Healthcare on the Move
Mobility, wheels help redesign, reinvigorate rounding where healthcare is needed.
Travis and Amanda LeFever
Founders, Mission Mobile Medical
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2 7 Impressions from ProMat 2025 From rethinking warehouse design, operations to worker safety and human-robot team-ups.
8 ‘Urgent Threat’ Emerging fungus has healthcare providers on alert.
10 Healthcare on the Move Mobility, wheels help redesign, reinvigorate rounding where healthcare is needed.
20 Supply Chain By the Numbers
22 From Competence to Capability
The evolving landscape of leadership.
The Journal of Healthcare Contracting is published bi-monthly by Share Moving Media
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The Journal of Healthcare Contracting (ISSN 1548-4165) is published bi-monthly by Share Moving Media, 350 Town Center Ave, Ste 201, Suwanee, GA 30024.
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7 Impressions from ProMat 2025
From rethinking warehouse design, operations to worker safety and human-robot team-ups.
BY R. DANA BARLOW
CHICAGO – A recent “9 To 5” cartoon by Harley Schwadron shows an executive sitting behind his desk propping his feet up and quipping to a fellow executive, “We have cars that drive for us, computers that think for us, apps and robots that do stuff for us. So why bother to do anything?”
The short answer is simple enough: Because all this advanced technology isn’t sentient. That loosely means the tech can’t think or reason entirely by itself (yes, it can influence or make decisions based solely on coded logic) and requires initial and ongoing programming, maintenance and updates.
In fact, this leaves the door at least ajar, if not fully open, for a burgeoning number of non-physical labor opportunities, which provides some longevity for the fitness, nutrition and pharmaceutical industries.
This represented one of the overarching themes at the sprawling ProMat show spanning two halls at McCormick Place in late March. Hosted by the Material Handling Institute (MHI), ProMat showcases technology, products, equipment and education for the manufacturing and supply chain industry and generally alternates every other year with MHI’s MODEX show between Chicago and Atlanta.
At the ProMat shows throughout the last decade, educational sessions and exhibits alike highlighted the emergence and growth of robotics and automated technology and their impact on job openings and opportunities for humans. At this year’s conference, those themes continued but were snuggly wrapped in human context as heightened attention seemed to shift toward artificial intelligence as the newest operational boogeyman.
Video games aren’t just for kids, leisure
A number of exhibitors used video games as training exercises for a variety of tasks, inserting the fun into the fundamentals of supply chain. Attendees roaming the show floor could
choose from playing tic-tac-toe against a “cobot” arm (cobots are automated robotic arms that work alongside or in place of humans to do repetitive tasks), driving a forklift around a stockyard and throughout warehouse aisles, picking and loading shelves, navigating semi-trailer trucks into the proper dock space, piloting drones to count stock and survey the landscape and using simulation software to create digital twins of your own operations to test solutions before actual deployment and rollout.
Signage trips the light fantastic
All sorts of informational and instructional markings and signs may adorn stockroom or warehouse walls or be painted on applicable flooring, but several exhibitors demonstrated ways to reduce or eliminate physical clutter 24/7 and replace it with limited-time digital alternatives. These companies promoted virtual signage that can be projected from cameras onto walls, flooring and even ceilings for maximum exposure.
Wearables enable logistic suits of armor
Desktops, laptops and even notebooks seem rather quaint and oh-so-15-minutes ago as the largest tracking devices on display and being demonstrated topped out at smartphones – even the so-called rugged versions. Exhibitors allowed attendees to test drive a plethora of options that included individual finger scanners, glove scanners, wrist computers, necklace-based trackers and even eyeglasses and deviceattached headbands. More analog-oriented exhibitors demonstrated fabric- and plasticconstructed bodywear to help improve posture and to facilitate repetitive lifting safely without injury or muscle straining, which has earned appreciative nods (and even financial assistance) from insurance companies for minimizing or preventing workers compensation cases. These companies
stopped short of offering those body suits you see online that allow you to sit down as they unfold to provide a two-legged stool that balances with your own two feet.
