to see you?

John Pritchard

Recently I saw a survey asking Suppliers what their

I think pre-COVID, Supply Chain Leaders

biggest challenge is in this crazy healthcare con-

budgeted time for Suppliers they were not cur-

tacting and sourcing market. The most common

rently doing business with (maybe even unknow-

answer was “Access to IDN Decision Makers.” I

ingly). But now that remote work is more com-

could tell from the responses this struck a nerve

mon it is just easier to not take meetings that

for Suppliers, and they were at a loss as to why they

they may have five years ago. It’s almost like we

couldn’t get an occasional meeting with Supply

have lost the decorum of doing the buyer-seller

Chain Leaders. I thought I’d share my thoughts on

mating dance. I am not sure that is all bad, to

why it is so difficult to get venue with IDNs today.

be honest.

The days of Sourcing Executives giving someone

Hospitals and IDNs are not going to have

the courtesy of a meeting to present a competitive so-

their purchasing decisions swayed much by a

lution to an incumbent Supplier or to present a new

courtesy meeting. When was the last time you

product, therapy or service are long gone. And not

made a major purchase, say a car or a house, and

coming back anytime soon. Suppliers need to clearly

it was influenced by a selling party? Research

understand their competition is not other brands in

shows business-to-business buyers do over 70%

their category. Their competition is everything com-

of their research before they engage a brand to

peting for Supply Chain Leaders’ attention! Here is a

discuss a conversion.

very short list of what some of those things could be:

` Mergers and acquisitions ` New ERP implementation ` Changing GPOs or Distributors ` Building a CSC ` Exploring hyper aggregation opportunities

I get the sense that buyers are not influenced by sellers anymore or to the degree they used to be. They prefer to learn features and benefits from other users, read third party reviews and search online for social proof.

I’d love to hear your thoughts.

And a myriad of other projects. All this in an

2

environment of high inflation and labor challenges.

Thanks for reading this issue of The Journal of

It is the perfect storm, again.

Healthcare Contracting.

April 2025 | The Journal of Healthcare Contracting

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

MODEL OF THE FUTURE

Finding Value in Trust McLeod Health’s BJ McCluskey believes effective collaboration with clinical stakeholders in supply chain starts with transparency.

Implementing a new value analysis process for McLeod Health has led to

it. We get to be the liaison between the

some interesting conversations for BJ McCluskey, AVP of Strategic Sourcing and

supply chain business side of the world

Contracting for the organization. Not only does he have regular conversations with

and our clinical teams.”

clinicians across all the health system’s service lines, but he’s also talking to prospective clinicians during the interview process.

McLeod Health’s supply chain goal is to support the Institute for Healthcare Improvement’s (IHI) Quadruple Aim, a value-based healthcare strategy designed to

Indeed, the South Carolina-based

“The process is entirely collaborative,”

improve the patient experience, population

health system recognized that when a

McCluskey said. “The supply chain team

health, cost of care, and provider experi-

physician would be onboarded – say, a

can’t do their jobs without the clinical

ence. “We’re on the finance side of the

proceduralist surgeon – there would often

team’s involvement. They’re our major

world, so we want to look at reducing cost,

be a supply-related fire drill because the

stakeholders. We’re here to support them,

but we also want to improve the patient

clinicians didn’t have what they needed in

and they’re here to support our patients

experience, population health and the care

the OR.

and the needs of our community.”

team’s well-being by taking care of our clini-

“We knew we had to address it col-

cians so they can take care of the people in

laboratively, because supply chain is not

need. That’s the ‘why’ behind what we do.”

the only department looking for informa-

Finding supply chain’s ‘Why’

How does supply chain bridge that

tion,” said McCluskey, MBA, CVAHP,

McCluskey’s focus areas are strategic

gap? Trust is the main attribute in the

FAHVAP, FACHDM. “Our central pro-

sourcing, category management, contract-

equation, McCluskey said. “You do that

cessing department needs to know about

ing, and value analysis. “We get to help

by building relationships. You have to

instrumentation. Our clinical leads in the

develop the strategies for what we use

spend time with the clinicians in their

OR procedure room must get preference

and how we use it and then work with our

areas, whether it’s in the OR, or in the lab.

card information. We have to make sure

clinical teams to do that and then monitor

Then you must have a methodology and

the supplies are available, and contracts

framework on how you’re going to con-

are in place.”

sistently and effectively engage them.”

It takes a team to pull that off. The

For McLeod Health, that’s their value

collaboration begins even before day one

analysis program. Several years ago, the

for the physician, McCluskey said. Sup-

health system started with two service

ply chain gets to sit in on the physician

lines, orthopedic, and heart and vascular.

interviews for the organization for any

They created multidisciplinary teams

procedural surgical area. When physi-

and have added one or two more service

cians are onboarded, McCluskey and his

lines every year as they learned and built

team can work with them months ahead

on their framework. McLeod Health

of time to make sure the organization is

currently manages 19 service lines; 15 of

ready to go with everything from supplies to equipment, resources and staffing.

4

BJ McCluskey

those are clinical, and four are non-clinical service lines across the organization.

April 2025 | The Journal of Healthcare Contracting

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

MODEL OF THE FUTURE

Transparency plays a big role in driving

assessments. Prior to McLeod Health’s

everybody understands what we’re trying

the effectiveness of those service lines,

value analysis program maturing to where

to accomplish, that becomes OK,” Mc-

McCluskey said. “At the end of the day, the

it is today, it could take weeks or months

Cluskey said. “But if you don’t have those

framework you use to engage your physi-

to get an assessment done. “We’ve sped

expectations, it becomes a frustration for

cians doesn’t matter. It has to be an open

that up tremendously,” McCluskey said.

the entire organization when things get

forum, and an open space for consider-

Supply chain can now work on more

drawn out.”

ation,” he said. “Everybody truly must feel

projects throughout the year to improve

“The last benefit, and perhaps most

like they can bring value to the conversa-

outcomes, reduce waste or save from a

important is, you tend to get it right the

tion, whether that’s to support ideas or to

financial standpoint.

first time when you’re doing it collab-

challenge them. You must have an environment built, a safe place to do that.”

“We can more quickly build opportunity

oratively,” McCluskey continued. “In the

assessments that are reliable. We can do

way we’ve structured our value analysis

McLeod Health’s supply chain team

evaluations on new product requests. We

programs, you have the right people at the

also utilizes data. Whether it’s related to

can measure clinical outcomes more reliably

table making the decisions the first time.

cost, quality, outcomes, or safety, data

and track things more reliably. That was a

That’s not to say we don’t make mistakes.

must drive the conversations, McCluskey

huge frustration for our clinicians, under-

You live and learn and push forward. But

said. “I think we can all agree that we’re

standably so, because we want to keep them

overall, I think we’re making the right

all very emotional in healthcare, which

at the bedside. We don’t want them tied up

decisions out the gate and we’re not hav-

is understandable. You’re taking care of

doing business things. But they also have

ing to rework projects because of lack of

people, and you want to do the best you

to be a major decision maker in all that we

support or buy-in.”

can. But you do have a business to run,

do, so we want to value their time.”

so you must be mindful of the finances.

The organization now has a defined

Having a defined process, methodology, and framework has been crucial for

The more data, analytics, and metrics can

governance structure on who has the

McLeod Health to be efficient in what

guide the conversation, the better the col-

authority to make what decisions. They

they do. “The organization wants to

laboration becomes.”

have accomplished this by developing

always measure value – outcomes divided

project charters for every committee. A

by cost,” McCluskey said. “That’s how we

governing document outlines how each

measure value. So, we’ve got to be able to

Setting expectations

committee will conduct business and sets

do that. And a lot of what we do is really

Over the years, it has taken supply

the expectations for everybody.

complex. Some of these assessments

chain/value analysis teams a long time to put together accurate and reliable

“Even when things do take a while to produce, if the expectation was set and

are very detailed, and we put everything through a rigorous workflow. So that can take time, especially if you haven’t become efficient at it. But the collaboration with clinicians has helped us become

McLeod Health serves patients across northeastern South Carolina and southeastern North Carolina, with multiple hospitals and healthcare facilities in locations such as Florence, Darlington, Dillon, and more.

Known for its focus on clinical quality and compassionate care, McLeod Health is dedicated to community health improvement, offering educational programs, community outreach, and advanced technology to enhance patient outcomes. The health system offers a wide range of services, including specialized care in heart and vascular health, cancer treatment, women’s and children’s health, orthopedics, and rehabilitation. It operates hospitals, outpatient facilities, and physician practices across the region.

more efficient.”

Today’s challenges and tomorrow’s solutions McLeod Health’s strategic plan in 2025 includes growing the organization’s stroke program. Clinicians already do work in heart and vascular, cardiology, and neuroscience service lines, but the organization is bringing in a neuro interventionalist and

6

April 2025 | The Journal of Healthcare Contracting

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

MODEL OF THE FUTURE

creating a neuro-interventional committee

that we’re doing. More of our assessments

McLeod Health’s supply chain

that can support a vision of growth.

include more risk factors that may persuade

team is taking a very slow approach to

“We’re onboarding a new physician

us to go one way or another on a decision.”

evaluating new technology – specifically

now,” McCluskey said. “We’ve been meet-

Cost and finding ways to mitigate cost

AI applications. “We have a robust

ing with him to make sure that we are set

increases, whether that’s due to inflation

amount of data. We don’t have a

up from an inventory standpoint, that

or other factors, is another focus point

problem with data and healthcare,

we have contracts in place, consignment

for the organization.

but we do have a problem with data

agreements in place, that we have inven-

So too is new technology. “I read an

integrity. Everything that you’re going

tory on the shelves ready to go day one, so

article recently that said in the next 10

to spin up into a data warehouse or a

he doesn’t get in a procedure room and not

years, we’re going to advance from a tech-

large language model, whatever you’re

have what he needs to care for his patient.”

nology standpoint like we did over the last

going to do, if it’s not reliable, then you

Resiliency continues to be a heavy focus

100 years,” McCluskey said. “That’s how

can start producing unreliable results if

for McLeod Health’s supply chain and

fast technology is advancing. And we all

you use AI or some type of automation

value analysis teams in 2025, McCluskey said.

know technology comes at a premium, so

to get you there. So, we’re taking a slow

“There is still a heightened focus for the work

that circles back into the cost challenge.”

approach to that.”

How value analysis professionals and industry partners can work together For his contributions to advancing collaboration between healthcare value analysis professionals and physician champions, BJ McCluskey, MBA, CVAHP, FAHVAP, FACHDM, Assistant Vice President of Strategic Sourcing and Contracting from McLeod Health, was awarded the 2024 AHVAP Presidential Citation Award.

This prestigious award is presented to individuals who have demonstrated extraordinary leadership and commitment to improving healthcare through the integration of value analysis and clinical expertise.

“BJ McCluskey’s tireless dedication to fostering stronger relationships between healthcare value analysis professionals and physician champions has been instrumental in driving impactful, evidence-based decision-making within healthcare organizations,” AHVAP said. “His leadership has not only enhanced communication and collaboration but has also ensured that value analysis initiatives are aligned with clinical priorities, ultimately leading to better patient outcomes and more cost-effective care.”

McCluskey, who has been involved with AHVAP since 2017 and is currently on the board, said the association has done a good job of setting expectations for the role of value analysis professionals and their involvement in getting industry partners to the table.

8

“Probably the most important thing for the vendor/industry partner to get engaged with supply chain and value analysis to understand the process at whatever organization they’re at,” McCluskey said. “This is where it gets hard because every organization has a little different flavor to value analysis, and they may have a different workflow on how the vendors need to be involved. It’s not a standard across the industry, so they’re going to have to stay close with each of their organizations to understand what the expectations are and how they can support that assessment for the organization that they’re working with.

