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November 2026 • Vol.17 • No.6

GPOs Maneuver Through Changing Marketplace Providers, suppliers seek more specialized services amid traditional staples.

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C O N T E N TS | N OV E M B E R 2 0 2 6

2 The New Rules of Supply Chain Resiliency

34 Measuring What Matters in GPO Performance

12 GPOs Maneuver Through Changing Marketplace

48 Be Thankful for Supply Chain

Florida AHRMM leaders say preparation, communication and collaboration are essential as healthcare organizations face increasingly complex disruptions.

Providers, suppliers seek more specialized services amid traditional staples.

The Journal of Healthcare Contracting is published bi-monthly by Share Moving Media 350 Town Center Ave, Ste. 201 Suwanee, GA 30024 Phone: 770/263-5262 FAX: 770/236-8023 e-mail: info@jhconline.com www.jhconline.com

PUBLISHER John Pritchard

jpritchard@sharemovingmedia.com

DIRECTOR OF BUSINESS DEVELOPMENT Anna McCormick

Without uniform reporting requirements or consistent evaluation criteria, comparing GPOs remains a challenge. John Strong discusses the metrics, transparency and independent oversight needed to make rankings more credible. Imagine the inefficiency and void resulting from its absence.

EDITOR Graham Garrison

ART DIRECTOR Brent Cashman

SENIOR WRITER R. Dana Barlow

CIRCULATION Laura Gantert

ggarrison@sharemovingmedia.com

bcashman@sharemovingmedia.com

lgantert@sharemovingmedia.com

amccormick@sharemovingmedia.com

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. Copyright 2026 by Share Moving Media All rights reserved. Please note: The acceptance of advertising or products mentioned by contributing authors does not constitute endorsement by the publisher. Publisher cannot accept responsibility for the correctness of an opinion expressed by contributing authors.

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 RESILIENCE

The New Rules of Supply Chain Resiliency Florida AHRMM leaders say preparation, communication and collaboration are essential as healthcare organizations face increasingly complex disruptions.

For Florida’s healthcare supply chain leaders, disruption is no longer an occasional event to prepare for. Natural disasters, cyberattacks, product shortages and other challenges have made resiliency a day-to-day priority. At the same time, leaders are taking a closer look at the data behind their decisions, the relationships that help them respond to problems and the vulnerabilities buried deep within their supply chains.

In an interview with The Journal of Healthcare Contracting, Florida AHRMM chapter officers discussed what is keeping supply chain professionals up at night, how provider-supplier relationships are evolving and what organizations can do now to prepare for the next disruption.

November 2026 | The Journal of Healthcare Contracting

Providing responses for the Florida AHRMM 2026 were the following chapter officers: ` President: Rodger Landers, MBA, CMRP, FAHRMM, BayCare Health System, Procurement Manager ` President-Elect: Diana Carvajal, Sierra-Cedar, Vice President, Healthcare & Commercial Solutions ` Vice President Elect: Sara Reschke, Staritas, Senior Account Executive ` Treasurer: Scott Wilcox, CMRP, FAHRMM, Sarasota Memorial Health Care, Director, Supply Chain Operations The Journal of Healthcare Contracting:

And finally, resiliency has moved from being something we talked about after a disruption to something leaders need to build into their everyday strategy. The question is becoming less “How do we respond when something happens?” and more “How prepared are we before it happens?” JHC: What are FLAHRMM’s key initiatives and areas of focus right now, and where is the greatest opportunity to help members?

A big part of FLAHRMM’s role is education, connection and sharing what we’re learning across the industry.

What issues are keeping Florida supply chain leaders up at night, and how have priorities changed?

We think three things are really keeping supply chain leaders up at night right now: data, cybersecurity and resiliency. Data integrity and the ability to quickly retrieve and trust your data have become much more important. It’s not just about having data. It’s about knowing where it came from, validating the inputs and being confident we’re making decisions based on accurate information. We’re also seeing more focus on utilization and conservation, particularly when products are at risk or distribution is limited, such as we’ve seen with contrast media. Cybersecurity continues to be a very real threat to healthcare. A cyberattack can quickly become a supply chain issue when systems, ordering, distribution or communication are disrupted.

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Rodger Landers, Procurement Manager, BayCare Health System

Diana Carvajal, Vice President, Healthcare & Commercial Solutions Sierra-Cedar

Sara Reschke, Senior Account Executive, Staritas

Scott Wilcox, Director, Supply Chain Operations, Sarasota Memorial Health Care

A strong provider-supplier relationship means both sides are comfortable having transparent conversations even when the news isn’t good.