Remote control options expanded … literally
Even though the prevalence and prominence of automated guided vehicles (AGVs) and autonomous mobile robots (AMRs) came of age in the 20-teens, the emergence of the global COVID-19 pandemic in 2020 and the resulting remote workforce capabilities stretched the boundaries of traditional thinking. During this period, supply chain professionals learned how they could direct, drive or pilot AGVs, AMRs, drones, forklifts and semi-trailer trucks from control towers or even while walking on site. Now, even that may be
limiting. Several companies highlighted how workers not only can operate these vehicles remotely from their homes on secure online connections, but also how workers from neighboring countries in this hemisphere or even countries overseas can navigate and operate these vehicles, stretching the boundaries of remote operation and taking a cue from international customer support operations via computer or telephone.
These are not your fathers’ robots
China may be earning severe street cred online by showing humanoid robots dancing, running marathons, performing martial arts moves and serving food, but that kind of enthusiast eye candy for the consumer market isn’t lost on the trades. Attendees in the exhibit hall watched with
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brandished smartphone cameras whirring how four-legged, two-legged and wheeled robots moved boxes, stocked shelves, picked products from bins and even interacted with enraptured attendees. While several companies pre-programmed their robots to complete certain repetitive tasks and travel a selected route, others had staffers who actually controlled the robots in nearby “seclusion” so they could hand beverages, candy and snacks to the adoring crowds and wave to them on occasion or shake hands. Several robots even shrugged when they dropped the pre-packaged snacks and soda cans. Verbal comments by experts on site concluded that the humanoid robots equipped with wheels instead of mechanical legs seemed more effective and efficient for individual picking and shelving while the small vehicles on rails or wheels seemed more effective and efficient for bulk-picking quickly, particularly for dense, vertical shelving systems.
Navigating through robotic system selection, warehouse design
If you thought your ability to choose the optimal robotic system or warehouse design was challenging before, you likely think now that as technology advances more rapidly than your own mental faculties can comprehend that either task would be even more difficult to achieve. Yes and no. Certainly, technology seems to be outpacing our ability to acquire it and use it cost-efficiently right now, but that doesn’t mean you lack the capability, context and understanding of what to choose and how to configure it.
Much of the products and equipment on display – including third-party consulting services – as well as a number of educational sessions provided helpful history-of and how-to tutorials on the type of systems available that can be matched to any operational framework. From dense automated vertical shelving operations for high-capacity logistics to smaller systems with a few robotic vehicles on rails or wheels to assist with picking and sorting, attendees walked away with some conceptual blueprints to bring back to their workplaces.
Just as choosing the optimal robotic system hinges on mobility and modularity, so does designing the optimal warehouse for your operation, according to experts lecturing in the educational sessions and chatting on the exhibit floor. It involves more than simply locating and investing in a vacant Kmart store before a Spirit Halloween franchise scooped it up during the autumn months. Some outlined how small you can configure cargo/shipping containers and semi-trailers to fulfill the
functionality you need and how large you can scale that footprint to maximize throughput. Think of it as auxiliary, flexible, “pop-up” or mobile warehousing that expands and moves with you.
AI in real life not like AI in reel life
While lecturers and panelists quipped that AI really isn’t bent to take over the world and enslave or kill us all as depicted in popular entertainment (e.g., films, novels and television shows). Based on coding and programming alone and self-learning, the technology still has miles to go but it’s making great strides and time. Just as AGVs, AMRs, cobots and robots are designed to help humans do the heavy lifting and perform the monotonous, morale-draining physical work so that the humans can concentrate on mental strategic and tactical ideating and planning, AI is designed to help humans hone and speed up their thinking processes by handling all the mundane calculations, data collection and information mining. Think of it as just short of the computer on the starship Enterprise from “Star Trek.” Experts agree that companies today are investing billions in AI such that by 2030 (five years from now) up to 30% of all labor and management decisions will be AI-generated as businesses adjust to cybersecurity, data privacy, programming errors and project management failures. In short, the tech will need people at least as much as people need the tech to improve overall performance. R. Dana Barlow serves as a senior writer and columnist for The Journal of Healthcare Contracting. Barlow has nearly four decades of
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‘Urgent Threat’
Emerging fungus has healthcare providers on alert.