“I can tell you we value our industry partners here at McLeod Health,” he continued. “We have to rely on them to put together good assessments, and we have to rely on them from education and clinical monitoring standpoints. They’re deeply involved throughout the process; it just may look a little different depending on the organization.”

AHVAP’s focus and vision is to be the preeminent professional association and resource for healthcare value analysis professionals, leaders, and stakeholders in the healthcare continuum.

The association is doing that through the efforts of examining and defining the profession and then putting out best practices through position statements and educational offerings.

April 2025 | The Journal of Healthcare Contracting

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“Stumbling” into the lab: The many paths to a career Emily Berlin, Vice President, Lab Products, Cardinal Health, recently sat down

August when I went back to school, I

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changed my major.

spanning topics from their own lab origins, to attracting lovers of science to the industry, and looking at the future of lab.

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tive, what are your thoughts on

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The Journal of Healthcare Contracting | April 2025

9

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We’ve also done a lot with our own

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the Healthcare Industry Distribu-

Thank you for having me.

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10

Berlin: Thank you, Sam.

April 2025 | The Journal of Healthcare Contracting

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ASCs

The Times Are A-Changing Adapting to new regulatory norms.

BY PETE MERCER

In an era where healthcare regulations seem to shift almost as quickly as the

maintain a high standard of care, patient

technology that drives patient care, ambulatory surgery centers (ASCs) find themselves

safety, and legal compliance require-

under increasing pressure to stay compliant. As new rules emerge and existing guidelines

ments. Each accrediting body significant-

evolve, ASCs must continually adjust to ensure they’re meeting both the letter and the

ly influences surgery center operations,

spirit of the law.

shaping policies and procedures.”

These organizations are responsible for setting the regulatory framework for

From changes in billing practices to

Services (HHS) regularly update and

the whole of healthcare, but there are also

heightened patient safety standards and

issue new rules that have an impact on

regulatory expectations on the state-level.

updated infection control protocols, the

daily processes like billing procedures

Kara Newbury, Chief Advocacy Of-

landscape is anything but static. Under-

and safety protocols. Jeff Kremer, the

ficer for the Ambulatory Surgery Center

standing the dynamic world of ASC com-

senior director of business develop-

Association, said, “I think the challenge

pliance is critical to operating in this day

ment for Henry Schein Medical’s ASC

is that you do have to stay on top of

and age, especially as regulatory standards

division, said, “ASCs are highly regulated

compliance issues. Staying on top of it

continue to change. Adapting to these

healthcare facilities that must comply

can be difficult, because you have to pay

new regulatory norms has to be the way

with several federal, state, and accredited

attention not only to what’s happening at

of life for any healthcare organization in

bodies such as the Joint Commission, the

the federal level but also the state level.”

today’s market.

Accreditation Association for Ambulatory

Newbury said that ASC operators

Navigating the regulatory landscape

Health Care, the Accreditation Com-

who want to better understand the regula-

mission for health Care, and QUAD A.

tory expectations on a state-level should

These organizations ensure that ASCs

join their state associations, as well as the ASCA for the national-level association.

ASCs are facing a growing number of

“The ASCA typically comes into the fold

regulations that affect nearly every aspect

as an educational source. We make sure

of their operations. Whether it’s compli-

that all of our facilities are aware of the

ance with Medicare standards, state health

ASC Quality Reporting Program, which

department rules, or infection control

ASCs have to participate in to comply

protocols, there’s no shortage of regula-

with Medicare requirements.”

tory hurdles to navigate. With so many

Kremer also recommended joining

moving parts, it can be challenging to

associations to keep informed about

keep up.

the evolving regulatory environment.

One of the major catalysts for

“Actively participating in professional

change regarding ASC regulations is

associations such as the ASCA and

the federal government. Organizations

regularly attending industry conferences

like Centers for Medicare & Medicaid

are effective ways to stay informed about

Services (CMS) and Health and Human

regulatory changes.”

12

April 2025 | The Journal of Healthcare Contracting

Balancing compliance with patient care

“ASCs should strive to align technol-

As regulatory mandates continue to

ogy, policies, and ongoing staff training

change, ASCs must stay agile, adjusting

One of the challenges with maintaining

to meet patient needs, while maintaining

quickly to new policies and guidelines that

regulatory standards is how to balance

compliance requirements. ASCs should

emerge. The increasing complexity of

those measures against the quality and

integrate compliance into the facility’s

these regulations, coupled with a height-

effectiveness of the patient care. While ad-

culture, making it a shared mission of the

ened emphasis on patient outcomes,

hering to regulations is crucial for avoiding

staff, rather than a burden,” Kremer said.

will demand innovative strategies for

penalties and ensuring safety, it’s essential

maintaining compliance while achieving

that these efforts don’t overshadow the

high-quality care. In this environment,

core mission of providing quality care. In

The future of ASC compliance

technology will play an even more signifi-

fact, many regulatory changes are intended

As regulations continue to evolve, particu-

cant role, with electronic health records,

to improve patient outcomes, such as up-

larly with the shift towards value-based

real-time monitoring, and data-driven

dated infection control protocols or patient

care, ASCs will increasingly rely on ad-

decision-making becoming indispensable

safety standards, which ultimately benefit

vanced analytics and automation to man-

tools for compliance management.

both providers and patients.

age compliance efficiently. Predictive tools

Newbury said that one of the topics

Newbury said that the ASCA has

and AI-driven software will help identify

discussed in Congress is site neutrality,

raised certain concerns with the CMS

potential compliance risks before they

which is the idea that the patient would

about the ASC Quality Reporting Pro-

become issues, enabling proactive action.

pay the same amount of money for

gram as the 2026 rulemaking process

At the same time, regulators are likely to

a procedure, regardless of the site of

begins. “One of them is concerned with

place even more focus on outcome-based

service. “We want to make sure all the sites

whether the quality reporting measures

measures, pushing ASCs to not only com-

are created equal. Site neutrality is nuanced,

that are being added to the program really

ply with safety and billing standards but

and it’s important that each surgical site

speak to the quality of the facility, and it’s

also to demonstrate measurable improve-

has the same regulations and complies

information that’s beneficial to the facility

ments in patient care.

with the same safety physical requirements,

and the patients. We’re not seeing that with some of these measures, so we’re trying to make sure that any of these measures that our facilities have to report on are actually helping someone.”

When that balance between compli-

ASCs should integrate compliance into the facility’s culture, making it a shared mission of the staff, rather than a burden.

ance and patient care is off, it often points to a lack of alignment across the board.

Kremer said, “As procedures shift

Think about it like this – an orchestra is

from hospitals to more convenient and

made up of a lot of different components,

cost-effective settings, such as ASCs,

With discussions around site neutrality

all working together towards a common

[CMS] regularly updates its reimburse-

gaining traction, ASCs will need to closely

goal. Different sections of the orchestra

ment rules, increasing pressure on

monitor how legislation unfolds and assess

play different parts, but they all contribute

ASCs to demonstrate efficiency and

how any changes could impact their finan-

to something greater than an individual

high-quality outcomes.”

cial structures and operational workflows.

ensuring that we are directing care to the appropriate sites of service.”

instrument can achieve on its own. When

In order to meet the changing regula-

These ongoing legislative and regulatory

all the pieces of an ASC – everything from

tory requirements, Kremer said that ASCs

changes are pushing ASCs to refine their

billing to patient intake – are working

can work to develop a cross-functional

practices and ensure that they not only

together to meet regulatory requirements,

team of stakeholders to understand and

meet the letter of the law but also contrib-

it’s much easier to get a perfect balance

assess regulatory changes from clinical,

ute to a healthcare system focused on both

between patient care and compliance.

financial, and operational perspectives.

cost efficiency and quality outcomes.

The Journal of Healthcare Contracting | April 2025

13

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14

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Rising Leaders in Supply Chain How these emerging supply chain leaders are helping reshape the U.S. healthcare industry.

I 16

n an ever-evolving healthcare landscape, the demand for innovative solutions has never been greater. But who will implement these changes?

The Journal of Healthcare Contracting spoke to several rising leaders in the U.S. healthcare supply chain. These individuals are driving change with unique backgrounds that give them fresh perspectives, new skillsets, and a relentless commitment to improving efficiency and patient outcomes.

April 2025 | The Journal of Healthcare Contracting

RISING LEADERS IN SUPPLY CHAIN

Megan Jarrell Please tell us about your role and responsibilities with Advocate Health.

Advocate Health. My team handles all

You were recently honored with the Advocate Health Supply Chain Innovator of the Year Award. What project did you and your team work on to receive this recognition?

things reporting and analytics specific

This was based on the work we did

to the realms of inventory management

around the IV fluids shortage this past

and inventory operations, procurement,

fall. When the Baxter Plant temporar-

and master data. We also do financial

ily shut down after Hurricane Helene,

reporting for the organization on sup-

we were immediately impacted and

ply expenses. We work with market and

threatened by the shortage of IV fluids.

facility leadership to create scorecards

Within a 48- to 72-hour period, my team

around supply expense as a percent of

stood up an enterprise-wide analytics in-

net revenue, per adjusted discharge, or

frastructure around our current on-hand

any other high-level KPIs that can help us

position and historical usage so that we

get a sense of how we’re trending on our

could forecast the effects that the dis-

I am the Analytics Manager for Supply Chain Operations and Finance with

MHA, Manager, Analytics – Supply Chain Operations & Finance, Advocate Health

ruption would have on our operations.

We also used these tools to measure the

We operate datasets out of two completely different systems – Workday and Oracle Cloud. We had to find a way to bring the data together from both systems, normalize it, and make it speak to each other so that we knew, “Here’s what we look like on normal saline from an enterprise perspective,” or, “Here’s what we look like on lactated ringers from an enterprise perspective.”

impact of conservation efforts that were put into place.

We partnered with pharmacy to understand where their product was sitting, and partnered with operations to document any other safety stock. Ultimately the work resulted in a dashboard that our executive team used to make the call about whether to delay any surgical cases – which we never had to do.

It was an intense effort for us to get the reporting off the ground quickly because we live in two ERPs right now. We operate datasets out of two

18

supply expenses compared to budgets,

completely different systems – Workday

and how we’re looking as an organiza-

and Oracle Cloud. We had to find a way

tion in affordability and financial health

to bring the data together from both

metrics related to supplies. I have a team

systems, normalize it, and make it speak

of five phenomenal analysts who I work

to each other so that we knew, “Here’s

with to make all of this happen.

what we look like on normal saline from

April 2025 | The Journal of Healthcare Contracting

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RISING LEADERS IN SUPPLY CHAIN

One natural disaster or one cyber security event could cause a huge disruption. I know operationally our team is putting tactics into place to advance our supply chain resiliency, but we also have a big role to play from an analytics point of view in helping our team make data driven decisions.

an enterprise perspective,” or, “Here’s what we look like on lactated ringers from an enterprise perspective.”

We’re going from having about 30 facilities in the ERP to the full 60 plus

That really helped our team figure out where we had places

that we have as an organization. From a

where we could share a product, where we could leverage each

transactional standpoint, it truly is dou-

other and leverage our size. We’re in six states. We were able to

bling the number of transactions going

help one another because we had a one-stop shop where we had

on in this ERP. We’re doing a lot of test-

visibility into all of that data. We had several different instances

ing and work to make sure that everything

where we shipped product from our distribution center in Char-

is still going to perform the way we need

lotte up to our main facilities in Milwaukee and helped them out

it to when we go live on day one, because

when they were a little bit tighter on product. I think the reverse

we don’t want to leave people in the dark

happened as well.

without the information that they need to

The visibility into that data really helped us get through that time period and helped us stabilize while we were going through the shortage.

do their job.