 RESILIENCE

One area we want to continue emphasizing is data – helping supply chain professionals understand where their data is coming from, whether they can trust it and how to turn that information into better decisions. Cybersecurity is another important area. The threat is very real, and recent incidents involving organizations such as Boston Scientific, Stryker, OneBlood and Tallahassee Memorial show how quickly a cyber event can affect healthcare operations. There’s an opportunity to help supply chain teams understand both the risks and the everyday actions employees can take to help prevent a breach.

The best practice we see is consistent communication – not just when there is a problem.

We also want to continue promoting resiliency as a discipline, not simply a response to an emergency. That means learning how to identify potential disruptions earlier, understanding the warning signs, and having a plan to recover quickly when something does happen. The recent contrast shortage and Solventum software issues are good examples of why that preparation matters. JHC: What does a truly strong providersupplier partnership look like today?

For us, it really comes down to trust and communication. A strong provider-supplier relationship means both sides are comfortable having transparent conversations even when the news isn’t good. For example, if a supplier knows an item is at risk of going on back order, communicating that early gives the provider options. They can look at substitutes, adjust utilization or change their purchasing strategy rather than panic-buying when the back order happens. And when the product becomes available again, they can adjust back. That kind of partnership helps everyone. When there is trust and communication, the supply chain has options. Without it, the supply chain can break down very quickly. JHC: How important are established relationships and communication channels before a crisis?

They’re critical. We don’t want to exchange business cards for the first time in the middle of a crisis.

November 2026 | The Journal of Healthcare Contracting

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 RESILIENCE

The relationships and communication channels need to be established before the disruption happens. When a provider and supplier already know each other, there is a level of trust and understanding that allows them to move much faster. The best practice we see is consistent communication – not just when there is a problem. Providers and suppliers should be talking about potential risks, alternatives, inventory levels, lead times, and emerging issues before they become emergencies. That way, when something does happen, the conversation starts with “How do we solve this together?” rather than “Who is responsible for this?”

JHC: What lessons from Florida’s hurricane experience should other supply chain leaders pay attention to?

The bigger lesson is that we must prepare before the disruption – not while the disruption is happening.

Florida has learned a lot about preparing for disruption because hurricanes give us a regular reminder that whatever is inbound may not arrive when you need it. IDNs that self-distribute can have an advantage because they have more control over inventory and can position critical products ahead of the storm. But it’s not simply about stocking up. It’s also about understanding what we already have on hand, what we need, and optimizing inventory before the storm arrives. For organizations that don’t distribute, having multiple inbound sources

November 2026 | The Journal of Healthcare Contracting

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 RESILIENCE

and contingency plans becomes even more important. The bigger lesson is that we must prepare before the disruption – not while the disruption is happening. JHC: How can providers and suppliers balance efficiency and cost savings with resiliency?

We think communication is one of the biggest levers we have. There are plenty of opportunities to improve efficiency. For example, providers purchasing by the full pallet, pallet layer, or truckload can create significant efficiencies when the demand and storage strategy support it. But efficiency can’t come at the expense of visibility. If a supplier knows an item is becoming an “at-risk” item, communicating that before it becomes a back order gives the provider the opportunity to make a different decision. The best back order is the one we avoid. Too often, providers react to a back order because they weren’t aware there was a problem until it was already too late. Early communication gives everyone more options and allows providers to balance cost, inventory, and resiliency much more effectively. JHC: Where should healthcare organizations think differently about resilience?

One area we think deserves more attention is understanding the true source of critical products. It’s not enough to know who the supplier is. Providers need to understand

Sometimes the most valuable information is simply knowing that someone else is seeing the same issue, has found a workaround, or has learned something the hard way.

where critical products are manufactured, the country of origin and where those products are distributed from. That visibility becomes especially important when there is a disruption in a particular region or manufacturing location. The contrast media shortage is a good example. When a significant portion of a critical product category is dependent on a limited number of manufacturing sources, a disruption in one location can have a much broader impact. For critical products, we should be asking: Where is it made? Where does it come from? How many sources do we have? And what happens if that source goes down? JHC: If you could give supply chain leaders one piece of advice about preparing for the next major disruption, what would it be?

Be part of the community – and keep talking. No one organization has all the answers, and disruptions rarely affect just one organization. Whether it’s AHRMM, an affiliated chapter like FLAHRMM, HIRC, or other industry networks, sharing information helps everyone see what’s happening beyond their own four walls. Sometimes the most valuable information is simply knowing that someone else is seeing the same issue, has found a workaround, or has learned something the hard way. The more we share, the better prepared we all are. Resiliency isn’t something we build by ourselves. It’s something we build together.