An emerging fungus first reported in 2016 has risen to the level of “urgent threat” in healthcare facilities in less than a decade.
Candida auris is a yeast that can lead to serious infections, including bloodstream, wound, and ear infections, particularly in healthcare settings, according to the Centers for Disease Control and Prevention (CDC).
Many strains of C. auris are resistant to common antifungal treatments, making infections harder to treat.
C. auris spreads easily between patients in hospitals and other healthcare facilities, especially on surfaces and medical equipment. People can have C. auris on their skin and other body sites without having symptoms, the CDC notes. Healthcare providers refer to this as ‘colonization.’
People who are colonized can spread C. auris onto surfaces and objects around them and to other patients.
Cases of C. auris have been on the rise in recent years. The CDC reported 4,514 new clinical cases in the United States in 2023, marking a continued increase since the first case was identified in 2016. The Los Angeles Times reported that during this same period, California reported 1,566 infections, more than any other state.
The CDC declared C. auris an “urgent threat” in a 2023 public safety announcement because of how resistant it is to many antifungal drugs, and how rapidly it can spread in healthcare settings.
It mainly affects individuals with severe underlying health conditions or those who use invasive medical devices, like catheters or feeding tubes. Healthy people are typically not at risk.
Prevention
Healthcare workers should be aware of several key strategies to prevent the spread of C. auris in healthcare settings:
1. Hand hygiene. Frequent hand cleaning with alcohol-based hand sanitizers (ABHS) or soap and water if hands are soiled is crucial.
2. Infection control measures. Patients with C. auris, whether infected or colonized, should be isolated in a separate room. Gloves, gowns and frequent cleaning of the patient’s room with special disinfectants are essential.
3. Screening. Regular screening for C. auris colonization helps identify
asymptomatic carriers who could spread the infection.
4. Precautions when transferring patients. Notify receiving healthcare facilities if a patient has tested positive for C. auris or has been in an outbreak area to prevent transmission.
“The rapid rise and geographic spread of cases is concerning and emphasizes the need for continued surveillance, expanded lab capacity, quicker diagnostic tests, and adherence to proven infection prevention and control,” said CDC epidemiologist Dr. Meghan Lyman.
Healthcare on the Move
Mobility, wheels help redesign, reinvigorate rounding where healthcare is needed.
BY R. DANA BARLOW
Delivering healthcare may not require walls, roofs or even buildings. Rather, a set of wheels may be just what the doctor ordered to cover remote, rural or underserved areas and to provide hands-on patient service in far-flung locations with heightened demand.
Perhaps no one knows this better than Travis and Amanda LeFever, who founded, created and developed in 2020 a company that builds and deploys patient-centric mobile health clinics for hospitals and other healthcare providers in underserved communities. Since inception during the global COVID-19 pandemic, Mission Mobile Medical has deployed more than 200 turnkey, customized mobile health units in 42 states and Canada.
By reconfiguring and outfitting charter coaches into rolling clinics, the LeFevers sought to solve a host of challenges experienced by people in rural and other geographically distant communities that may not have access to healthcare. Patients in these areas can face a shortage of available local providers, limited access to transportation and financial constraints. The pandemic may have brought telehealth forward as a workable option, but patients and caregivers alike have found some limits to the scope of physical examinations. Further, the emphasis on telehealth emerged somewhat parallel to increasing concerns about data privacy and cybersecurity. Technical difficulties also complicated matters, particularly if patients in these areas lacked access to technology for digital conferencing with clinicians, which also affected the patient-clinician relationship.
Rather than establish a stationary facility and bring a community to it for healthcare services, the LeFevers flipped the concept to bring a mobile facility to an established community as the optimal strategy to fulfill healthcare needs. To discuss their mobile healthcare model, including how they keep the rolling clinics stocked with supplies, Travis and Amanda LeFever shared their clinical and operational passion with The Journal of Healthcare Contracting in an exclusive interview.
JHC: Mission Mobile Medical provides healthcare infrastructure via mobile health programs to offer healthcare to underserved areas and populations, but how does it compare to telemedicine as an option, particularly if an urban or suburban healthcare system offers that as an opportunity to reach rural settings? What makes a physical presence preferred over a virtual one?