The second focus is on the idea of supply chain resiliency. That’s such a buzzword these days, especially considering what happened with IV fluids. One

20

What’s in store for you and your team in 2025?

natural disaster or one cyber security

Two big things come to mind. First, this year we’re doing another

event could cause a huge disruption. I

ERP implementation for half of our organization, but everyone

know operationally our team is putting

will feel it. Our Midwest region is already on Workday and our

tactics into place to advance our sup-

Southeast region will be going live on Workday this summer. So,

ply chain resiliency, but we also have a

we will all be on the same instance of Workday at the end of

big role to play from an analytics point

this, but it’s a huge effort to get all that data ready for conversion

of view in helping our team make data

and for my team to get all the reporting in place. We have many

driven decisions.

reports in place already that our Midwest team uses, but we are

It’s taking and moving our reporting

making sure that the reports that the Southeast team relies on

and analytics from being reactive to pro-

in Oracle have a match in Workday. We also have to make sure

active and ultimately to predictive. That’s

that the Power BI dashboards that we have deployed in different

the transformative journey we’re going to

areas still work after we convert and expand our data sources.

be on this year.

April 2025 | The Journal of Healthcare Contracting

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RISING LEADERS IN SUPPLY CHAIN

Jessica Carrillo As Director, Consolidated Services

the warehouse, storage and outbound,

Center, Supply Chain Services for

we also work at the corporate level,

Banner Health, Jessica Carrillo’s role

focused on the vision and strategy of

entails overseeing both the IDN’s

our senior leaders.

consolidated services center as well as an offsite distribution building.

What’s unique about running Banner Health’s self-distribution center and logistics center?

Director, Consolidated Services Center, Supply Chain Services for Banner Health

What have the last few years been like working with disruptions in the supply chain?

It has been constant. I would say that for Banner, we’ve been able to strat-

With Banner being the largest health-

egize on a lot of critical supplies and

care provider in Arizona, we support

ensuring that we have a safety stock or

17 hospitals utilizing our Arizona-

healthy inventory so that if there is a

based warehouses. We also support

disruption, whether it be a few weeks

our hospitals outside of Arizona when

or even a month or two, we often have

their normal distribution channels

strong inventory so that we have time

through a national distributor or direct

to plan not only contractually where

orders with a supplier are disrupted.

we go to look for alternate supplies,

We have the leverage to reach out and

but also clinically to vet and review

support them.

alternatives. The disruptions have been

Something else unique in my role is

constant, but we are continuously look-

the partnership with Banner’s contract-

ing to grow what type of products we

ing and clinical teams at a corporate

stock, ensuring the most critical are

level. We work together frequently

being assessed.

whether through disruptions that arise or a contract negotiation to really capture contracting expertise, the clinical side of our business as well as operations. My team not only oversees operations and workflows from receiving into

We have seen a flawless accuracy in our order fill rate; always above 99% daily.

That is where a picker can go to a location and fulfill 99% of the orders that come through. Our inventory accuracy rates have also drastically improved.

22

Looking at your career to date, is there anything that you consider your first big win, either at Banner Health or supply chain in general?

Within supply chain, focus is around disruption and how to respond. We spend a lot of energy there, but what has been exciting for me was a project implementing a warehouse management system.

During the COVID years, we also had a long-term initiative to improve our

April 2025 | The Journal of Healthcare Contracting

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RISING LEADERS IN SUPPLY CHAIN

Having that visibility in your hands, especially with inventory in multiple facilities, knowing exactly where everything is – the quantities, the expiry dates – has been a huge leverage for our operation to plan better, to maintain inventory and better rotate safety stock. WMS has given us the transparency and control necessary to ensure scalability and stability for our operation.

period, we lifted our team off paper picking where they were

What do you see as the biggest stress points for the U.S. healthcare system?

How can supply chain help to find solutions?

filling orders off manual pick sheets to electronic-based hand-

There are two primary areas that we

held devices.

focus on to relieve the burden in sup-

technology within the distribution center, going from our paperbased manual processes to system-based through a warehouse management system. In 2023, towards the end of the year, we implemented the new technology. And, over a four-day

While implementation was four days, it took us eight

ply chain. One is the continued focus

to nine months of planning and thorough process review

on cost savings with low margin. To

and development. For me that was one of the most

eliminate that concern we try to focus

successful projects because not only as a team did we

on less complexity in the variety of sup-

succeed in change management, really pulling together

plies. In other words, standardization.

to focus on that end goal, but we have been reaping the

With the self-distribution center, we

benefits ever since. We have seen a flawless accuracy in

focus on resiliency by having enough re-

our order fill rate; always above 99% daily. That is where

sources in our warehouse, whether that’s

a picker can go to a location and fulfill 99% of the orders

60 or 90 days of supply. But we also want

that come through. Our inventory accuracy rates have also

to focus on formulary items, something

drastically improved.

that every hospital is using or that is criti-

Having that visibility in your hands, especially with inventory in multiple facilities, knowing exactly where everything

24

cal when a patient presents themselves through our emergency department.

is – the quantities, the expiry dates – has been a huge leverage

The second area is the overall disrup-

for our operation to plan better, to maintain inventory and

tions that we continue to face. That is why

better rotate safety stock. WMS has given us the transparency

we are focused on our vision of growth

and control necessary to ensure scalability and stability for

and trying to be as resilient as possible and

our operation.

be able to support the most critical items.

April 2025 | The Journal of Healthcare Contracting

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RISING LEADERS IN SUPPLY CHAIN

Alyssa Shull Please tell us about your role and responsibilities at Corewell Health My role involves a lot of different

diverse workforce that’s scattered across the system, either on site or within a corporate capacity.

One of the last things is I partner fre-

components. I manage the operational

quently with other leaders to help develop

excellence and products implementation

our strategic direction. We are starting

teams within supply chain. Our OPEX

to lean more into the development of

team is focused on project management

our talent strategy to help support team

and process improvement within supply

members and leaders in their growth and

chain. And our product implementation

development at Corewell Health.

team is very aptly named, but they help to coordinate the implementation of any

that are being introduced to the system or

Those are a lot of different categories. That must keep you on your toes.

any sort of standardization activity that’s

Absolutely. And we’re a fairly new depart-

happening, any sort of product change

ment with the teams that we have. I’ve

typically will run through that team. That

only been in my role since July of last

team is new and growing, so we’re excited

year. In that short amount of time, we

to get them up and running.

have been trying to figure out what the

sort of product change within our orga-

Director, Business Operations – Supply Chain, Corewell Health Supply Chain

nization. This involves any new products

In addition to those things, any sort

long-term vision for the department looks

of integration activity falls to my team to

like and building the plane as we fly it, so

manage from a supply chain perspective.

to speak.

When I say integration, I mean if there is another location joining the Corewell

We help integrate them into the overall

What’s exciting – and challenging – with working on the ground floor of an initiative?

system from a supply chain perspective.

What’s exciting is number one, we get to

We also manage the communication

support supply chain teams. We are the

Health Network and Corewell Health is either acquiring or merging that location.

strategy related to our very large and

ones that can identify the gaps that we currently have in our overall structure

One of the very first projects I was able to lead was the implementation of a new ERP system, which was a very challenging project, but I was also able to learn a lot. And from there, I think I just found my niche in being able to lead people and lead projects.

26

and try to figure out if there’s a way our teams or my department can fill some of those gaps.

It’s also very exciting because you get to start new. While we’re not starting from a completely clean slate, we get to understand and develop what the overall strategy is going to look like. It’s more

April 2025 | The Journal of Healthcare Contracting

forward-thinking than maybe some other

started in our indirect sourcing space and then moved more into

teams get to experience.

a project role. One of the very first projects I was able to lead

But ultimately, those can be some of

was the implementation of a new ERP system, which was a very

the disadvantages to overcome. We’re

challenging project, but I was also able to learn a lot. And from

trying to execute work while also trying to

there, I think I just found my niche in being able to lead people

understand what the future vision looks

and lead projects.

like. So, my team members are incredibly resilient. They are hard-working and they know what they must accomplish here and now. They’re also sometimes okay with a little bit of ambiguity. I don’t think that my teams would be successful if they were not okay with that ambiguity.

Of course, it can be a little bit challenging. That’s the biggest disadvantage – the unknown or the ambiguity associated with

It’s not as easy as it sounds, but once we’re able to get to a place where everyone is bought in, everyone truly understands what we’re striving for, it’s a lot easier to determine our focus and what we should be working on.

trying to stand up a new department.

How did you get started in supply chain?

You mentioned a few facets of your position like process improvement, product changes, and standardization. Are there any success stories you’d like to share?

To be completely honest, I didn’t know

There are so many projects that my team is working on right

what supply chain was when I started my

now, but as far as successes that we have been able to celebrate,

freshman year at Michigan State. I think

two immediately come to mind.

just through some exposure via the busi-

The first I wasn’t directly involved through the whole pro-

ness college, it became more and more

cess. We had to manage a lot of the supply disruptions within

attractive to me because you get a very

our supply chain teams. This has been confusing at times, but

unique view of the end-to-end business.

we’re not alone in experiencing those disruptions. We’re one

After a few internships in college

of many healthcare systems that have faced those. It was really

within the area, I started my career in

encouraging to see so many people in groups come together to

manufacturing. My time in manufactur-

tackle a problem with the patient in mind.

ing was focused on global sourcing,

And then the second one I’m particularly proud of is the

logistics, and continuous improvement.

reset and creation of an overall supply chain strategy for the year,

Those were incredibly invaluable experi-

and with shared metrics across the department. Being able to

ences that I would not trade for anything

speak the same language and understand how each of our teams

because I was able to bring a lot of those

plays a role in each of the metrics or large projects is encourag-

skills that I learned from manufacturing

ing to see. It’s not as easy as it sounds, but once we’re able to get

and try to apply them to healthcare.

to a place where everyone is bought in, everyone truly under-

Back in 2018, I transitioned to what was Spectrum Health at the time. I

The Journal of Healthcare Contracting | April 2025

stands what we’re striving for, it’s a lot easier to determine our focus and what we should be working on.

27

RISING LEADERS IN SUPPLY CHAIN

Sergey Ptachik

Have you been able to observe the connection with what you do in supply chain and how it affects your clinicians and patient care?

spend management for the lab space,

What drives me is the opportunity to

overseeing a spend of $150+ million.

serve others, especially the poor and vul-

The responsibilities include collaborating

nerable. Although we don’t directly work

with our clinical system lab leaders and

with patients, we support their care by

internal business partners in maintain-

ensuring the necessary supplies reach the

ing contracts, standardizing procure-

hands that heal. This mission motivates

ment systems, and driving efficiencies. I

me to start early and work late, knowing

support in developing strategic sourcing

that our efforts ultimately help those in

partnerships to enhance our financial

desperate need.

forecasting models to predict future expenditures, ultimately aiming to deliver value through savings initiatives.

Sourcing Manager, Purchased Services & Laboratory, The Resource, Engineering and Hospitality Group (REH), Providence

Can you tell us about your interests outside of work?

Outside of work, I thrive on challenges

What’s unique with sourcing and contracting in the lab category?

that promote personal growth. My work

The lab category is special in its own way

tude, persistence, and patience. To balance

by presenting its own risks. Managing lab

this, I engage in activities that challenge

inventory is challenging due to its rapid

me physically. This year, I’m training for

turnover. However, we are improving our

Light at the End of the Tunnel marathon

understanding and management of this

in June and then the Seattle-to-Portland

through dedicated internal teams. This

cycling race in July. Please pray for protec-

complexity distinguishes lab management

tion from any injury as I push my body to

from med/surg.

the limits.