November 2026 | The Journal of Healthcare Contracting

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GPOs Maneuver Through Changing Marketplace Providers, suppliers seek more specialized services amid traditional staples. BY R. DANA BARLOW

ooking at today’s group purchasing organizations (GPOs) yields one overarching observation adapted from the television commercial of a discontinued automobile brand: Today’s GPO is not your father’s GPO.

While the fundamentals remain consistent, the mechanisms for delivering them and the scope and span of services required extend far beyond what went before. Three prime examples of this involve achieving and assuring data transparency, expanding out to nonacute or remote care facilities and adopting and implementing technology, the latter of which consistently updates and upgrades at least each year.

Crystal clarity Calls for “data transparency” hearken back to at least 50 years, long before the industry elevated that phrase to buzzworthy level. During the 1980s, intense debate over the ill-fated Common Category Database (CCD) centered on its ability to give providers and suppliers access to reams of information about product attributes, enabling them to compare components, pricing and other elements.

GPOS MANEUVER THROUGH CHANGING MARKETPLACE

Not surprisingly, providers favored it, but suppliers did not because that capability would reveal too many trade secrets. By and large, these days the calls for data transparency revolve around costs – or rather, pricing – for clinical procedures so that patients – but more accurately, payers – can compare provider service charges for payment and reimbursement. But calls for data transparency also center on the ability of providers, suppliers and payers to share product, service and patient data to streamline the delivery of clinical care, which includes demand and supply chain management, and more accurate. Yet critics contend the line likely needs to be drawn somewhere to protect research and development, sourcing and production parameters to a degree. GPO executives acknowledge the ongoing discussion continues as a work-in-progress.

“GPOs shouldn’t have a place in the real-time transactional flow, like demand and supply projections. There are technical network solutions that solve that and belong as direct relationships between providers and suppliers.”

“Healthcare organizations are asking for more transparency and visibility because they need better information to make decisions in a rapidly changing environment,” said Bruce Radcliff, president, Supply Chain Services, Premier Inc. “While achieving complete real-time visibility across the entire supply chain may not always be realistic, significant progress is possible and already underway. “At Premier, we’re seeing growing demand for insights into product availability, utilization trends and contract performance,” Radcliff continued. “Advances in technology are making it easier to provide that information and help organizations respond more quickly to changing conditions. At the same time, strategies such as supplier diversification and fixed-price contracting need to be balanced with factors such as cost, availability and long-term sustainability. The goal is not simply to add more suppliers or more data, but to help providers build a more resilient and informed supply chain.” Prior to Premier, Radcliff spent more than a decade at Advocate Aurora Health leading supply chain operations. Yet how reasonable is it for providers to request or even mandate data transparency and real-time visibility into demand (consumption) and supply (production) activities, fixed-price contracting and supplier/vendor relationships with GPOs? Steve Downey, Chief Supply Chain and Patient Services Officer, Cleveland Clinic, argues that it’s unreasonable, if not unrealistic.

November 2026 | The Journal of Healthcare Contracting

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GPOS MANEUVER THROUGH CHANGING MARKETPLACE

The real opportunity is connecting provider, supplier, clinical, financial, operational and consumption data into the workflows where products are selected, purchased, used, paid for and evaluated.

“These are two distinct issues that shouldn’t be combined,” Downey insisted. “GPOs shouldn’t have a place in the real-time transactional flow, like demand and supply projections. There are technical network solutions that solve that and belong as direct relationships between providers and suppliers. Data transparency, like costs, incentives and profits, is a question behind the design construct of the GPO. Member-owned GPOs typically have transparency requirements built into their governance. For others, it’s a design choice that needs addressing at the model level.” Before joining Cleveland Clinic, Downey spent nearly a decade at Vizient and Excelerate in leading supply chain operations and consulting. Transparency, in fact, may not be enough anyway, according to Simrit

Sandhu, President, Spend Management, Vizient. “Transparency is not a standalone strategy,” Sandhu noted, “it is a requirement for the overall strategy of intelligent supply chain orchestration. The real opportunity is connecting provider, supplier, clinical, financial, operational and consumption data into the workflows where products are selected, purchased, used, paid for and evaluated. “We see this when supplier data and Vizient analytics come together to identify gaps in areas like facilities and biomedical services, set KPIs and create providerspecific action plans,” she continued. “We also see it in clinically complex categories, where supplier insight, provider feedback and data can help clarify which products, technologies or care models are delivering value and where adoption needs to be tailored. That requires providers and suppliers to operate differently, with stronger data sharing, clearer accountability and a shared focus on closing the performance gap between negotiated value and realized financial impact.” Sandhu previously led supply chain operations at Cleveland Clinic for nearly 15 years. John Strong, a veteran healthcare supply chain executive with experience in the hospital, distribution services, GPO and consulting segments, questions the achievability of data transparency demands, too. “It is tough,” Strong told The Journal of Healthcare Contracting, “as some of the systems and processes are trade secrets. Sharing too much data may bring about

