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
Learn how our team can help you today!
CONTENTS APRIL 2025
The Journal of Healthcare Contracting is published bi-monthly by Share Moving Media 350 Town Center Ave, Ste 201 Suwanee, GA 30024 -6914 Phone: 770/263-5262 FAX: 770/236-8023 e-mail: info@jhconline.com www.jhconline.com
Editorial Staff Editor Graham Garrison ggarrison@sharemovingmedia.com
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 by Share Moving Media. All rights reserved. If you would like to subscribe or notify us of address changes, please contact us at the above numbers or address. POSTMASTER: Send address changes to Share Moving Media, 350 Town Center Ave, Ste 201, Suwanee, GA 30024-6914. 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
SPOTLIGHT ON SEEING RESULTS CLEARLY For over a century, Baxter has been at the forefront of medical innovation, redefining what’s possible in patient care. Our pediatric vision screening solutions help you detect the six risk factors of amblyopia.
of vision disorders can be prevented or cured 1, 2
The Welch Allyn Spot Vision Screener captures vision screenings on children 97% of the time3
< Scan here to view our full product portfolio References: 1. “80% of Visual Impairment Can Be Avoided or Cured.” Central European Journal of Public Health 12, no. 1 (March 2004): 31. 2. Lee SY, Gurnani B, Mesfin FB. Blindness. StatPearls. Treasure Island (FL): StatPearls Publlishing; 2025 Jan. https://www.ncbi.nlm.nih.gov/books/NBK448182/ 3. Crescioni M, Miller JM, Harvey EM. Accuracy of the Spot and Plusoptix photoscreeners for detection of astigmatism. J AAPOS. 2015 Oct; 19(5):435-40. Baxter, Spot and Welch Allyn are trademarks of Baxter International Inc. or its subsidiaries. US-FLC158-250014 (v1.0) 03/2025
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
NOT COMPLEX.
DUPLEX. The DUPLEX Drug Delivery System DUPLEX is a ready-to-activate, two-compartment container that keeps pre-measured medication and diluent separate until you’re ready to mix and administer. The closed system is designed to prevent contamination, protect potency and ensure diluent cannot be delivered without the drug. Without the need for syringes, vials or added steps that slow you down, the DUPLEX Container is designed to save time, labor, space and waste.
®
NOW AVAILABLE for Cefazolin 3g
COMING SOON Piperacillin and Tazobactam in the DUPLEX Drug Delivery System* *Not yet approved for sale in the U.S. Rx only.
Learn more at bbraunusa.com/duplex Rx only. © 2025 B. Braun Medical Inc., Bethlehem, PA. All rights reserved. 24-0549D_02/25
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
Scrape-n-Suction™ Tongue Cleaner Effectively removes thick, encrusted biofilm from the tongue. Tongue scraping is more effective at eliminating biofilm than tooth brushing alone.1,2,3 May help reduce the risk of ventilator-associated pneumonia (VAP) and other respiratory infections, improving overall patient outcomes.4,5 Designed to reach the back of the tongue with ease. Compact size with a uniquely curved front end for enhanced maneuverability. Fits comfortably in the oral cavity, even when occupied by an endotracheal tube (ET Tube).
QUALITY YOU CAN COUNT ON
Easily attaches to suction for convenient removal of scraped biofilm.
For a free sample call 800-343-3980 or visit dalemed.com/samples
Represented Nationally by:
Access Reference articles at dalemed.com/scrape-n-suction
Dale is a registered trademark of Dale Medical Products, Inc. Scrape-n-Suction is a trademark of Dale Medical Products, Inc. ©2025 Dale Medical Products, Inc. All rights reserved. AD-132 Rev B
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
Sponsored
Cardinal Health
“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
with Sam Terese, CEO & President of Alverno Laboratories for a conversation
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.
I went from the clinical side when I started at Beaumont Hospital into clinical research, then moved through roles in product management, business develop-
On getting their start in lab and the evolution of their careers:
ment, marketing leadership eventually
Terese: [My start] in the laboratory is
and that journey really solidified to me
kind of a “stumbling” event. I was a
that diagnostics was my passion. For
biology major and looking for a career. I
the last 12 years I’ve been with Cardinal
had someone say, “there’s a career called
Health in various capacities and now lead
medical technology and since you like
the lab business.
spending a couple years in med devices,
the laboratory it might be a great choice for you.”