What are some industry level trends that you’re keeping an eye on in 2025?

As a Contract Manager at Providence,

You helped contribute to Providence’s External Spend Excellence program by helping to convert the lab distribution business to a preferred vendor. Can you tell us about that experience?

we support our system lab leaders by

Last year, we standardized to our pri-

ence labs like LabCorp. I have noticed

managing our vendor relationships and

mary distributor, Medline Industries. We

numerous other smaller vendors are

taking action on contractual agreement

supported the transition of all laborato-

emerging in this space, offering special-

adjustments to our ERP system whether

rians and labs to Medline, which resulted

ized testing such as DNA sequencing.

it is a simple extension, item update, or a

in $2+ million in savings. We continue

These tests, while specific and special-

more complex initiative with complexi-

to collaborate with Medline to identify

ized, are not cost-effective for us to

ties such as RFP’s. I focus on category

further cost-saving opportunities.

perform in-house.

Please tell us about your role and responsibilities at Providence.

28

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April 2025 | The Journal of Healthcare Contracting

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RISING LEADERS IN SUPPLY CHAIN

Mariem Ruiz Martinez

What motivates you in your role today?

Knowing that our work directly impacts our community is a huge

exposure to different facets of healthcare

motivator. By supporting diverse

supply chain management. That experience

suppliers, reducing environmental

helped me develop a strong foundation in

impact, and ensuring cost-effective

strategic sourcing, vendor management,

sourcing, we’re making a real difference

and cost optimization, which I’ve contin-

in people’s lives – particularly on

ued to build upon in my current role.

Chicago’s West Side. Seeing that impact fuels my passion for supply chain strategy.

MBA, Manager of Strategic Sourcing, Rush University System for Health

What is a recent “big win” for you and the supply chain team?

What did you learn from that experience?

How do you try to improve as a supply chain professional?

One of our biggest wins was Rush’s

I’m always looking for ways to innovate

first Supplier Diversity Summit, which

and stay ahead of industry trends –

exceeded expectations with over 120

whether through mentorship, continued

attendees. This event brought together

education, or cross-industry collabora-

community organizations, hospital sup-

tion. I also engage with professional

ply chain executives, and our GPO part-

councils like the Vizient Environmental

What’s unique about your organization and the care it provides to patients?

ners to foster meaningful connections

Sustainability Council, in which I am a

with diverse and local suppliers. The key

member, and the NPC Supplier Diversity

takeaway was that intentional collabora-

Council, in which I serve as the co-chair,

Rush is deeply committed to its Anchor

tion – both internally and externally –

where I can learn from and contribute to

Mission, which means we go beyond just pro-

can drive real change in making supply

best practices in the field.

viding healthcare – we invest in the well-being

chains more inclusive and equitable.

of the communities we serve, especially

This commitment extends to our supply

What about now? Is there a current or upcoming initiative you are excited to be working on?

chain strategy, ensuring that our purchasing

I’m excited about Supplier Diversity Sum-

What are some of the biggest stress points for today’s healthcare providers?

How can supply chain help solve challenges related to those stress points?

decisions support diverse, local, and sustain-

mit 2.0, where we’re looking to build on

Healthcare is facing a rapidly changing

able businesses that align with our mission.

our initial success with even more engage-

landscape, from supply chain disrup-

ment and impact. Additionally, I launched

tions to cost pressures and regulatory

on Chicago’s West Side. Through initiatives focused on health equity, local economic development, and sustainability, we aim to address the root causes of health disparities.

a Sustainability Workgroup last year and

changes. Supply chain professionals

How did you get started in supply chain?

our group is now developing new policies

can help by driving efficiency, fostering

to integrate sustainability into our procure-

supplier and community partnerships,

I began my career in supply chain through

ment processes. These initiatives align with

and implementing innovative sourcing

the Leadership Development Program

Rush’s mission to create a more equitable,

strategies that balance cost, quality,

at AdventHealth, which gave me broad

sustainable, and resilient healthcare system.

and sustainability.

30

April 2025 | The Journal of Healthcare Contracting

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RISING LEADERS IN SUPPLY CHAIN

Jose Flores Please tell us about your role and responsibilities.

to vendor negotiation and contract execu-

I am the Senior Contract and Sourcing

Management, Legal and IT Departments

Lead supporting the Tower Health Sup-

when a contract requires their input, ap-

ply Chain Department in the Purchased

proval or in preparation of an RFP; moni-

Services & Goods for the Maintenance,

tor and evaluate vendor performance and

Repair, and Operations category for all

continually engage with vendors to build

Facilities Management Departments under

upon a professional business relationship.

tion; work closely with Value Analysis, Risk

Tower Health. These facilities include Reading Hospital, Reading Hospital sity College of Medicine at Tower Health,

How did you get started in supply chain?

Pottstown Hospital, Phoenixville Hospital,

I began my career in supply chain while

St. Christopher’s Hospital for Children,

serving in the United States Marine Corps

TowerDIRECT, Tower Health at Home,

as a Contract Specialist. While being a

multiple Tower Health Urgent Care sites,

Marine was very challenging with multiple

and multiple Tower Health Medical Group

moves up and down the East Coast and

sites. I manage a Book of Business with

two overseas Middle East deployments

an estimated 400 reoccurring annual con-

during Operation Iraqi Freedom and

tracts. This number does not include the

Operation Enduring Freedom, profes-

annual contract requests that are submit-

sionally it was very rewarding. I knew

ted for one-time purchases of services and

that I most certainly found a career that

goods and capital purchases.

I could enjoy until I retired.

School of Health Sciences, Drexel Univer-

SPSM, Sr. Contract Administrator, Supply Chain Management, Tower Health

The IT Department worked with the Supply Chain Department to revamp a system already in use

by IT that could be revamped into a Contract Management tool with very little increase in cost.

32

My responsibilities include but are not limited to performing analytical tasks in

ommendations and best industry practices

What is a recent project that really stretched you and your team?

that support internal business decisions

Recently, the Supply Chain Depart-

related to costs, risk management, contract

ment changed their Contract Manage-

terms and conditions, vendor selection,

ment System. The prior system used

SOWs, and RFPs; strategic sourcing and

was based off multiple management

system-wide contract standardization with

systems. Although the previous system

an emphasis on co-terminating contracts;

was effective, it was time to utilize a

keeping an open business mind to solve

more efficient contract management tool

complex problems as there are many solu-

that integrated the multiple systems we

tions, ideas, and compromises that can be

were using. The IT Department worked

used to achieve a resolution; managing the

with the Supply Chain Department to

entire life cycle of contract administration

revamp a system already in use by IT

from the solicitation of bids and proposals

that could be revamped into a Contract

support of securing savings and streamlining processes; providing data driven rec-

April 2025 | The Journal of Healthcare Contracting

Management tool with very little increase

two. During a recent realignment of Supply Chain personnel, Supply

in cost. This innovative thinking not

Chain Leadership selected me to manage all Facilities Management

only brought about significant savings, it

contracts by myself. While challenging, this initiative led me to re-

brought the Supply Chain team together

evaluate my work process and to find ways to be more efficient. This

to collectively share ideas and process

is exciting because I’ve been empowered and entrusted to effectively

improvements for the new system. The

manage my own contract portfolio. In time, I will self-evaluate my

IT Department and the consultants used

progress and create my own case study to show what worked, what

the information provided to build upon

didn’t work, and what I could have done better.

the existing system that was technically not meant to be used as a contract management tool. Within a few months, the team successfully created a contract management tool tailored to the needs of our Supply Chain Department.

From this experience, I learned that you don’t have to be the smartest person in the room. Your ideas for process improvement and efficiency are just as

Your ideas for process improvement and efficiency are just as important as those of the individual next to you. We all had a common goal and worked together to share our ideas and create conversations around what would work best.

important as those of the individual next worked together to share our ideas and

Is there a source of motivation for the work you do in the healthcare supply chain?

create conversations around what would

I was raised in the projects less than one mile away from Reading

work best. It was like a scientific experi-

Hospital. Three of my sisters were born in Reading Hospital. My

ment where all our ideas were utilized in

dad and I would walk from the projects to Reading Hospital to

some way or another to create the con-

visit my mom after the birth of my first sister and thereafter with

tract management tool we are using today.

each sister, we would walk to visit my mom and the newborn

to you. We all had a common goal and

sister. I vividly remember how nice the nurses were and that was my first introduction to doing what you love and the sense of

What about now? Is there a current or upcoming initiative you are excited to be working on?

gratitude of serving your community.

I was recently assigned to be the sole

made me feel good. Little did I know I would one day have the op-

contract administrator for the entire book

portunity to work at Reading Hospital doing something that I love

of business for all Facilities Management

and feeling the sense of gratitude for serving my community. There

contracts. The significance of mentioning

is something about providing a service behind the scenes that im-

this is at one time, this book of business

pacts the lives of thousands of patients and their family members

was handled by four contract administra-

that motivates me in my role today. I was recently promoted to a

tors. Around the time Tower Health sold a

Senior Contract and Sourcing Lead. The promotion made me feel

few hospitals and Urgent Care facilities, the

like my contributions matter. Serving my community and making

contract administrators went from four to

sure that I do not fail them is what motivates me in my role today.

The Journal of Healthcare Contracting | April 2025

At the time, I didn’t know what doing what you love or what a sense of gratitude meant, but I knew I was treated in a way that

33

RISING LEADERS IN SUPPLY CHAIN

Juliana López Echavarría Juliana López Echavarría is directly re-

to be part of the things that needed to be

sponsible for strategic sourcing, procure-

done for that treatment to be possible.

ment and value analysis, as well as supply

What motivates me and what is really my

chain projects and performance improve-

passion is to make sure that what we are

ment, across Adventist HealthCare. Ad-

doing is helping Adventist HealthCare

ditionally, López Echavarría is responsible

provide highest quality healthcare to our

for inventory control, warehousing,

patients and community.

conversions and supply chain technol-

With this in mind, I try to be a good

ogy implementation. The work that she

example and a good leader. That’s why

does touches every Adventist HealthCare

building strong relationships with my

entity, including hospitals, outpatient

team is so important to me. Building

centers, schools and offices.

those relationships with them takes a lot of my time but is one of the things that

Director Supply Chain Management, Adventist HealthCare

I enjoy the most. Getting to know them,

Where do you find your source of passion for what you do in supply chain?

getting to know what is motivating my team, is important.

I always knew that I wanted to work in my passion was to be a doctor up until

What’s a recent project that stretched you and your team?

I was 12 years old when I got sick with

One of the biggest wins for us, not just

appendicitis. I had to experience a lot of

in supply chain but for all of Adventist

things that took me off that idea. How-

HealthCare, was how we managed the

ever, I knew that my passion was to help

recent IV fluids crisis.

healthcare. In fact, I was 100% sure that

people. I just needed to understand where and how to make that work.

Even though I studied communica-

The crisis was an opportunity to put into practice all the knowledge we gained from responding to the COVID-19

tion in school, I have always worked in or

pandemic. After COVID, we had a lot of

near the healthcare field. I wasn’t going to

information, especially in supply chain,

be a doctor giving treatment, but I wanted

on what worked and what didn’t. We challenged ourselves to do even better the next time a crisis tested our organi-

What motivates me and what is really my passion is to make sure that what we are doing is helping Adventist HealthCare provide highest quality healthcare to our patients and community.

34

zation. We wanted to plan ahead even more and have even better labels, supply diversification, etc. The IV fluids crisis was that next real crisis.