November 2026 | The Journal of Healthcare Contracting

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GPOS MANEUVER THROUGH CHANGING MARKETPLACE

antitrust concerns and still today pricing lacks the context in which it was given, such as volume, compliance, corporate agreements, etc. Historically, some hospitals have been reticent to share all their purchasing information with their GPO, and some not.” Still, Strong foresees data transparency growing with the emergence of AI-based supply chain technology that can link systems from the electronic medical record (EMR) to the materials management information system (MMIS) or enterprise resource planning (ERP) system to the GPO, distributor and manufacturer. In fact, he believes suppliers may be more open and amenable to working with providers in different ways. “As healthcare systems continue to consolidate, suppliers are looking at ways to really partner with them,” he observed. “There is growing universal agreement that leading suppliers are working on ways to make their products AI-friendly. This is only part of the equation. At the same time, they are developing or acquiring companies that can assist hospitals with their care path from prior to a procedure, through the procedure to post-procedure. Companies – and perhaps GPOs – that develop the ability to do this will be the long-term winners in the next five years.” Strong recently retired as Co-Founder and Chief Consulting Officer, Access Strategy Partners Inc., and his career included serving as president and CEO at Consorta for nearly 11 years before it became part of HealthTrust, leading the original Premier Health Alliance GPO for

90s Through mergers and acquisitions that reached a frenzy during the 1990s, the healthcare marketplace started consolidating to fewer independent organizations and more healthcare systems that required contracting, logistics and services to be updated to reflect the diverse delivery options.

seven years and prior to that serving as Chairman, Division of Materials Management at Lutheran General Hospital and President of Healthcare Materials Corp.

Reaching remotely Early in the history of cooperative buying, the forerunner of group purchasing, the cooperative buying organizations (CBOs) primarily worked with acute care hospital facilities. Since that time, the healthcare industry has expanded to include remote care facilities that reference both geography and specialty, including ambulatory surgery centers (ASCs), clinics, diagnostic

November 2026 | The Journal of Healthcare Contracting

imaging centers, laboratories, long-term care facilities, physician offices and more. This development marked a shift in healthcare dynamics from the facility pulling the patient in for care to the facility pushing patient care services closer to the population. Through mergers and acquisitions that reached a frenzy during the 1990s, the healthcare marketplace started consolidating to fewer independent organizations and more healthcare systems that required contracting, logistics and services to be updated to reflect the diverse delivery options. GPOs started addressing this organizational migration as far back as the 1960s with the changes

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“As part of the healthcare provider spectrum, it’s absolutely necessary to think of all these sites as part of the equation.”

reaching a fever pitch with the enactment of managed care in the early 1980s as payers were granted more influence and power by Congress in 1983. For today’s GPO and supply chain executives, this is business as usual. “As part of the healthcare provider spectrum, it’s absolutely necessary to think of all these sites as part of the equation,” indicated Cleveland Clinic’s Downey. “How a GPO supports them depends on what service is needed. If it’s contracting, ensure the contracts cover them in scope. If it’s analytics or benchmarking, ensure the data is segmented appropriately. GPOs can also support supplier communication, onboarding and implementation as systems bring new or affiliated facilities into the fold. And because they have broad visibility across their membership, GPOs are wellpositioned to surface best practices and practical insights that help organizations navigate an increasingly complex care delivery landscape.” If anything, GPOs should reflect the nature of their clients and customers, according to Premier’s Radcliff. “As care continues to move beyond the four walls of the hospital, healthcare organizations need a more coordinated approach to supply chain management across the entire continuum of care,” he said. “GPOs can help create that alignment by providing common contracting strategies, data insights and benchmarking across different care settings. Hospitals, ASCs, clinics and physician practices often face similar challenges, but they may

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GPOS MANEUVER THROUGH CHANGING MARKETPLACE

solve them in different ways. By helping healthcare organizations identify opportunities for standardization and operational improvement, GPOs can support greater efficiency while still allowing flexibility to meet the needs of individual sites.” But Vizient’s Sandhu emphasizes that monolithic contracting for larger systems does not and should not apply to everyone. “The opportunity is not simply to extend hospital contracts into ambulatory sites,” she emphasized. “That is where organizations can get stuck. ASCs, clinics, physician offices and imaging centers do not all buy, operate or adopt technology the same way, especially when some sites are owned, some are affiliated and others are independent. “Supply chain needs to support providers across the entire continuum of care,” Sandhu continued. “That starts with visibility: Where spend is happening, where purchasing behavior varies and where contract coverage is inconsistent. From there, the answer may be simple contract access, guided buying, price assurance, supplier partnerships or workflow support, depending on how the site actually operates. The larger value is pattern recognition. A single ASC or clinic sees its own experience. Vizient can see across many providers and care settings, helping organizations understand what works, what can scale and where a different approach is needed. The goal is to help providers manage performance across the full care continuum, not force every site into the same model.”