Terese: That’s just an incredible journey
My first job while I was in school was as a phlebotomist. Prior, I didn’t even know there was such a thing as phlebot-
and it truly highlights the opportunities Emily Berlin
omy. But fortunately for me, my mentor
around being involved in laboratory medicine. The industry makes such an exciting career path.
said, “don’t worry, I will teach you.” From there I went into the diagnostic
Berlin: As you think about the op-
lab space, and I was very fortunate early
portunities that exist for the clini-
on to get my first position as a supervi-
cal lab from a technology perspec-
sor. I found a passion in managing and
tive, what are your thoughts on
creating laboratories, so I followed that
how we attract more young people
passion and that’s taken me all the way
to the profession?
to my current role as CEO and president
Terese: While I don’t think the solu-
of Alverno Laboratories.
tions are easy, we need to start by getting people excited about lab. Our team works
Berlin: I was smiling as you said you stumbled upon the laboratory, because
Sam Terese
with junior high schools to present the laboratory as a potential career path. At
when I think about my career journey,
these presentations we aren’t bringing
I too feel like I’ve stumbled upon the
in microscopes and the old tools that
laboratory. I originally pursued a chemical
in healthcare?” We toured the hospital,
we used to use, instead we’re bringing in
engineering major because I liked science.
and when we walked past the clinical lab,
virtual reality goggles that allow them to
My uncle, who worked at a local hospital,
I stopped and looked in. [The lab direc-
experience the laboratory in ways they’re
asked, “have you ever considered a career
tor] showed me around the lab, and that
used to engaging with.
The Journal of Healthcare Contracting | April 2025
9
Sponsored
Cardinal Health
We’ve also done a lot with our own
Berlin: Let’s talk a little bit about
across all classes of trade. They have
workforce in trying to expand our recruit-
your industry involvement in the
a lab focus and I chair their laboratory
ing pool to non-traditional applicants
various associations that that
advisory committee, a forum where we
through innovative career training pro-
you’re involved with and why you
come together from both a distribution
grams. Positioning these opportunities in
stay so involved. Obviously, you
and a manufacturer community and talk
a manner that demonstrates to applicants
have a very clear mission at Alver-
about our industry, trends, best prac-
why they should want to begin a career in
no, which is critical to patient care,
tices, and how we advocate on behalf
the laboratory, and more importantly, why
but you’re also an advocate for our
of our customers.
they will want to continue their career in
industry. Can you share a little bit
this industry, is crucial.
about your involvement from an
Berlin: Are there any last thoughts
association perspective?
that you would like to share in terms
Berlin: Do you see technology
Terese: As leaders, we have a duty to
of laboratory testing in general?
advancements like digital
give back to the industries that have
Terese: Despite all the challenges, when
pathology, digital imaging, and
helped shape our careers. It’s an oppor-
you look at the laboratory and its impact
AI attracting a new generation of
tunity to not only share what you know,
is on care, it’s really quite incredible. Ev-
students to the industry?
but also to learn from one another. This
erybody that works in a laboratory should
Terese: I do. If you think back to both of
extends to anybody at Alverno; it’s not
be very proud of what they’re doing on
our histories, it was science that attracted
just me that attends meetings and speaks
behalf of patients.
us to the laboratory. I think that same
out on industry topics, but a lot of our
And in our world, we define it as a
kind of interest and passion for science
associates and our other leaders are do-
great privilege that we are able to provide
or these emerging technologies will bring
ing the same thing. And we encourage
care to our patients, not just testing, but
individuals with a different skill set to the
that involvement.
care. I think it’s a great honor to work in
laboratory. The innovative programs you
this business and this profession, so for
listed in conjunction with advancements
Berlin: From my perspective at Cardi-
me, it’s been a great journey. Cardinal
we’re seeing on the automation front are
nal Health, we too have opportunities
Health, as always, has been a great partner
also hugely important to help from a pro-
to get involved. I participate in HIDA,
of Alverno for many, many years now.
ductivity measure, but also to take out the
the Healthcare Industry Distribu-
Thank you for having me.
variability that we all face in any business,
tors Association and they cover both
including the laboratory.
laboratory and Med/Surg distribution
10
Berlin: Thank you, Sam.