The most important thing that we did differently was that we did not focus all our efforts into procuring IV fluids,

April 2025 | The Journal of Healthcare Contracting

RISING LEADERS IN SUPPLY CHAIN

The big win was that we never canceled a case, we never turned away a single patient. We never had to call another facility to ask for fluids. We had moments of, “Wow, we are down to only one or two days of inventory levels. What are we going to do here?”

emergency, we were able to divide our efforts better into both

What do you think are the biggest stress points for hospitals and health systems, and how can supply chain be a difference maker in those?

procuring IV fluids and working on conservation strategies.

Well, it’s always going to be budget. The

which I feel would have been the main goal had this happened during or before COVID. During the pandemic, everyone was primarily focused on trying to get PPE [personal protective equipment]. This time, and in part because of the nature of the

Usage is one of the things that supply chain oversees the

financial piece, the financial component,

most. We talk all the time about savings through managing costs,

it’s always going to create a huge stress

savings through negotiating contracts, and savings through con-

on what we do. Ideally healthcare would

version. But the conversation we were not having enough is on

be able to focus just on helping people,

how we grab savings through controlling usage. We got into that

but in reality healthcare has to also

conversation. We said, “Okay, we need to control usage. How

think about business factors. It can be

can we conserve the fluids we have right now and manage the

difficult to find balance between those

quantity that we are receiving from allocation, while keeping the

two components.

quality of our care outcomes high?”

36

I think that the role that supply chain

It was a very special experience to get everyone involved with

plays is important as we are the ones help-

supply chain so they could better understand what was happen-

ing to keep guard on how money is being

ing from our perspective. We all needed to understand that it

used. If we are able to negotiate better, if

was not just about the possibility of getting the product, but also

we are able to keep our medical supplies

about what we were doing with the product that we were getting.

in a good range of pricing, if we are able

The big win was that we never canceled a case, we never

to work with physician preference items

turned away a single patient. We never had to call another facil-

(PPI), we are going to be able to keep that

ity to ask for fluids. We had moments of, “Wow, we are down

budget tight enough to help to sustain

to only one or two days of inventory levels. What are we going

the business. That way, we give Adventist

to do here?” But that was when my team and I were able to

HealthCare better opportunities to invest

work with our supplier partners who could step in to help us

in innovative technology, initiatives to

manage that situation. Our physicians and nurses never fully

improve our patients’ experiences, and

noticed the magnitude of the crisis because of how we were

support for the total well-being for our

able to manage it.

team members.

April 2025 | The Journal of Healthcare Contracting



CLINICAL INTEGRATION

Clinical Integration: Can You Define It?

Many generally know how to classify and define the word “clinical.” Many also know how to classify and define the word “integration.” When you affix them together for a simple phrase,

Success sees beyond ‘Resistance is futile … you will be integrated.’

however, most in healthcare get mired

BY R. DANA BARLOW

eye-rolling adage at the turn of the mil-

in a dictionary bog. It’s like that old lennium, “Once you’ve seen one IDN, you’ve seen one IDN.”

Might healthcare organizations learn something from H.B. Reese, the dairy

A host of complications (authority

farmer for Milton Hershey, who embarked on his own path by pairing chocolate with

and influence among them), hangups

peanut butter back in late November 1928 to make a popular candy treat?

and professional personality quirks can

The Journal of Healthcare Contracting | April 2025

37



CLINICAL INTEGRATION

hamper the establishment of a univer-

in a setting where the physicians are not

the idea of a ‘clinically integrated supply

sally accepted definition, but they ulti-

directly employed by the hospital,” said

chain’ is still developing – we are all figuring

mately may lead healthcare organizations

Jimmy Chung, M.D., FACS, FABQA-

out what it means and what exactly it looks

to something more definitive: When

URP, CMRP, Chief Medical Officer,

like. For those clinicians that are deeply

the perspectives of clinicians (doctors,

at Cincinnati-based Advantus Health

engaged in the work of supply chain, they

nurses, physicians and surgeons) become

Partners and Bon Secours Mercy Health.

understand a clinically integrated supply

a meaningful part of financial and op-

“There’s no universal template, but often

chain as one that serves the needs of the

erational decision making.

these ‘clinically integrated networks’ or

clinical teams. This can happen in a variety of ways from clinical value analysis to

“ Speaking the right language is critical. When presented in clinical terms by someone who has credibility in the space, clinicians will be much more likely to engage in active dialogue.

Clinicians want to do the right thing for their patients, and so do the supply chain teams, and [together] do the best for the enterprise.”

– Steve Downey, vice president, Chief Supply Chain & Support Services Officer, Cleveland Clinic

data integration to new staffing models.”

As a healthcare supply chain leader, Koczela expresses interest in clinicians’ focus on integrating outcomes and clinical data into supply chain contracting decisions, supply chain sourcing decisions and formulary management.

“This integrated data could be used for shared risk agreements, monitoring real world outcomes, reporting to registries, etc.,” Koczela continued. “Of course, we already document and monitor clinical data in our EMR systems. What value and

The key questions that linger when try-

CINs involve sharing data, risk, goals

insights could we unlock by linking clini-

ing to define clinical integration are these:

and metrics, value- or performance-

cal practice data with supply chain data?

How do you define it? Who should define

based revenue and other resources.

Historically, organizations have had clinical

it? What can and should be included in the

“In supply chain, we refer to CI in

data from the EMR and supply chain data

definition to make it universally accept-

the context of optimizing supply chain

in the ERP, but the two systems do not

able? How might clinicians define it differ-

resource management based on patient

exchange robust information. I have heard

ently from supply chain? What can supply

outcomes by prioritizing clinical needs over

many clinicians ask for more integration to

chain learn from their point of view? Four

financial or administrative goals,” Chung

help understand utilization trends, cost per

supply chain executives who have nurtured

continued. “Regardless of how we use the

case, and links to improved outcomes.”

deep ties with clinicians share their insights

term CI in healthcare, the core values are

with The Journal of Healthcare Contracting.

the same: Improving the patient experience

for implants, which have relatively strict

and reducing cost through evidence and

tracking and data requirements, according

patient-centered value-based care models.”

to Koczela. “How can we efficiently

Clinical perceptions

Most health systems can already do this

Jack Koczela, director, Sourcing &

extend this to all equipment and supplies?

Not surprisingly, clinical integration

Transformation, supply chain, at Milwau-

With more robust information about what

generally means different things to

kee-based Froedtert ThedaCare, echoes

is used for each patient stay, we will be

different audiences.

the duality shaping clinical integration.

able to determine impact on key measures

“The term ‘clinical integration’

“It is worth noting that many clinicians

such as infection rates and length of stay.

outside of supply chain is a generalized

think about clinical integration as a term un-

“Ultimately, the shared goals be-

term that usually refers to collaboration

related to supply chain,” he noted. “It usu-

tween clinicians and supply chain will

between providers (i.e., hospitals, clinics

ally describes alignment between the clinical

drive the most meaningful changes,”

and physicians mainly) to improve care

teams or systems. In the supply chain arena,

he insisted. “Through close connection

38

April 2025 | The Journal of Healthcare Contracting

and dialogue, both groups will help define what we mean by a ‘clinically integrated supply chain.’”

For Steve Downey, vice president, Chief Supply Chain & Support Services Officer, Cleveland Clinic, clinical integration means active involvement and participation.

“Clinicians should be involved in the selection process for supplies and pharmaceuticals,” he indicated. “They have to use it to treat patients every day, often in critical situations. That process should be fair and broad, ensuring those with the highest usage have a voice and anyone with a conflict of interest is exempted. Wherever possible, the process should be data-driven, showing exact current consumption by supplier, area of use and, if possible, outcomes.”

Clinical integration from a perceived clinician point of view draws a quip from Ed Hisscock, senior vice president, Supply Chain, Trinity Health,

Supply chain perspectives

care to maximize reliability and efficacy of

Livonia, Michigan.

Where clinicians might see clinical integration

the resources used for them.”

“I shudder to think what clinicians

differently in their realm, supply chain execu-

Clinical strategies need to be incor-

think about being ‘integrated,’” he chuck-

tives view it as an invitation to their world

porated into the supply chain process

led. “We have overused and under-deliv-

and a way to balance clinical, financial and

overall to make it meaningful for

ered on the term mightily in our industry.

operational demands for the organization.

caregivers and patients alike, according

The ‘I’ in IDN for instance, really? As

“Years ago, supply chain was called

to Downey, but supplier and vendor

a verb, the term suggests an action to

‘materials management’ and had very little

connect or form some deep interrelated

to do with clinical strategies,” Dr. Chung

association. Not something we can lay

said. “Supply chain was simply responsible

many factors, including cost, supply

claim to in most cases.

for procuring whatever the clinicians (and

risk, clinical outcomes and total cost of

relationships must be assessed.

“Product selection needs to include

non-clinicians) wanted, so there was a lot

ownership,” he said. “Ensuring fair and

would say that clinical integration is

of unnecessary spend and waste due to

unbiased input in the product selection

directionally correct,” Hisscock contin-

variability in clinician preferences. Today’s

process can be challenging, especially

ued. “The idea that to deliver quality care

supply chain leaders recognize that this

when an incumbent supplier has worked

we must integrate (I think choreograph)

variability without evidence of patient

heavily with the clinicians.”

all supporting services into the care

benefit actually leads to patient harm and

workflow seems logical. Integration likely

safety risks, as well as adding unnecessary

approach this process as a general

drums up thoughts of the EMR and the

complexities in the care delivery process

contractor on a construction site as

workflows in the application. Indeed, the

and unrealized savings opportunities. A

Hisscock alludes.

EMR is designed to facilitate integration

true clinically integrated supply chain starts

of many aspects of care delivery.”

with the patients and aims to standardize

“That said, I believe that clinicians

The Journal of Healthcare Contracting | April 2025

If anything, supply chain should

“First, we view the term as a necessary step to gather specifications,” he

39



CLINICAL INTEGRATION

said. “Just like engaging with engineers

integration is all about decisions that are

a paucity of data makes it difficult to nail

designing products for assembly, we need

made in collaboration with the clinicians. It’s

down actual real-world outcomes related

to know what components and services

very important that the clinicians feel heard,

to a particular medical supply,” Koczela

are required to deliver care. Once speci-

engaged, and involved with those decisions.

continued. “Some of that data do not

fied, we need to do our job to acquire at

“A key characteristic of a clinically inte-

exist, such as patient level tracking for

the lowest cost, highest quality, which of-

grated supply chain involves clinicians feeling

every medical supply. At some point, the

tentimes requires ‘integrating’ with other

a sense of buy-in with supply chain steward-

return on investment for tracking every

clinicians performing like procedures to

ship, whether it be through savings initiatives

supply is not worth it. Even from a clinical

obtain leverage in supplier negotiations.

or waste reduction or preference card stan-

standpoint, not every patient interaction

Then, once acquired, we need to integrate

dardization, that they feel a sense of engage-

is recorded in the charge. Sometimes the

into the care delivery workflows to deploy

ment with that process. It’s not just something

data exist but are buried in an unreportable

in an efficient manner for the caregivers

happening to them. It’s something that they

or unstructured format. I am excited to

and patients we serve.”

are driving with supply chain,” he said.

see how [large language models] can help unlock some of this information.”

“ A key characteristic of a clinically integrated supply chain involves clinicians feeling a sense of buy-in with supply chain stewardship, whether it be through savings initiatives or waste reduction or preference card standardization, that they feel a sense of engagement with that process. It’s not just something happening to them. It’s something that they are driving with supply chain.”

– Jack Koczela, director, Sourcing & Transformation, Supply Chain, Milwaukee-based Froedtert ThedaCare

Fusing the links One common denominator among all four healthcare supply chain executives is that they fully embrace having a medical director of supply chain on the team to facilitate relationships and decisions – generally in that order. This is a physician who understands the clinical, financial and operational aspects of healthcare and patient care delivery and serves as a bridge that unites multiple teams.