“While GPOs do a good job on price and working with suppliers to enforce compliance through pricing tiers, there is still a lot of friction in the healthcare supply chain.”

GPOs have been making inroads with some progress, according to Strong. “I think the three national GPOs bring together these providers on a regular basis with committees, national and regional meetings and other forums,” he said. “The big question for me is how the national GPOs can make ordering, especially by non-acute care providers, more efficient than an electronic catalog alone. The brass ring here links the GPO price with the electronic order, inventory, payment, etc. While a great deal of work has been done on this, I’m not sure that all of it has been brought together yet.” Suppliers also are getting into the game from another direction. “Suppliers are working with hospitals to push services closer to the patient and the population,” Strong noted. “Many leading suppliers are working on combining their products and services to create a more seamless patient experience. This is the future, and I’m not certain that these efforts involve the GPOs or not. As suppliers work toward ‘partnerships’ with consolidating health systems, you have to wonder how that fits with their GPO. “While GPOs do a good job on price and working with suppliers to enforce compliance through pricing tiers, there is still a lot of friction in the healthcare supply chain. This is not necessarily the GPOs fault, but the amount of administrative burden continues to grow,” he acknowledged. Strong also argues that hospitals, if not GPOs, may have to change vendors from time to time to obtain lower prices.

November 2026 | The Journal of Healthcare Contracting

The long-term, sole-source contract likely has outlived its usefulness. “There can be partnerships, but it has to be a two-way street,” he said. “And that will require visionary C-suite support. When I worked at Lutheran, the CEO believed that supply chain and human resources were two things that would make or break the financial year.”

Tackling the toolbox Healthcare organizations – acute care hospitals in particular – simply cannot sidestep investing in technology in any way, whether it involves, clinical, diagnostic, surgical, administrative, financial or operational. Such technology contributes to the effectiveness and efficiency of providing care to patients. GPOs historically have worked to help provider organizations evaluate the need

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GPO performance ratings in the tech space, however, draw mixed reviews, depending on the function, intent and perspective.

for and type of technology for front-facing clinical, diagnostic and surgical services as well as for back-office operations, including supply chain, sterile processing, accounts payable and information systems, among other functions. Much of the technology buzz during recent years has centered on IT-related areas, including artificial intelligence (AI), blockchain, robotic process automation (RPA) and robotics in general for logistical and surgical applications. GPO performance ratings in the tech space, however, draw mixed reviews, depending on the function, intent and perspective. Vizient’s Sandhu encourages providers to think realistically and with maturity about technology. “Providers do not need more technology for its own sake,” she said. “They need tools that help them make better decisions, reduce unwarranted variation and improve performance. That starts with a disciplined question: What problem are we solving, where does it fit in the workflow and how will we know whether it improved cost, quality or operations? “In clinical and procedural categories, product and technology decisions cannot be evaluated on purchase price alone,” Sandhu noted. “A device, implant, supply or workflow tool may affect utilization, physician practice patterns, throughput, labor, outcomes and total cost of care. The question is not only what something costs, but whether the right product is being used in the right place for the right patient, and whether variation is clinically justified.”

GPOS MANEUVER THROUGH CHANGING MARKETPLACE

Sandhu emphasizes that technology must be used to fit into a larger aim. “Clinically integrated supply chain gives providers a shared fact base for those decisions. By connecting product cost, utilization, procedural, outcomes and contract intelligence, health systems can bring supply chain, finance, value analysis and clinical leaders into the same decision model, align on the right actions and monitor whether decisions are delivering the intended financial and clinical results,” she said. “Vizient’s role is to support that work through healthcare expertise, categoryspecific strategies, benchmarking, procedural analytics, implementation support and governance models. The goal is not to add another dashboard. It is to help providers make confident decisions that reduce unwarranted variation, protect quality and turn clinical supply chain performance into a measurable enterprise value lever,” she added.

Providers need more than product information but help in understanding which technologies will deliver measurable value and fit within their broader operational and clinical goals, according to Premier’s Radcliff.