April 2025 | The Journal of Healthcare Contracting
Cardinal Health™ Clinical Laboratory Distribution Services
The critical importance of specialized lab distribution When your patient care is on the line, choose a lab distributor who cares about more than their bottom line. For healthcare organizations looking to optimize their supply chain to best support their labs, the importance of choosing the right laboratory distributor is crucial. Specialized lab distribution and supply chain collaboration are vital to driving efficiency, optimizing performance and expanding access to testing for a wider population of patients.
Extensive product breadth National brand access, exclusive manufacturer relationships and Cardinal Health™ Brand private label offering.
Specialized handling and cold-chain network Cold-chain solutions across the U.S. with 34 laboratory distribution centers.
Scan the QR code to connect with our distribution expert today for a consultation.
© 2024 Cardinal Health. All Rights Reserved. CARDINAL HEALTH and the Cardinal Health LOGO are trademarks of Cardinal Health and may be registered in the US and/or in other countries. All other marks are the property of their respective owners. Patent cardinalhealth.com/patents. Lit. No. 2LAB24-3127358-02 (10/2024)
Seasonal support for respiratory testing Leverages historical data to support reserving inventory ahead of the season.
An industry leader in supply chain transparency and resiliency Awarded the HIRC resiliency and transparency badges for continuous efforts and commitment to supply chain resiliency and transparency.
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
Sponsored
HealthTrust
Beyond Cost The essential role of clinicians in the sourcing process
face the dual challenge of deliver-
How do the Clinical Advisory Boards impact sourcing at HealthTrust Performance Group?
ing high-quality patient care while
The Clinical Advisory Boards at
maintaining financial stability.
HealthTrust impact every aspect of
Supply chain decisions play a crucial
the sourcing process. Starting with the
role in this balance, directly impacting
category kick-off, the boards validate
clinical outcomes, operational efficiency,
the strategy and help determine the level
and cost management. By integrating the
of product evaluation needed. Once a
clinical voice into the sourcing process,
product is identified for contracting, the
health systems can ensure that purchas-
boards will assist by supplying end-user
What value can a clinically led sourcing approach provide over the next five years?
ing decisions align with both financial
feedback and ensuring patient care goals
Healthcare innovation continues to drive
goals and the real-world needs of pro-
are incorporated into the decision. As
new technologies and processes into the
viders and patients.
product conversions begin to be imple-
market. Evaluating these innovations ap-
mented, the Clinical Advisory Boards
propriately can only be done with a strong
Board & Clinical Operations at Health-
help drive adoption and ultimately deliver
clinical voice at every step of the sourcing
Trust Performance Group, shares her
value to the health system.
process. How will new technologies be
In today’s rapidly evolving healthcare landscape, health systems
Jennel Lengle, VP Supply Chain
Jennel Lengle
thoughts on the value of integrating the
prioritized? Will the potential improve-
clinical voice in the sourcing process.
ment in outcomes be offset by increasing
How does a clinically led sourcing help deliver consistency of care?
complexities and cost of operationalizing
Product standardization across organiza-
supply chain goals by balancing patient
tions has been shown to improve safety
outcomes and value. The clinical voice
Healthcare has four main areas of focus
by reducing variance in care and sup-
has become a critical element to manage
for improvement:
porting our changing healthcare market.
the complexity of the current healthcare
` Patient experience ` Population health ` Cost reduction ` Provider experience
To deliver consistency of care, the clini-
environment which is faced with supply
cal voice is needed during the sourcing
disruption, staffing shortages, inflation-
process. Without this representation,
ary pressures, and challenges with the
sourcing events become a financial ex-
consitent delivery of care. We see our
Why is it important to have a clinically led sourcing strategy for a health system?
new technology? The clinical voice, when leveraged, can support organizational
ercise that may or may not help produce
processes, which are driven by clinical
Sourcing in healthcare is very dif-
quality outcomes. It’s one thing to source
engagement, as a market differentiator
ferent than in other industries. At the
a product, but it’s another thing to ex-
to support these challenges.
end of every decision is a patient. The
ecute a conversion that understands and
integration of the clinical voice in the
meets the needs of the patient. A strong
sourcing process ensures patients and
clinician voice as part of the sourcing
these key areas of focus are prioritized
process helps to ensure delivery of safe
and represented.
patient care.