(See “Physician/Surgeon-Supply Chain Relations Fueled by Circle of Trust,” JHC, September 2024, pp. 14-22.)

Koczela calls clinical integration a

Koczela points to value analysis as the

“It has been my experience that

journey, one that relies on value analysis

first stop in the journey to clinical integra-

having a Medical Director for Supply

to link strategies and ensuing tactics.

tion. “Ultimately, clinicians should be

Chain has been beneficial,” Hisscock

“Supply chain leaders hope to achieve

running through value analysis process and

observed. “Having a clinical champion

it through aligning closely with the needs

controlling the supply formulary for the

who knows us and gets our strategies

of our clinician partners and customers,”

organization,” he indicated. “This structure

moves conversations along more quickly

he noted. “This means we need to layer in

should have robust support from supply

and concisely. Conversely, he guides our

strong connections with our clinical staff

chain and a number of other key advisors

approach to help ensure successful clinical

through formal org chart relationships,

in our organizations. Clinician-driven value

engagement and implementation.”

through clinical value analysis and struc-

analysis can quickly allow clinical teams

Supply chain leaders point to language

tured customer relationships with service

to understand and align on contract and

barriers as one culprit, but an equation for

lines. Roles such as the medical director

standardization opportunities.

success exists.

of supply chain can help with this integra-

“Clinician-driven value analysis also

“Speaking the right language is criti-

tion. For supply chain executives, clinical

leads to faster, more robust decisions when

cal,” Downey insisted. “When presented

40

April 2025 | The Journal of Healthcare Contracting

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

CLINICAL INTEGRATION

in clinical terms by someone who has cred-

getting what they want for their patients,”

the top, but some organizations might

ibility in the space, clinicians will be much

he observed. “To be fair, most physicians

feel differently.”

more likely to engage in active dialogue. Cli-

believe that their choice of product will

nicians want to do the right thing for their

lead to better outcomes ‘in their hands.’

sion statements for the operation as a

patients, and so do the supply chain teams,

Hospital leaders often misconstrue the

whole a priority and department leaders

and [together] do the best for the enterprise.

clinicians’ demands as stubbornness or

within organizations likely do the same

Creating a process that is clinically led, with

unwillingness to change.

for their teams, so should the concept of

Healthcare organizations make mis-

support from supply chain medical directors

“What is absolutely true, however, is that

who can defend the decision past contract

both sides want the best for the patients,”

“Clinical integration should be a facet

award and to other stakeholders, is key.

Dr. Chung insisted. “And for the most part,

of your supply chain’s mission or vision,”

Supply chain facilitates the process, negoti-

physicians do care about costs and waste.

Koczela indicated. “Of course, a mission

ates the deal, leverages the clinicians in the

The common ground for this conversa-

statement is not enough, you still have to

negotiations as appropriate and ensures all

tion must start with data, however, so that

define what you mean by clinical integra-

the factors are looked at in the award.”

clinical integration be given equal footing?

effective leaders can invite physicians to

tion. Nevertheless, it is good to include

Koczela recognizes that a “shared de-

identify where care could be more effective

the language to remind your team, your

sire for maximizing value” emanates from

and efficient. In the future, we might come

organization, and yourself that you must

clinicians and supply chain alike.

together to utilize AI to define best practices

remain centered on patient care.”

“When aligned, we share a goal to

that maximize the patient experience.”

improve outcomes and experience, while

Dr. Chung also questions the need for a universal definition.

balancing the need to manage cost,” he

“Having multiple definitions within

noted. “We should also align on how we

Untangling entanglements

the right context is not harmful, as long

approach this challenge. Both groups

While the profession may yearn for a uni-

as ‘clinically integrated’ always means

should be transparent and collabora-

versal definition for clinical integration,

putting the patient and quality first in

tive. I have spoken to numerous physi-

supply chain executives remain mixed.

whatever process or entity that it is de-

cians who have simply asked to be more

Koczela ponders whether one could

involved in the conversations and more

ever exist or even be needed.

scribing,” he noted. “Even within today’s many definitions, there are common

informed about the impact of decisions

“Clinical integration is a continuum,”

and contracts. Sharing this information

he countered. “Many organizations define

with the goal of focusing on what is

helps them manage their practice and

clinical integration differently, and they

best for the patient. You might ask, ‘But

their team. A collaborative and strategic

may all be correct but on a different point

didn’t we always do what we thought

transparency helps us understand how we

of the journey. SMI structures clinical in-

was best for the patient?’ Yes, we did

can be there to serve the clinicians.”

tegration as a framework, which perfectly

individually, but not together. Working

represents how clinical integration can

together means agreeing on certain core

Hisscock expresses doubt about the

themes that connect all of them, mostly

depth of deviation. “The clinicians see

look at different maturity levels and in dif-

values and vision, sharing data and met-

themselves as the epicenter of specifi-

ferent parts of an organization.

rics, applying principles or high reliability

cation, and we acknowledge that fact.

“But is a standard definition even

and governing with shared account-

However, the integration part is where we

needed?” Koczela continued. “Not

ability. In addition, we must not forget

get tripped up. Not universally between

really. As an organization, you need to

that the patient’s voice also needs to be

the clinicians and supply chain, but also

understand your vision for what clinical

‘integrated’ into CI definitions.”

between the clinicians,” he added.

integrated supply chain should look like.

Dr. Chung acknowledges that hurdles and speedbumps exist.

“Clinicians often misconstrue the efforts of supply chain leaders as a barrier to

42

Do you want to get to the third level

Downey sees confusion among the variety where standardization may benefit.

of the SMI framework or are you okay

“The role of the clinician in supply

with the first level? Personally, I want to

decisions is key yet often avoided in many

be part of an organization operating at

organizations,” he indicated. “They may

April 2025 | The Journal of Healthcare Contracting

Clinical integration: Who gets it, who’s got it The term “clinical integration” typically fuels a great deal of debate and discussion. But some healthcare organizations are well on their way to in-depth implementation. Here’s a rundown of four.

Cleveland Clinic: Steve Downey, vice president, Chief Supply Chain & Support Services Officer “Cleveland Clinic is blessed to have seven medical directors, one from each major supply consumption institute.

Dr. David Gurd (Orthopedics), Dr. Erik Kraenzler (Anesthesia/Respiratory), Dr. Sharon Sutherland (Women’s Health), Dr. Ed Savage (HVTI), Dr. Deborah Benzil (Neurosurgery), Dr. Sunguk Jang (Digestive Diseases) and Dr. Sean Lyden (Excelerate) all serve with a portion of their time reimbursed.”

Advantus Health Partners and Bon Secours Mercy Health: Jimmy Chung, M.D., MBA, FACS, FABQAURP, CMRP, Chief Medical Officer “Generally, health systems that are investing in data governance and evidence-based service line models to deliver value-based care are the winners in this area. Systems like Kaiser, Mayo, and Cleveland Clinic have traditionally targeted quality and efficiency by leveraging their size and reputation, but even small independent hospitals can do this, if they have the right leadership and innovative financial models.”

Trinity Health: Ed Hisscock, senior vice president, Supply Chain “I think there are pockets of very high and very low ‘get it’ in most organizations. If the issue is indeed communication and respect, as in most human interactions, some relationships work, some, not so much. Most of us spend countless hours developing processes to root out, promote and motivate relationships that work. Some of us have the benefit of supporting organizational cultures.

And some of us have leaders that ‘get it.’ Put all that together and you have a recipe for as successful a ‘get it’ pie as our perverse incentives will allow.”

Froedtert ThedaCare: Jack Koczela, director, Sourcing & Transformation, Supply Chain “Of course, I am biased, but I think we are making great progress towards a more clinically integrated supply chain.

Here are a few ways: “Over the past few years, we have added a new medical director of supply chain who advises us on clinical integration strategy and assists with making connections with key physician leaders. Dr. Jon Gould has been an excellent member of our supply chain team.

“With Dr. Gould, we have launched our clinical supply chain governance council (CSCGC), a group that includes service line chairs and other physician leaders to help guide supply chain strategy. The council is designed to promote top quality patient care and simultaneously thoughtful financial stewardship.

“Our value analysis program helps give clinicians a real voice when we’re talking about formulary and product decisions. Jessica Gerke, R.N., manager, Value Analysis, and her team have rolled out a structure that ensures we are regularly connecting with our clinicians. Through these VA Committees, we have aligned on product decisions, contract decisions, and standardization opportunities.

“We have also launched ‘contract compasses’ for some key contract areas. These quarterly emails are sent to the top 10 surgeon-users of a particular contract category, the service line chair and the administrative leaders. The email is a simple 10-slide deck that shows overall contract compliance and usage patterns by physician. Our physician partners have appreciated the transparency, and it helps them come to VA conversations more prepared with better data. It also helps to coordinate usage when contracts are awarded to multiple vendors. With this data we can have conversations about how each physician’s contributions affect the overall goal for their team.”

let GPOs make the choice, have a medi-

and that include a robust decision-making

respect for the supply chain profession,

cal director outside the specialty or allow

process for supplies.”

our industries’ integration wherewithal

conflicted parties too much voice. Occasionally, private-practice physicians make their own choices and demand it from the

The bottom line can be found in cinema, according to Hisscock.

and between the clinicians themselves,” he said. “Not surprising, given the

“[The famous quote in] ‘Cool Hand

perverse incentives at play. I think defini-

health system, creating excess costs and

Luke’ said it best: ‘What we’ve got here

tions are a healthy thing to foster discus-

workarounds in the supply chain. The best

is failure to communicate.’ A failure,

sion and debate. They help us get to the

processes are those that are standardized

I believe, that is rooted in respect …

nub of the issue(s).”

The Journal of Healthcare Contracting | April 2025

43



CHPs

Private Equity Firm to Acquire Walgreens Boots Alliance Companies say the deal will leverage WBA’s healthcare expertise and Sycamore’s established leadership in retail and consumer services.

BY DANIEL BEAIRD

Walgreens Boots Alliance (WBA)

Stock Market and WBA will become a

announced that it has entered into a

private company.

“Our trusted brands and deep commitment to our customers, patients,

definitive agreement in March to be

WBA shareholders will receive total

communities and team members have and

acquired by an entity affiliated with

cash consideration of $11.45 per share

will continue to anchor our business as we

Sycamore Partners, a private equity firm

in cash at closing of the Sycamore

realize our goal of being the first choice

specializing in retail, consumer and

transaction and one non-transferable

for pharmacy, retail and health services,”

distribution-related investments.

right to receive up to $3 in cash per

said Tim Wentworth, CEO, Walgreens

The total value of the transaction

WBA share from the future monetiza-

Boots Alliance, in a statement.

represents up to $23.7 billion. The WBA

tion of WBA’s debt and equity inter-

Once committed to making

board of directors has unanimously

ests in VillageMD, which includes the

VillageMD the centerpiece of its

approved the proposed transaction. It is

Village Medical, Summit Health and

healthcare strategy, Walgreens changed

expected to close in the fourth quarter

CityMD businesses.

course, closing 160 VillageMD clinics

of calendar year 2025. Upon completion

The company will continue to operate

in 2024 with other plans to close over

of the transaction, WBA’s common stock

under Walgreens, Boots and its portfolio

1,200 underperforming stores during

will no longer be listed on the Nasdaq

of consumer brands.

the next three years. Walgreens has about 8,500 stores in the U.S. and has closed about 2,000 locations during the past decade.

The Walgreens right-sizing turnaround plan had been met with optimism by investors before the definitive agreement with private equity was announced.

“Sycamore has deep respect for WBA’s talented and dedicated team members, and we are committed to stewarding the Company’s iconic brands,” said Stefan Kaluzny, managing director of Sycamore Partners. “This transaction reflects our confidence in WBA’s pharmacy-led model and essential role in driving better outcomes for patients, customers and communities.”