Cleveland Clinic’s Downey feels that GPOs are well-equipped to satisfy technology demands based on the social networks of their members. “By knowing the members and serving as a many-to-one evaluation, GPOs can do tech briefs on all sorts of offerings,” he indicated. “Equally important is creating forums and mechanisms for members to share what’s actually working in practice. That peer-level intelligence cuts through vendor marketing and helps systems identify real innovations worth a closer look.” Providers need more than product information but help in understanding which technologies will deliver measurable value and fit within their broader operational and clinical goals, according to Premier’s Radcliff. “Providers are increasingly looking for technologies that connect data across the enterprise rather than create additional silos,” he said. “GPOs can help by evaluating solutions through the lens of performance, interoperability, scalability and long-term return on investment.” Radcliff echoes the application of social interaction as key. “Perhaps most importantly, GPOs can bring lessons learned from across their membership. Organizations often benefit from understanding what has worked, what hasn’t and how their peers have approached similar technology decisions. The goal isn’t simply to help providers buy technology. It’s to help them successfully implement and use it to improve outcomes,” he insisted. Strong expresses a critical eye about GPOs and their mastering of technologyrelated issues – and with a logical reason.

November 2026 | The Journal of Healthcare Contracting

“Not to bang on the GPOs, but there are several things that GPOs still do not do terribly well: Capital equipment procurement, services contracts, value analysis and meaningful new product evaluation from small and start-up companies.” These four areas share a common thread, according to Strong. “They require a high degree of personalization, by health system or facility,” he observed. “This limits the scalability of them, and with three national GPOs in about 99% of American hospitals, it is understandable that they struggle. They have done a good job on evaluating limited amounts of new technology. The limits are understandable because they would be inundated with new ideas.” Strong acknowledges that GPOs can offer more personalized services through consulting divisions, which can be costly

www.jhconline.com

additions to members’ budgets if they aren’t able to apply their share-back funds to these services. As something of a workaround to the CCD, several GPOs work with smaller groups of members to transact business through their corporate purchasing systems so they can collect and analyze data in the areas of pricing and usage, which ties into rebates, according to Strong. “Doing things that are group purchasingcentric for your members is always a win,” Strong said. “But you’ve got to do it efficiently, you’ve got to do it effectively and it’s got to be credible. And your members have to agree – or a portion of your members have to agree. When you get to 2,000 or 3,000 hospitals, it gets very complicated. Not everybody wants to share their data either. But GPOs can still grow and succeed.”

“Doing things that are group purchasingcentric for your members is always a win. But you’ve got to do it efficiently, you’ve got to do it effectively and it’s got to be credible.”

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To me, I would say that a truly strategic nonacute partnership spans visibility, strategy, standardization, activation, and accountability. It’s having someone that can be a trusted advisor throughout the entire process and become an extension of the team. Health systems are under tremendous pressure to control costs. Where can they find meaningful supply chain savings beyond negotiating lower unit prices? Heyndrickx: Of course, price matters and is im-

portant. But we also need to look at the bigger picture. Look at variation. Look at inventory. Look at freight. Look at how many suppliers and SKUs are being managed. Look at products that are expiring on shelves. And look at how much time clinical teams are spending ordering supplies, tracking things down, or dealing with issues that really shouldn’t require their attention. That’s especially important in non-acute because those costs can be spread across hundreds of locations. A little inefficiency at one site may not look like much. Multiply it across the network, and it’s meaningful. So, I think the question is not only, “Did I get the lowest unit price?” It’s also, “What does it actually cost me to operate this supply chain, and where is complexity creating expense that I may not be seeing?” What is your vision for the role Henry Schein can play as health systems navigate this evolution? Heyndrickx: Our role is to be a trusted part-

ner that health systems can rely on to connect its larger strategy with what’s happening across the non-acute network. Henry Schein has served healthcare professionals for more than 94 years. We bring together a breadth of products, services, and technologies with strategic guidance,

When GPO alignment, distribution, and site-level practices are disconnected, health systems can miss opportunities for contract compliance, standardization, visibility, and savings.

analytics, and people who understand the non-acute supply chain. We want to help a health system assess where it is today, use the data to identify opportunities, help activate those opportunities across the network, and then stay engaged to measure the results. That’s really what we’re trying to accomplish with what we call ALIGN, our approach to serving the non-acute supply chain. It’s not a product or a software solution. It’s a strategic process to help health systems see, understand, and optimize their non-acute network. How important is it for health systems to align their GPO strategy, distribution model, and site-level execution — particularly across non-acute care? Heyndrickx: GPO strategy can

create significant value, but that value is only realized when contracts translate into purchasing behavior and consistent execution across the network. When GPO alignment, distribution, and sitelevel practices are disconnected, health systems can miss opportunities for contract compliance, standardization, visibility, and savings. The goal is to connect the strategy to what actually happens at each site — while ensuring the distribution model supports the needs of both acute and non-acute environments.