Travis LeFever (TL): Telehealth is a clinical service provided by almost every mobile health program in every Use Case. Piping in expertise from far away is complementary to what we’re supporting for a health system, which is efficiently delivered healthcare to every corner of their current catchment area.
You know, if you’re tech-savvy and have relatively routine needs, telehealth tech enables a patient like me to not have to travel when it’s inconvenient, like when my kid has another ear infection. We all know it’s an ear infection, we all know the protocol and prescription, but the pediatrician doesn’t want us cluttering up her clinic any more than we want to take off work for another five-minute visit. So, we call in for a telehealth visit.
Stark differences come into play when folks aren’t tech-savvy, like our elderly population, or in the many rural American communities who don’t have reliable access to fast internet. In these cases, an in-person clinician-assisted telehealth visit at the closest mobile clinic, with no waiting, is far more efficient and productive.
Amanda LeFever (AL): I’ll second the kid’s ear-infection thing – it’s wildly convenient. Our clients see Telemedicine and
Mobile Health as complementary. Think about it – we’re piping an Oncology, Cardiology, or Neurology expert into a small town where those appointments, in every other scenario, are miles and months away. No one wants to feel alone, and when you’re scared or sick, no one wants to wait for reassurance or relief.
JHC: A leading accounting and advisory firm surveyed leaders at rural healthcare organizations who responded that they are optimistic about their financial viability even though fiscal concerns and reimbursements remain a significant challenge, they are “not likely” to consolidate or merge with another organization, and they express serious concerns about cybersecurity. How do you respond to and fit within that mindset?
TL: Those are two wildly different topics, but I’ll try. Rural healthcare teams are incredibly resilient – they are honed razor sharp in a tough environment. They come from families and communities who, for generations, have been forced to make the most of scarce resources, and soldier through tough times. My experience is that consolidation isn’t for everyone. Success in Healthcare is local, not corporate.
Regarding cybersecurity – I’m with them. Everyone should be extremely concerned. When it comes to digital banking, today’s business leaders are surrounded by strangers, invisibly working around the clock to rob your organization just like desperados used to break into banks and walk out with your cash. The sooner that we, as leaders, admit we don’t understand the risks around cybersecurity and let our IT professionals lead in those areas, and give them resources, the better.
Amanda LeFever
Travis LeFever
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AL: I think about cybersecurity more from the perspective of Mobile Health operations. We work with client IT teams daily to ensure the programs, outside the four walls, meet the same compliance and security standards as every other healthcare facility, from HIPAA-compliant telehealth setups to data encryption and secure imaging.
JHC : How does Mission Mobile Medical get the opportunity to work with underserved patient populations and care communities? Do you contract with interested hospitals, hospital systems, and integrated delivery networks (IDNs) to expand their service reach, or do you contract with community care organizations, local and state governmental agencies, and payers? A variety of providers and service organizations?
AL: Trust is the key. Our organization is a B-Corp (nearly certified – yay!) and there to serve the community, so we first ask what services they need and want. As the saying goes, ‘Nothing about us, without us.’ We work with community partners, meeting with health centers, who are our favorite partners, then health departments, churches, advocacy groups – anyone who plays a role in connecting people to care. Stakeholders have been very supportive. We were even fortunate enough to earn federal support for designing the next generation mobile care delivery platform, in an ARPA-H award of up to $26 million, which will expand our efforts to make an even bigger impact in rural and underserved areas.
JHC: When you partner with hospitals, healthcare systems, and IDNs, how does your internal supply chain work to support the contracted
For Operations, we manage our own supply chain, of course. For clinical supplies, the satellite clinics restock at their brick-and-mortar ‘Home Base’ and leverage their own GPOs.
TL: We contract with health systems. We help them identify care gaps in rural communities, then use predictive analytics (AI) to pinpoint where care is needed the most and the savings providing that care might generate for the stakeholders. Then we collaborate with community stakeholders to co-design the program and engage the patients. Because our costs are so low (we’re vertically integrated), we’re able to bridge quality and care gaps in a way that’s extremely costefficient and very effective.