44

April 2025 | The Journal of Healthcare Contracting

Sponsored

McKesson

Transforming OR Efficiency, Safety and Workforce Management: A New Era in Healthcare DinamicOR introduces its suite of solutions to McKesson’s ASC customers.

“With so many surgeries moving to ASCs that are sometimes one-fourth the size of ORs in a hospital, you don’t have the space you used to have,” said Todd McKenzie, regional ASC director in surgery center sales for McKesson. “So, it’s even more important to have a smaller footprint for the instruments you need to complete the case.”

To complete our comprehensive suite of solutions, DinamicOR’s workflow management app enhances surgical operations with numbered placement icons that direct staff through consisA perfect surgery is a dance. It’s where

fully loaded tables to accommodate staff

tent tray arrangements. This feature

the handoff of instruments is fluid and

heights, minimizing strain, and boosting

facilitates the smooth onboarding of

there are no delays. The challenge is to cre-

operational efficiency. The robust drape

new team members and ensures the

ate a smoother process behind the surgeon.

simplifies tray arrangements, providing

seamless transfer of essential procedural

“Every retail space has a purpose so you

a consistent approach that conserves

knowledge, resulting in a unified and

can quickly shop and know where the prod-

precious time and ensures a smooth and

efficient operating room experience.

ucts are in the store,” said Jeff Gerstner,

sanitary OR setup.

“Surgeons are different, and their

chief executive ambassador for DinamicOR.

Our mission is to advance the ef-

setups are different,” Gerstner said. “We

“But most surgical tables are flat with no

ficiency and consistency of surgical

want to save their preferences so anyone

organization and the scrub tech has to do

procedures, empowering periopera-

can walk in and have the same set up.

the best they can with what they’ve got.”

tive staff to concentrate on delivering

The surgeon should expect that regard-

Introducing DinamicOR’s revolution-

exceptional patient care. While this isn’t

less of who the staff member is working

ary configurable back table – an absolute

a new problem, it’s a timely opportunity

behind them.”

game changer for operating rooms. This

to introduce a unique product like this,

is the ideal solution that supply chain

especially after the shifts in the health-

table. Each location on the table has an

leaders can offer to their clinical teams,

care landscape due to COVID-19 and

identifier that’s specific to a surgeon.

designed to boost efficiency and shave

staffing challenges.

nearly 20 minutes off OR time.

The adjustable tiers and ergonomic features allow for raising and lowering

The Journal of Healthcare Contracting | April 2025

Our vision is to establish the bench-

The app is tied to the mapping of the

“This solution works,” Gerstner said.

“And McKesson will help apply it to

mark for organizational efficiency in the

their customers. But we’ve solved a lot of

OR setting.

problems right out of the gate.”

45

Frontiers

of the HEALTHCARE SUPPLY CHAIN

Contributed by

Supply Chain By the Numbers

BY JOHN STRONG, CO-FOUNDER AND CHIEF CONSULTING OFFICER, ACCESS STRATEGY PARTNERS INC

The biggest value often comes from the boldest changes Albert Einstein said that irrational persis-

Kaufman Hall’s “Hospital Flash

to perform far worse. While labor and

tence is defined by doing the same thing

Report” for December 2024 illustrates

other overhead costs have increased,

over and over and expecting different out-

the expense issues clearly, and it is not all

basic supply costs continue to rise at

comes. So it goes in the healthcare supply

about drug prices3.

unsustainable levels. With new threats

chain as well.

In late December 2024, Mark Cuban’s

As an industry, we continue to barely break even, and in some cases

and an even riskier environment in 2025, what do we do?

drug company racked up its third health system account with Penn Medicine, agreeing to purchase their 100 most frequently dispensed medicines for its retail pharmacy network1. This amounts to

1.5 million subscriptions per year.

Cuban also added Community Health Systems (CHS) as they searched to reduce costs and improve value2.

Both health systems are pioneers, willing to take on new risks for gain

Kaufman Hall Hospital Flash Report – December 2024 Revenues vs. Expenses 20% 18% 16% 14% 12% 10% 8% 6% 4% 2% 0%

from innovative solutions. Gains require

Net Operating Revenue per Calendar Day Dec 24 vs Dec 23

different levels of risk, but any gain requires risk. While there are many BandAid solutions to rising prices and product shortages, only significant movement away from the status quo will bring about meaningful cost reduction and new value for healthcare providers.

I used to quip when we were changing contracted suppliers that “nothing gets an incumbent supplier’s attention more than making a change.” Painful, sometimes, but the financial and quality rewards were often stunning. As we confront more supply chain risks every day, are we becoming afraid of taking the risk of making substantial changes in products or suppliers to gain greater value?

46

Net Operating Revenue YTD Dec 24 vs Dec 23

Net Operating Expense per Calendar Day Dec 24 vs Dec 21

Net Operating Expense YTD Dec 24 vs Dec 21

Increases in Supply Chain Controlled Purchases 25% 20% 15% 10% 5% 0%

Supply Drug Purchased Expense per Expense per Service Calendar Calendar Expense per Day Day Calendar Dec 24 Dec 24 vs Day vs Dec 23 Dec 23 Dec 24 vs Dec 23

Supply Drug Purchased Expense per Expense per Service Calendar Calendar Expense per Day Day Calendar Dec 24 vs Dec 24 vs Day Dec 21 Dec 21 Dec 24 vs Dec 21

Graphs adopted from KaufmanHall “Hospital Flash Report” for December 2024 at pp. 8, 9, accessed March 9, 2025.

April 2025 | The Journal of Healthcare Contracting

Worries about renewed inflation and new tariffs It is understandable that when you add renewed worries about inflation, a recession, and tariffs adding to the cost of healthcare goods and services, you get a pretty bleak picture. As a number of organizations including GPOs and others said, now is the time for preplanning.

75%

The percent of medical devices purchased in the United States that could be impacted by tariffs because they are manufactured overseas4. On the pharmacy front, about

80% of

Active Pharmaceutical Ingredients (APIs) come from overseas – and growing. For example,

China had 219 API facilities in 2023, versus 134 in 20215.

U.S. Medical Device Market 2023 Projected U.S. Medical Device Market 2033

$197.8B $305.1B6

All of this is consequential because the U.S. medical device market is expected to continue to grow quickly. Beyond the solutions I have seen to date, here are a few more.

First, ask questions and be an active listener

by using an Economic Order Calculator7. Sure, they have been

Some companies have already announced that they cannot fully

around for a long time but they still work and can also avoid

absorb the cost of tariffs. While this should be considered,

issues down the road.

there is confusion about what products are actually covered, how much the tariff actually is, the effective date, and other key details. When examining large volume purchases, a key can be working with your supplier and understanding these and other details. If they cannot absorb the full amount of the tariff, can they swallow part of it – and how much? This is an area for inquiry and negotiation.

Inflation is another worry. As you look back into your

(

EOQ Formula

) ½

2 x Annual Demand x Ordering Cost

EOQ=

Holding Cost

suppliers’ supply chains, the question I like to raise is: what,

Finally, consider onshoring

when, and how much of a price increase was taken by the

One of the major complaints about onshoring has been the

supplier from their suppliers for the products in question.

increased unit cost. It probably does cost somewhat more, but

Asking them in a nice way to provide those increases to

is the total increased cost of the purchase less than the total

you may pave the way for reaching a compromise around

holding cost? If the answer is yes, dig deeper and consider

inflationary price increases. Again, this is an area for inquiry

some other advantages.

and negotiation.

Be sensible Many suggestions include something like making bulk pur-

` A shorter supply chain yielding reduced delivery charges ` Avoids the total cost of over-buying products in bulk ` Can improve product quality

chases well in advance of the issues. Buying large quantities of products in bulk may seem like a solid solution to retain

By supporting onshore suppliers, you can add to their

lower cost inventory for a longer period of time. However,

volume and help them reduce the cost of their own raw

there is a break-even point financially and it can be calculated

materials, thereby lowering the price.

The Journal of Healthcare Contracting | April 2025

47

Frontiers of the HEALTHCARE SUPPLY CHAIN For years, the U.S. has worried about the quality of APIs from China. Now the Chinese are, too Perhaps the good news is that only about China, versus

67%

13% of APIs used in the U.S. come from

from all other countries.

A report in January 2025 from The New York Times suggests that many Chinese

Update on PFA: How is your budget holding up?

The market is seeing rapid uptake with the adoption of Pulse Field

are now worried about the quality and price of their own domestic drugs . Think:

Ablation (PFA) catheters. While these

Anesthetics that don’t put patients to sleep. There is also a disparity in the quality and

catheters are more expensive, there are

price of drugs used in China’s public hospitals versus other providers. Approximately

a number of compelling reasons to

70% of China’s hospitals are public, and some of this may result from a drug bidding

consider them.

8

system that China introduced a few years ago. It is based on volume.

“The national procurement system does keep prices down,” said Zheng Minhua, the director of surgery at the prestigious Rhijin Hospital in Shanghai, “but at such low prices the quality of the drug may be unreliable.”

This certainly makes sense in the United States. Manufacturers will first seek to cut costs of ingredients, packaging and materials to hang on to their margin. In consumer goods, we’ve seen this with “shrinkflation” where the sizes of everything from cracker

` Enhanced safety from decreased risk of damaging adjacent organs

` High efficacy and patient value.

Current techniques may result in a 40% chance of a patient requiring a second procedure

` Faster procedures for high volume electrophysiology labs can add to

boxes to cereal and rice products have shrunk.

Next, manufacturers will then ask themselves if they can justify and afford to put

savings and profitability goals9.

capital into improving the product, the plant and their equipment. If they can’t then they close the plant and stop making the product. This brings us back to the topic of shortages.

Does this all sound familiar? Could it be happening with the more than 300 supply shortages the U.S. now endures at any time? The graphic below shows that while drug

In 2024, there were 1.4 million cardiac ablations performed, and this is projected to grow at a CAGR of 8.8%.

shortages are declining, we still have a long way to go on that front as well.

Increases in Supply Chain Controlled Purchases

$ 6.4B Global Ablation Market in 2024

$12.8B Projected Global Ablation Rate in 203410 According to LSI (Life Science Intelligence), this growth rate will also command significantly higher prices because of the introduction of more advanced technology.

1 Becker’s Hospital Report, accessed December 12, 2024.

2 Finance.yahoo.com 3 KaufmanHall “Hospital Flash Report” for December 2024 accessed on March 9 2025.

4 Bushak, Lecias, “Trump’s tariff proposal may impact prices of medical devices, generic drugs”, Phreesia Life Sciences, Published December 2, 2024 at 8:00 a.m.

5 www.beckershospitalreview.com/supply-chain/tariffs-on-china-threaten-could driveup-drug-costs-exacerbate-shortages-5-notes.html 6 GlobalData, Published November 22, 2024.

48

7 Public domain. Accessed March 10 2025 using AI and Google Images.

8 S tevenson, A., and Wang, Z., “In China, Rare Dissent Over Effort to Cut Drug Prices”, The New York Times, Monday, January 27, 2025, pp. B1, 5 9 L SI, “State of the Market: Cardiac Ablation”, Published February 15, 2025 in “The Numbers”. (subscription required.)

10 www.ashp.org/drug-shortages/shortage-resources/drug-shortagesstatistics?loginreturnUrl=SSOCheckOnly#:~:text=The%20number%20of%20 active%20drug,began%20in%202022%20or%20earlier

April 2025 | The Journal of Healthcare Contracting



HEALTHCARE DISTRIBUTION

Provider Perspective How University of Miami uses distribution.

distribution centers just 10 to 15 minutes away, making it highly efficient to rely on them instead of building and maintaining our own infrastructure.