November 2026 | The Journal of Healthcare Contracting

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 TRENDS

John Strong, a healthcare industry veteran with more than 50 years in executive supply chain leadership among provider organizations, suppliers, service companies and group purchasing organizations (GPOs) has participated on both sides of the discussion throughout his varied career – as a source contributing data and information to such lists and also as an assessor and validator of such lists. Strong spoke with JHC Senior Writer and Columnist R. Dana Barlow, who, for more than three decades, has tracked GPO history back to the concept’s debut in 1910 with the Hospital Bureau of Standards and Supplies Inc., about the value, variance and verity of these lists, particularly around GPO performance.

Measuring What Matters JHC in GPO Performance

: What are some of the inherent dan-

gers in producing lists like these beyond

John Strong Healthcare Industry Veteran

Humans love lists, particularly those “listicles” that media outlets post, print and publish to promote something, causing readers to brag, criticize, dissect and wave off, too, whether it involves consumer enthusiasts and fans or professionals in the various trades. What tickles our fancy are topics like “best hospitals,” “best suppliers,” “best GPOs” and “top GPOs,” among myriad others.

their obvious entertainment and marketing value, but also in reading, interpreting and extrapolating from them? Why? Strong: There are several problems. Perhaps the most important is any internal bias when a buyer of any kind offers a supplier a “best” recognition. Why did they create the list? Is there a quid-proquo? Because most lists don’t post how the awards were calculated, it is impossible to really know why an individual or company landed on any list. Another big problem is there are hundreds of them, all using different metrics for determining how a hospital became a “Top 100” for example. Why? Some of the metrics are arguably right (low HAIs, for example). Others are arguably

November 2026 | The Journal of Healthcare Contracting

wrong. Does patient care admissions make a difference? Usually, when we know how an award was made it is for qualified vs. quantified reasons. All of this is much like restaurant reviews and star ratings. Everyone has different expectations so they may not align with your worldview. JHC: Focusing on GPOs, what do you feel are some useful metrics to consider when ranking GPOs and why? Strong: There are probably a few useful metrics that could be developed. Part of the challenge, however, is whether every national and regional GPO was willing to participate. Members probably would have to participate, too. Some useful metrics include: ` Contracted dollar volume spend going through the GPO by product category, unbundled. ` Measured commitment levels by contract, expressed in dollars, rolled up to a product category. Estimating or validating commitment in either dollars or percentages is arguably tough to do, and it requires transparency by customers. For many customers there is real fear in providing too much of this type of information, especially if they are a “cherry picker” and play different suppliers against one another. Greater transparency may lead some suppliers to actually offer better deals. ` Meaningful (not member preference) bid and pricing analysis of large spend products, compared to quality using real value analysis.

www.jhconline.com

Estimating or validating commitment in either dollars or percentages is arguably tough to do, and it requires transparency by customers.

I’ve suggested that for commoditized products it might be interesting for GPOs to conduct meaningful value analysis and not act like some of their members who treat VA as a form of the old “New Products Committee.” For young folks, those have been around for more than 50 years. GPOs find themselves in an interesting position when they do this, however. For multiple-category suppliers, there is always the risk of Contract Administration Fees (CAF) getting in to play as well – something that doesn’t always assist with member returns for those who care about the cash they receive back from the GPO. Life is sometimes filled with doubleedged swords and ambiguity, isn’t it? ` Meaningful “partnerships” with suppliers to offer value beyond price and demonstrate it for both the member and the supplier. We can’t go on looking at just price – although some prominent health systems have done GPO shootouts in the past few years focusing only on that. Today, too many people forget that good negotiations allow both parties to come away with a win. ` Real cash returned from the GPO to the member that can be applied to the cost of products. The former Consorta GPO was at 80% cash returns to members when it merged with HealthTrust. GPO bucks that are earned and can be applied to GPO services are largely meaningless unless a member finds true value in those GPO services.

 TRENDS

As a buyer, I always question being rewarded for buying more of something in the first place.

While these are all great thought-provoking suggestions, there is little incentive for more transparency across most parts of the supply chain. In some cases, the practicality of even obtaining, then cleansing information is highly questionable beyond food for thought. Even with the federal government setting standards unwinding the types of GPOs, their participating members (because some hospitals/providers belong to more than one GPO) and providers may see it like an impossible task.

supplies is second only to labor in most healthcare facilities. JHC: What measures should be avoided or excluded and why?

Medicaid reimbursement?

Strong: Because of continuing GPO consolidation, the risk of violating antitrust laws also grows. It is not just about the GPOs, however. Some suppliers who look at their market share within the national GPOs could become alarmed if they take a serious look at who they have contracts with, and what percentage of market share they control within the three. As a buyer, I always question being rewarded for buying more of something in the first place.