Mission Mobile Medical vehicle? Do you piggyback off the client’s negotiated supply and service contracts for products and equipment, or do you negotiate and maintain your own product and service contracts to implement as an extension of your client’s? What happens if the suppliers and vendors you use differ from what the client uses? Do your clients book your supply chain business partners as “purchased services” on their expense sheets?
TL: We’re a Managed Services Organization with our own supply chain. To be clear, we’re not a physician group – we contract with payers (and others) to standardize these operations and aggregate value in the chain, so when health systems are ready to efficiently distribute their resources in their catchment area and improve outcomes, they get paid for those improvements. We provide standardized systems of evidence-based predictive analytics, plus equipment, workforce support and staffing. On the operations end, we provide the infrastructure to capture clean data and illustrate the difference they are making.
AL: Transparency and flexibility are key to making these partnerships successful. We work in value-based, cost-plus, or fixed-fee agreements – whatever the health plan and health systems need to do the work. Plus, we take care of compliance – ensuring every program meets regulatory and accreditation requirements so there’s no red tape slowing down patient care. It’s a complete endto-end approach, making it easier for our healthcare partners to focus on delivering care, not managing logistics.
JHC: Do you negotiate your own supply, service and equipment contracts or do you work with any of the group purchasing organizations (GPOs) in the industry, such as Vizient, Premier, HealthTrust or others? What makes the most sense for Mission Mobile Medical and why?
TL: For Operations, we manage our own supply chain, of course. For clinical supplies, the satellite clinics restock at their brick-and-mortar ‘Home Base’ and leverage their own GPOs. That process takes
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advantage of the client’s existing supply chain, complements their existing inventory systems and prevents conflicts. That makes the most sense for our clients.
JHC: Do you equip each of your Mission Mobile Medical units with a supply cabinet of some sort? If so, is it automated (for tracking and tracing aspects) or manual? How is stock replenished within a vehicle? Do you rely on primary or third-party distributor trucks, vans or even drones? Or do you rely on a client’s consolidated service center (CSC) or internal logistics service?
TL: Five questions. I can do it. Drones are on the way, but not quite yet. Most programs schedule times back at a brick-andmortar location for regular resupply. It’s not overly complicated. Most programs are focused on primary and preventive care, so the supply requirements aren’t expansive.
Our vision is to reduce the distance between the patient and the provider (who
has
the tools
and
the knowledge to use them or train the patient how to use them).
AL: I can’t wait for the Healthcare Drone Superhighway. There’s some cool tech coming out of some universities in Texas.
JHC: HA! Good point! Hopefully, there’s a dedicated FAA division for drones! Kidding aside, though, how are your Mission Mobile Medical teams and “movable exam rooms” fortified with products to use on patients? I know how it works for hospitals, ASCs, clinics, physician practices, etc., but how does that work for you?
TL: On a regular basis, the staff re-supplies the clinic from Home Base,
usually a nearby brick-and-mortar client location in the community we’re serving. They go inside the facility, take supplies out of the supply closet or OTC medication area, log them into the program, and then put them inside the mobile clinic parked outside.
JHC: Mission Mobile Medical offers a variety of services to clients – from clinical (e.g., exams and treatment), dental, and educational outreach to research laboratory, transportation, and workforce development. Are you considering or have you considered adding diagnostic imaging
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and/or outpatient medical/surgical procedures to your repertoire? Why?
TL: Consider our value-add as ‘managing movable exam rooms.’ It’s not more complicated than that. Those exam rooms can support diagnostic imaging but aren’t particularly suited to surgical procedures. However, our ARPA-H work addresses that. In two-to-three years, health systems will be delivering hospital-level care to Rural America on an integrated care delivery platform.
For example, conditions like breast cancer, lung disease, and cardiovascular issues require imaging for early detection, but many patients in rural areas don’t have access to these services without driving hours to a facility. By integrating mobile diagnostic imaging, we can help healthcare systems reach these patients before their conditions become acute, which ultimately lowers costs and improves outcomes. The same applies to minor outpatient procedures – if we can prevent an emergency room visit with mobile surgical capabilities, that’s a win for both the patient and the healthcare system.