Ultimately, we decided to strengthen our relationships with our existing distributors, ensuring they understood our needs and could deliver efficiently. This approach allows us to leverage their infrastructure, expertise, and logistics networks

What happens when a University, medical school, and health system re-invents

rather than reinventing the wheel.

their departments as a single supply chain entity? In this month’s column on provider perspectives, HIDA interviews Judy Webb-Hapgood, Chief Supply Chain Officer for

operations area handling some contracting

In what ways do you work with your distributors on procurement?

and auxiliary services, like retail and copier

Because of my background as a nurse, I

services. There was a separate purchasing

interact frequently with doctors, nurses,

area responsible for procurement and sup-

faculty, and research staff, and I listen to

ply chain contracts on the university side.

their needs. An example of the collabora-

Everyone operated independently, which

tion between supply chain, our providers

created a fragmented approach.

and our distribution partner was how we

the University of Miami Health System.

pulled together to create a chemo spill kit.

Judy Webb-Hapgood

Can you tell us about your role in the medical supply chain?

When it comes to chemotherapy, there

What does your distribution model look like?

are OSHA and other regulatory requirements for specific safety products. My

When I arrived, we had different distribu-

team identified what was needed, and we

During my tenure as the Chief Supply

tion partners – one for physician practices

worked with our distributor to standard-

Chain officer for the University of Miami

and ambulatory care, and another for

ize the product offerings. Our distributor

Health System, the Miller School of Med-

outpatient services. They had recently com-

partner created a pre-assembled chemo

icine, and the University of Miami – my

pleted an RFP for outpatient distribution.

spill response kit, making the job of our

position oversaw all three organizations.

There was also a discussion about

clinicians easier and ensuring compliance.

It’s an interesting role because we provide

establishing our own warehouse distri-

medical supplies, medical equipment, and

bution model. However, given Miami’s

support services to all three organizations,

geography, it didn’t make sense. Self-

even if they don’t always realize they’re

distribution can be a costly endeavor.

receiving them from the university.

It requires significant investment in

What advice would you give about working with distributors?

facilities, staffing, and logistics expertise.

Distributors shouldn’t just be seen as

Unlike large-scale distributors who have

vendors – they should be true partners.

Before your time there, how was supply chain management structured?

economies of scale, a single institution

They need to understand your pain

attempting to manage its own distribu-

points and share in both challenges and

tion often finds it to be more expensive

successes. Establishing a collaborative

Each entity had its own stand-alone supply

and operationally complex. At Miami, we

relationship ensures mutual growth and

chain operations. There was a business

have two major medical distributors with

efficiency in the supply chain.

The Journal of Healthcare Contracting | April 2025

49



SHELF CONFIDENCE

Shedding and Shredding the Cloak of Invisibility

BY R. DANA BARLOW

QR code in the sidebar and you can see the list there.

Pop cultural purists may cry foul because a few of the items on the list linger either in vintage collections or some frequency of use. Arguably, a majority of these items likely won’t disappear altogether until the youngest of Generation X succeeds all of the Baby Boomers on Medicare.

Surprisingly, several items didn’t make this list for some reason, such as answering machines, Betamax, boomboxes, Gramophones (Baby Boomers might remember those), phonebooks, slide projectors and Walkmans. When you have some free time late at night and suffer from insomnia, try searching online for “technology we no longer use.”

The clickbait exercise brought to mind Online publication “Zen Parent” posted a headline recently that dared you to

how it might be applied to the healthcare

click on it out of sheer curiosity – “20 Things That Disappeared from Society and

supply chain, which seems on the preci-

Nobody Noticed.”

pice of its own generational shift.

Horizon scanning shows 3-D print-

Granted, it may be challenging for a healthcare supply chain executive, leader, manager or professional to move along and ignore a list of items – even a list of ideas – in inventory. Who wouldn’t want to know what you forgot if you’ve forgotten it?

What did the publication include in the forgotten inventory of items? Dial-up internet, VHS tapes, phone booths, floppy disks, handwritten letters, payphones, manual typewriters,

Scan the QR code to view the list of 20 things that disappeared from society.

ing, artificial intelligence (AI), augmented reality, automated guided vehicles (AGVs), blockchain, robotic process automation (RPA), robotics (and “cobotics”) and virtual reality, among others, in the now and future.

Looking backward provides memories

film cameras, paper maps, library card catalogs, cassette tapes,

of ASAP, Apple II computers, Blackber-

public smoking areas, Rolodexes, pagers, dot matrix printers,

ries, business cards (fading rather consis-

encyclopedias, fax machines, personal checks, analog clocks and

tently), calculators (students still use them,

drive-in theaters. Just in case this piqued your interest, scan the

however), COACT, group purchasing

50

April 2025 | The Journal of Healthcare Contracting

organization (GPO) paper contract binders (for pric-

What’s noteworthy is that the Bellwether League

ing lists), just-in-time/stockless (thanks, global pan-

Foundation, which operates the Healthcare Supply

demic), overhead projectors with transparency sheets,

Chain Leadership Hall of Fame, recognized that ob-

Palm Pilots, proprietary electronic data interchange

servation nearly 20 years ago and made that mindset

(EDI), slide rules, Teletype, value-added networks

a key part of its purpose, highlighted on its website’s

(VANs) to facilitate open EDI, among others.

front page bellwetherleague.org.

For cooperative buying-turned-purchasing-turned

Still, this isn’t the first time that supply chain re-

materials management-turned-supply chain, we can adapt

mains cloaked in invisibility to the point that it’s taken

a line from a famous song used for a cigarette commer-

for granted, frequently overlooked and consistently

cial in the late 1960s, “we’ve come a long way, baby.”

panned when something goes inexorably wrong (you

But apparently, not long enough.

Scan the QR code to view the Energy Transfer commercial.

know, backorders, shortages, stockouts, etc.).

Each year an organization called Energy Transfer airs a TV commercial promoting the use of gas and oil to make products we all enjoy, need and want (maybe not in that order). Let’s be honest: We should take nothing for granted and be appreciative, content and service-minded about everything we have and can share. This year was no exception. However, the one that aired during the NFL’s Super Bowl in early

Just about everything you see and use in a hospital setting is manufactured from gas and oil, either as raw materials or at some stage of the production process.

February hit rather close to home for healthcare supply chain executives, leaders and managers.

A sage supply chain executive at a prominent

See if you can read between the lines, scan the

IDN once quipped, “you know supply chain is doing

QR code in the sidebar to view their commercial.

its job well when the phone isn’t ringing or the emails

The script and visuals make a cogent point. Just

aren’t coming.”

about everything you see and use in a hospital set-

One wonders if too much of a good thing like

ting is manufactured from gas and oil, either as raw

that ultimately leads to complacency. Let’s face it:

materials or at some stage of the production process.

We’re decades away from the replicators on the

Without gas and oil, the hospital likely would be

U.S.S. Enterprise in “Star Trek.” In fact, 3-D print-

devoid of everything.

ing capabilities today are to additive automated

Yet as this cudgel makes one compelling argument, it completely misses (overlooks?) a powerful one.

How did the products actually get to the hospital?

manufacturing what the Easy-Bake Oven is to French cuisine.

Quite frankly, supply chain makes healthcare go

It’s one thing to make something; it’s another to get it

and the world run. From battles to wars, from corpo-

out of your manufacturing plant and into productive

rate development to growth, from cultural progres-

use somewhere.

sion to enlightenment, we’ve known this to be true.

This clearly represents a missed opportunity to promote an essential industry and profession.

The climactic slogan of “this is what a hospital would look like without the gas and oil industry” only covers half the argument at best. No, that empty hospital is what it would look like without supply chain.

The COVID-19 global pandemic merely reminded us of how essential a function, an industry, and profession it is and should always be remembered and celebrated throughout the year, every year.

After all, without supply chain, we’d be left with a lot of unusable space as a final frontier.

R. Dana Barlow serves as a senior writer and columnist for The Journal of Healthcare Contracting. Barlow has nearly four decades of journalistic experience and has covered healthcare supply chain issues for more than 30 years. He can be reached at rickdanabarlow@wingfootmedia.biz.

The Journal of Healthcare Contracting | April 2025

51



NEWS

Industry News Intermountain Health expands on-demand services

which delivers high-energy, external beam

pending anticipated regulatory reviews

radiation treatments that precisely target

and approvals.

Intermountain Health’s on-demand

a variety of cancer tumors wherever they

Overall, the joint venture between

services are expanding to bring patients

are in the body, including lung, breast and

Providence and Compassus will comprise

faster access to common medications and

prostate cancers.

24 home health locations across Alaska,

medical services without having to see a

The Varian Truebeam Linear Accel-

California, Oregon, and Washington, and

doctor. This recent expansion increases

erator will be an addition to the conven-

17 hospice and palliative care sites in Alaska,

the number of pharmacy products that

tional external beam radiation therapy,

California, Oregon, Texas and Washington.

patients can access in Utah, Nevada,

currently located at UPMC Hillman at

Providence and Compassus an-

Idaho, and Montana. The goal is to

UPMC Horizon. The second linear ac-

nounced the joint venture in October.

increase access to healthcare, especially in

celerator will allow for increased access

Compassus has also established similar

rural areas where patients may experi-

for the growing population of patients in

joint ventures with providers such

ence longer wait or travel times to see a

the region and the ability to treat different

as Nashville, Tenn.-based Ascension

specialist. Since 2022, Intermountain’s

types of cancers that have, in the past,

St. Thomas, Cincinnati-based Bon

on-demand pharmacy service has offered

required patients to travel to Pittsburgh.

Secours Mercy Health, and Columbus-

patients low-risk medications like smok-

based OhioHealth.

ing cessation treatment, birth control, hair loss treatment, erectile disfunction

Providence launches home care joint venture in 3 states

medication, and period pain relief, among

Renton, Wash.-based Providence has

others. In Utah, on-demand services

launched the first phase of its joint

Ascension boosts interest in nurse preceptorship through revamped training program

now include at-home lab draws where a

venture with Compassus, a Brentwood,

Ascension recognized a critical need to

phlebotomist visits a patient’s home to get

Tenn.-based provider with more than

revamp nurse preceptor training and

the samples and brings them directly to

7,000 employees and hundreds of

launched a comprehensive, evidence-

the lab for testing. This will be convenient

locations across 32 states, to transition

based overhaul of past training models

for many who are unable to make it to a

home-based care services to Compassus,

to directly address feedback from nurses

medical office.

according to Becker’s.

new to precepting, who identified a great-

and naloxone. Now, these options include

Providence at Home with Compassus,

er need for mentorship and onboarding,

the Covenant Health hospice program in

instead of just the transition to bedside

UPMC Hillman Cancer Center completes work on $10 million project to expand cancer care

Lubbock, Texas, that is part of Provi-

clinical practice. As of January, more than

dence, will be rebranded as Covenant

3,200 nurses have completed the training

Health at Home with Compassus, accord-

program to become certified precep-

The UPMC Hillman Cancer Center at

ing to a March 3 news release.

tors. Nurse preceptors play a pivotal

UPMC Horizon-Shenango Valley, has

Compassus will manage operations

role in these efforts, by supporting new

completed the addition of a second

for Providence at Home with Compassus,

graduates in their journey from student to

linear accelerator (linac). The $9.6 million

which has launched in Alaska, Texas and

professional nurse, a demographic of the

project included the construction of a

Washington, and will launch in Oregon

healthcare workforce that can experience

vault for the new, state-of-the art linac,

and California in the coming months,

high turnover in their first year.

52

April 2025 | The Journal of Healthcare Contracting

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