14
April 2025 | The Journal of Healthcare Contracting
WHAT A DIFFERENCE OUR DIFFERENCE MAKES HealthTrust Performance Group elevates supply chain by including clinicians at every step. It’s one thing to source a product, it’s another to understand and meet the needs of clinicians and, most importantly, patients. As hospital operators, it’s a difference only HealthTrust can make.
Dedicated to Making Missions Possible Learn more!
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
The Only Accredited Medical Weighing Available
Medication errors occur due to: Confusing units (kilograms vs pounds)
Calculations due to inaccurate weight measurements
DETECTO protects you against both of these common issues:
OneWeigh units locking into LBs or KGs
NTEP certified weighing accuracy
DETECTO has received NTEP (National Type Evaluation Program) approval administered by the National Conference on Weights & Measures for most of the company’s major medical scales. This verifies from a regulated governing body that DETECTO scales are manufactured to the highest accuracy and quality possible for medical scales used to treat patients.
COMPLIANT
Learn More (800) 641-2008
detecto@cardet.com
Webb City, MO USA
www.detecto.com
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
Innovative Medical Librarian Support to Improve Clinical Decisions A new approach to managing your medical library that’s cost-effective and drives savings while providing the vital research support your hospital staff depend on.
Expert librarian support to boost your bottom line. HPCLibrarianTM is a one-of-a-kind service for hospitals and health systems nationwide in need of medical librarians. HPC librarians have a proven track record of successfully: Managing institutional libraries Overseeing library subscription renewals
Amazing and underappreciated resource. Makes lit review and access to scholarly articles very easy. Thank You! – Nurse (RN, BSN, NP, DNP) at Penn Medicine Princeton Health
Negotiating the costs of library resources Building virtual library websites Providing research support to staff 7 days a week to fuel evidence-based practice and ensure compliance with healthcare accreditation guidelines and professional development requirements. HPCLibrarianTM brings the expertise and know-how necessary to support your library with no training needed. HPC can provide specialized support to expand your existing librarian team, or you can fully transition all responsibilities and operational oversight to HPC’s librarians who work remotely to support your staff in a virtual model.
A recent survey of library patrons using HPCLibrarian TM were asked how they benef ited f rom the information provided by their HPC librarian:
62.5% 33.3%
Validated a clinical decision Changed a clinical decision
Contact HPC today to find out how HPCLibrarian service can help your organization. Scan the QR code to learn more or get in touch with our team!
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
Results you can rely on Cardinal Health™ Brand Laboratory Products are clinically equivalent to leading national brands and undergo multi-step evaluation and qualification, giving you confidence in the products you depend on, today and tomorrow.
Plus, most facilities can save up to 10% when converting from National Brand products to Cardinal Health™ Brand Laboratory Products.1 Across all areas of the lab, drive savings while maintaining quality with the product portfolio that evolves to meet your needs.
Scan the QR code to connect with a Cardinal Health Laboratory Representative and start saving.
1. Contract savings recognized through GPO contracts based on historical data to date. © 2025 Cardinal Health. All Rights Reserved. CARDINAL HEALTH and the Cardinal Health LOGO are trademarks of Cardinal Health and may be registered in the US and/or in other countries. All other trademarks are the property of their respective owners. Patent cardinalhealth.com/patents. Lit. No. 2LAB24-3094261 (03/2025)
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
Fill their cup. We’ll take care of your breakroom so you can take care of your team.
May 6-12
Your healthcare breakroom, covered. Smartest selection. Find over 2,000 breakroom products made for the workplace.
Winning flavor, great value.
No-cost brewer* and water service.
Our Pick Me Up Provisions™ and Perk™ products are tested against the leading national brands.
Get your Total Coffee® solution and a water filtration system with no upfront cost.
Free, fast delivery. Get next-day delivery, direct to your department, to over 98% of the U.S.
*Minimum monthly spend on breakroom products required.