AL: We’re already witnessing strong demand for these services, and we’ve been collaborating with our health system partners to evaluate what is both feasible and impactful in a mobile setting. Our approach has always relied on data, and we assess where these services can be most effectively deployed without compromising care quality.
At the end of the day, for years, these efforts have been fragmented. We’re bringing them together, and our capabilities are a new standard intervention for community health disparities
and data to document the outcomes. We want health systems to say, ‘Oh, there’s a care gap in this community. Let’s get a mobile health program in there – call Mission Mobile Medical.’
JHC: Earlier, Black Box Research
released the results of an independent survey of healthcare organizations that found surging interest in adopting virtual care platforms, as well as active use of AI-driven remote patient monitoring, virtual hospitals, virtual nursing and telehealth solutions to optimize care delivery, which includes improving clinical outcomes, reducing clinician burnout and enhancing patient access, according to BBR. As the healthcare industry continues to migrate toward “hybrid care models,” which factor in nonacute care facilities and virtual healthcare opportunities, how does Mission Mobile Medical fit in with these plans vs. compete with them?
TL: I haven’t seen that survey, so I can’t comment. But it sounds like you’re asking about new combinations of the things we know work with additional tools.
Everyone wants the same thing – better outcomes at lower costs. And one path to that goal is to develop tools that save labor and reduce overhead. What you’re describing is, in some ways, the Home Depot of Healthcare – this row after row of tools helps us all work and live better in this industry.
AL: We fit in two ways. In this analogy, Mobile Health satellite networks are toolboxes full of those tools you talked about, delivered to the work sites where the work is, with an expert on board or on-call.
Traditional healthcare involves going to the doctor and waiting; mobile health involves the doctor coming to your community and waiting. Wherever a patient engages a clinician, they will have tools. Our vision is to reduce the distance between the patient and the provider (who has the tools and the knowledge to use them or train the patient how to use them).
Another research firm, Chartis, showed that “46% of rural hospitals are in the red and vulnerable to closure,” which can lead to “health deserts.” How can Mission Mobile Health populate those emerging deserts with oases that are not mirages?
AL: When health systems contact one of our Market Development team members, we typically walk through a Rapid Community Needs Assessment, run data for predictive analytics, and create a financial model with a fully loaded cost profile and net benefits. We identify the financial stakeholders the health system is engaged with and how they should or could partner in the program.
We also contract with the payers and partner with the health system in a valuebased care agreement to control costs and improve quality measures, especially for unable-to-reach patients.
TL: We combine best practices for care navigation and case management with increased convenience. We’re the only company in the country that can do this at scale and at risk.
For more information about Mission Mobile Medical, visit their website at www.missionmobilemed.com
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Supply Chain By the Numbers
BY JOHN STRONG, CO-FOUNDER AND CHIEF CONSULTING OFFICER, ACCESS STRATEGY PARTNERS INC
Is your supply chain strategy aligned with what your C-suite is thinking about?
In most industries supply chain excellence is considered a key strategic initiative. In healthcare, where supply chain managed products and services fall right behind labor as the most expensive items, it is often not the case. Where supply chain management is prioritized it can mean the difference between profit or loss, amounting to millions of dollars annually. It is not always about the price paid for products.
Paul Keckley, the noted hospital strategist, has summarized seven concerns for the hospital C-Suite1. Among them are two that the supply chain can have a direct impact on.
First is capital deployment. Progressive supply chains should have a voice, and in many cases final approval of contracts for all capital spending, service contracts and supply decisions in concert with the primary stakeholders. If supply chain is not playing an active role in these areas, ask yourself why not. Centralized procurement around an effective purchasing department is key to the controls necessary to ensure that capital is deployed in the most efficient fashion.
The second area is physician relationships. Physician stakeholders need to be active participants in capital, service, and supply decision making. Keckley notes that “Physicians are disgruntled.
They believe their interests are not being addressed by hospitals.” Physicians should be a part of the supply chain team, either formally or informally across the organization.
In December 2024, Chartis2 did a survey of 61 health system chief strategy officers serving systems with more than $1 billion in annual revenue. Of the seven key findings, three of them can be impacted by effective purchasing and supply chain strategy.
FACTOR
Competition from other Health Care Systems
Organization’s Overall Financial Strength and Ability to Invest in the Future
Organizational Ability to Execute Plans
CSO SEES AS PRESSURE
48%
41%
25%
Saving costs (in addition to lower pricing) through value analysis and other means does provide a strategic advantage. It takes a supply chain strategy that when implemented works together with a hospital’s overarching business strategy.
Year over year supply and pharmaceutical price increases continued unabated
The Strata monthly healthcare industry financial benchmarks did not hold good news for non-labor costs through March 2025. Non-labor costs jumped 9.1% from March 2024 to March 20253
Is your addiction to rebates and
Getting “extra” is the great American way of expressing value. Ever brag about the great deal you got on a new car (beyond free floor mats)? Everyone loves a good deal – and extra value. It seems like every supplier is already conditioning us for price increases caused by tariffs – that in many cases are not imposed yet.
“Price at the pump” used to be the mantra for many hospital supply chain professionals, but over the past few decades we have been taught by suppliers, our group purchasing organizations and others that sometimes you can get something extra through compliance to contracts and greater volume. In our desire to attain that value, are we sacrificing sound supply chain practices like
“sharebacks”
costing you money?
competitive bidding and meaningful product changes to our desire to gain that “extra”? How much is that extra worth?
` It is great to have “preferred products,” but by sticking with the same old products and not engaging in meaningful product evaluation are we sacrificing the same or better products at a much lower cost?
` Are you spending so-called “share backs” on services that are nice to have – versus needed? Are you using those services?
` Are pricing tiers and rebate schemes so complicated that it is almost impossible to determine the net price? Can you manage and audit the net price? If they are too complicated to manage, then how are you doing “apples-to-apples” comparisons of products and services? Is it time to look at things differently?
` Have you had certain “preferred” suppliers for too long? Nothing gets a supplier’s attention (and a price reduction) faster than making a product conversion.
As hospitals look to reduce expenses, it’s time to put everything on the table, and consider meaningful changes where they are appropriate. Unfortunately, expenses for supplies and services are increasing almost as fast as revenues in many organizations. Total non-labor expenses jumped 9.1% for the year ended March 2025, versus an increase in inpatient revenue of 9.6%.4 This is not a recipe for long-term profitable growth.
From Competence to Capability
The evolving landscape of leadership.
Over the past decade, we’ve witnessed a profound shift in the nature of effective leadership. What once revolved around competence – defined by a reliable set of skills like planning, decision-making, and team development – has now evolved into something deeper and more dynamic: capability.
Historically we have paid attention to outward things like planning, decision making, developing others, leading a team, and so forth. Capability is more of the “inner game” way of thinking about leadership, said Randy Chittum, PhD., a leadership consultant.
When senior executives are surveyed, a great number of them refer to increasing complexity as a major challenge for their organization. When things are truly complex (unpredictable), all the old leadership lessons are insufficient. “In this world, we need leaders who are present to emergence, who are adaptable, and can shift as things evolve,” Dr. Chittum said.
However, doing this requires that leaders can see what they might not have seen before. Further, leaders in this world need to understand how their own internal sense-making keeps them seeing what they are used to seeing.
In the following article, Dr. Chittum discussed how leaders can move more into the inner way of thinking.
New ways of fostering trust
The most obvious area of change for leaders over the last five years is in managing remote workers and teams. Less obvious but connected is leading culture and having staff feel “a part of” the organization even within the remote framework, Dr. Chittum said. “In many places, staff have been reduced to a metaphorical ‘pair of hands’ with less energy and commitment to the purpose and the cause,” he said.
But the challenges go beyond remote work. “I suspect that many people changed their feeling about, and relationship to, our institutions in general,”
Dr. Chittum said. “This includes work. The nature of the pandemic likely shifted our values to more family and personal well-being.”
Remote work environments mean leaders must think about fostering trust and communication in new ways. Dr. Chittum said some client organizations, and leaders, do this better than others. I think it is easy to lose sight of the fact that in most cases, leaders and employees enter into this new world in the context of a pre-existing relationship. “If I already had trust and good communication with my leader, it seems easier to hold on to that, even as context shifts. The opposite is also true.”