Thank your staff for all they do — shop our full breakroom assortment at staplesadvantage.com/appreciatenurses
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
life is demanding, requiring mental forti-
We are observing a trend towards utilizing reference lab suppliers for low-volume, esoteric tests. Providence outsources such tests to major refer-
April 2025 | The Journal of Healthcare Contracting
See what’s possible Distributors and self-distributing health systems now have complete transparency of their Dukal products’ from purchase order to delivery. Product Assigned at the Factory Level Product Tracking at the Item Level Compatible Excel Reporting Automated Communication Worldwide Tracking
Scan here to learn more or visit dukal.info/insight
Dukal is working with healthcare professionals around the world in manufacturing and supply chain solutions, to mitigate disruptions that impact business and patient health. Helping you manage everything from product to patient.
> Learn more at dukal.info/insight
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
Cardinal Health™ Laboratory Kitting Services
Optimizing specimen collection Our dedicated team understands use cases and testing requirements, helping our customers determine the most effective configuration to support collection practices, adherence to protocols and specimen integrity. Cardinal Health™ Laboratory Kitting Services benefits: • Boost overall physician, clinician and patient satisfaction • Revenue generation from shipping through results • Remote healthcare with personalized self-collection kits by type
We are your lab advisor. Expertise. Choice. Efficiency. Savings. To learn more about our custom laboratory kitting solutions, contact your Cardinal Health Laboratory Consultant or visit cardinalhealth.com/labkittingservices
© 2025 Cardinal Health. All Rights Reserved. Cardinal Health and the Cardinal Health LOGO are trademarks of Cardinal Health and may be registered in the US and/or in other countries. All other marks are the property of their respective owners. Patent cardinalhealth.com/patents Lit. no. 2LAB24-3066321 (03/2025)
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
Capital equipment is the workhorse of your lab
Benefits of choosing Cardinal Health for your fully automated equipment include:
Cardinal Health works with leading manufacturers to offer a comprehensive portfolio of instruments spanning lab disciplines. Analyzers are available for lease or purchase supporting:
Histology
Clinical chemistry
Blood bank
Hematology
Microbiology
Don't forget to ask about the third-party quality controls available to support these and other analyzers in use at your lab.
Scan the QR code now or talk to your lab sales representative to learn more about opportunities to further automate your lab. © 2025 Cardinal Health. All Rights Reserved. CARDINAL HEALTH and the Cardinal Health LOGO are trademarks of Cardinal Health and may be registered in the US and/or in other countries. All other trademarks are the property of their respective owners. Patent cardinalhealth.com/patents. Lit. No. 2LAB24-3216458 (01/2025)
Expert consultation Experienced diagnostic specialists help simplify your instrumentation decisions. We customize your solutions to help enable results that improve your organization’s operational efficiency without complicating your current processes.
Focused solutions Our comprehensive instrumentation portfolio provides single-source access to top manufacturers so you can select the most effective diagnostic instrument within your clinical laboratory discipline.
Value added We understand the challenge of needing a new instrument under budget constraints. Whatever the case may be, our competitive pricing and rental rates help keep your equipment purchases affordable.
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
We’re reaching new heights going lower than ever before. Midmark is the first and only manufacturer in the market to have both a procedure chair and an examination chair that comply with the US Access Board Standard. Getting to know the standard 01 Seat Height: <17" low and >25" high 02 Transfer Surface: 21" wide and 17" deep 03 Base Clearance: <26" wide 04 Transfer Supports: Compliant to the US Access Board Standard 05 Leg Supports: Compliant to the US Access Board Standard
Learn more at: midmark.com/GoLower
17"
15.5"
Midmark® 631 Procedure Chair
Midmark 626 Barrier-Free® Examination Chair
Scan to view patient transfer.
Source: US Access Board. (2024, July 25). Standards for accessible medical diagnostic equipment. Federal Register, 89(143), 47823-47839. https://www.federalregister.gov/documents/2024/07/25/2024-16266/standards-for-accessible-medical-diagnostic-equipment © 2025 Midmark Corporation, Versailles, Ohio USA
Premier Uncovers What Others Donʼt – Your Total Supply Chain Spend Premier's comprehensive spend management approach maximizes supply chain savings beyond the 35% of supply, drug and service spend typically addressed by a GPO, evaluating the total non-labor spend to ensure every dollar is optimized.
Upgrade Your Strategy