Empathy and compassion in the modern workplace
People need and want more empathy from their peers and leaders. Given how much meaning we get from our work (at least in the U.S.), having people appreciate us feels critical. And it feels much harder to do in a remote world.
“If empathy is basically defined as the ability to see the world through my eyes, that gets much harder when there is a whole part of your work life (at home, with family, etc) that I don’t have access to,” Dr. Chittum said.
To that end, compassion might be a more important characteristic than empathy. Can leaders have grace for their employees and assume the best of intentions?
“ The mistake most of us make is we love our certainty and are thus prone to create ‘false’ certainty even when none exists. We do this for psychological reasons but with real life impact. Part of the reason we love our certainty is that our lazy brains can stop thinking. Certainty equals a clear path forward in our minds.
More practically, Dr. Chittum has seen a lot of well-managed organizations take tactical approaches to helping people be in the same space at the same time more often. Those seem to include some days when everyone is in the office and some meetings (typically offsite) where bigger issues are tackled. “In many ways, this is not unlike what we did before.”
Again, the bigger challenge for many is that the changing work dynamics have made us accustomed to new ways of being together. “Like always – it is hard to help people shift out of what they know and expect.”
The counter to this is companies that do things like monitor the number of times your computer mouse moves in an hour.
“That kind of transactional thinking quickly destroys trust and empathy, and compassion,” said Dr. Chittum.
Adapting
How to adapt to constant change and uncertainty in the marketplace is the question of the next decade for leaders. Dr. Chittum said adding to the challenge is that the new political eco-system is a great cause of uncertainty and change.
“The mistake most of us make is we love our certainty and are thus prone to create ‘false’ certainty even when none exists,” he said. “We do this for psychological reasons but with real life impact. Part of the reason we love our certainty is that our lazy brains can stop thinking. Certainty equals a clear path forward in our minds. Michael Bloomberg said, ‘we are more certain than ever, but less informed, and far
less thoughtful.’ I think that sums up the challenge pretty nicely.”
Comfort with emergence is a key leadership capacity for our times. This requires intense presence to what is truly happening and constantly reassessing that reality. It sounds simple, but requires a different energy and focus than many leaders are used to. “I recently asked a team of executives to individually write a response to this question – ‘what is true
One underutilized skill
Dr. Chittum believes one of the most underutilized skills for today’s leaders is quitting. Behavioral economists have a smart way of thinking about quitting, he said. “It happens when the combination of sunk cost combines with opportunity cost. If the sunk cost doesn’t outweigh the opportunity cost, we should quit. This is a more practical approach to emergence and again, requires constant care and attention to what is shifting around us.”
now,’” Dr. Chittum noted. “Unsurprisingly, there was very little agreement on something so fundamental.”
The further challenge is to embrace presence and emergence with a sense of optimism and possibility. Noticing is a key capability and responding to what is noticed is a key leadership competence. “If we ruminate rather than reflect, we get drug down an emotional intelligence hole, from which we are incapable of leading anything.”
A delicate balance
In the book Good to Great, author Jim Collins talks about how successful companies have an enduring purpose, stimulated by big goals (what Collins called BHAGs – Big Harry Audacious Goals). “I suspect companies today still need both of those things, and the ability to shift out of either or both as new reality comes online.”
Given that both are good and useful AND that either or both can be overused (in relationship to the other) – a set of early warning signs could be valuable. “How will we know if we’re over-playing one of these against the other?”
What looks like innovation is often a response to emergent thinking. “Those who can see what others cannot (and see it sooner) are more likely to seem innovative. And good innovation often protects the core,” Dr. Chittum said. “One of my favorite ‘both/ands’ is to honor the past and innovate for the future.”
Randy Chittum, Ph.D. has spent his 25-year career working with leaders and executives worldwide in a variety of organizational settings. He works at all levels of the organization, specializing in leadership development (individual and team coaching, leadership workshops covering emotional intelligence, coaching for managers, managing change and transition, and branding and personal presence), and organization development (team and system level interventions) including strategy development and learning to collectively think differently to support sustainable change. Learn more at still-leading.com
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