Strong: Private payers might be willing to get involved, because the cost of all

JHC: What are some of the complications

JHC: Could participation be motivated by linking it to Medicare and

(beyond advertising/sponsorship or bias) that can arise that might call the data and interpretations into question? Strong: There are many. To your point about lists, examine just the number of hospitals that each of the national GPOs claim as members far exceeds the number of hospitals in the U. S. Because no one has ever established “uniform reporting requirements” for the GPOs there is always the risk of double counting purchase volume (Regional GPO volume being double counted with national, for example). Some experts believe that while there are modest aggregate savings with one national GPO versus another, it is highly dependent on what products within the product category a member hospital is using. That can tip the balance in favor of one GPO or another. High compliance

November 2026 | The Journal of Healthcare Contracting

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 TRENDS

How Healthcare Consolidation Might Impact GPO Market Share Data Making sense of data shared can hit speedbumps. BY JOHN STRONG

It has always been difficult to determine who is contracting for what volume across the healthcare supply chain. After all, some contracts are written outside a traditional, national group purchasing organization by a health system or integrated delivery network (IDN). In other cases, a regional GPO may be used by a hospital, or an affiliated ambulatory surgery center or other site of care. Hospital mergers, acquisitions and consolidation have continued over the past decade, pausing only for the global pandemic, and now rebounding again. This coincides with the consolidation

of hospitals usually around a large “anchor” facility, and more recently academic medical centers. Examining the number of hospitals within a health system and their GPO affiliation only tells part of the story, because it overlooks the purchasing volume they bring to a GPO. A recent “Research Letter” in the JAMA Health Forum indicates that when measured by number of hospitals, Vizient has the largest “share” of hospitals at 2,066 hospitals (43.4%)1. While true, this doesn’t really indicate the total impact and contract value that Vizient, Premier or HealthTrust have on the healthcare supply chain. It’s just one measure.

Reported Hospital Mergers and Transaction 140 120 100 80 60 40 20 0 2014

2015

2016

2017

2018

2019

2020

2021

2022

2023

Source: Kaufman-Hall Merger and Acquisition Reports 2014-2024

2024

In 2024, my consulting partner Joanna Almeida and I examined the purchase volume going through each of the three largest national GPOs, using supply and pharmaceutical expense data, and aligning it with GPO membership at that time, which showed considerably more volume and “share” going through each of those national GPOs. There are specific reasons for this. Vizient counts as members almost all the academic medical centers in the U. S. [because it includes the former University HealthSystem Consortium] and has an agreement with the Children’s Hospital Association (CHA) with their 200 plus members for GPO and other services. Both are voracious users of supplies, far greater than community hospitals, and more likely to represent significant volume for their national GPO. Indeed, our research indicated that in 2024 [the most recent year available] when measured by volume, the results show a considerable skewing toward Vizient market share at 54% versus 43.4%. Once again, this data focuses on the largest three GPOs in terms of reported facility numbers and annual purchasing volume.

November 2026 | The Journal of Healthcare Contracting

Why is this distinction important? Let’s count the ways. ` As consolidation of hospitals and small health systems into larger ones has continued, it also has fueled continuing consolidation within the largest national GPOs, with Vizient as the most likely “winner” when a hospital merger occurs. For example, after years of quiet, academic medical centers are now acquiring more hospitals around them, and in other states.2 ` As the federal government continues to examine the role of “middlemen” in the healthcare supply chain, something that reached a fever pitch during the healthcare reform years of the mid-to-late 1990s through the early 2000s, it is important that they have the best actual picture of the market. That must include contract volume — not just hospitals participating within a GPO; ` Small and rural hospitals are seeing more financial distress, but as contracting has “evolved” over the years, have they really benefited by being part of a large GPO because 1

National GPOs Total Med/Surg Supply Costs

HPG

18%

Premier

28%

Vizient

of the use of pricing tiers and compliance requirements based on volume? Contracting has moved (in many cases) to volume-based price tiers. This generally relegates smaller hospitals, including rural ones, to the worst pricing tier, or worst discount, because they simply do not have the volume to get a better price. ` Market share can certainly be defined in a number of ways, including number of hospitals and volume of purchases. The number of hospitals a group counts among its members is less valuable than the impact of the dollar volume of purchases being made through a particu-

lar group, and the results they get for both their members and the suppliers with which they write contracts. I call this “Actual Controlled Volume” (ACV) and is something members should be examining as they evaluate the performance of their GPO. ACV represents one factor of the so-called “leverage” a GPO has with suppliers. Whether using a GPO (national, RPG or your own) are we obtaining the very best value for healthcare in general? As financial pressures continue to grow, perhaps it is time to look at what we’ve been doing over the past three decades and try something a bit different.

T seng, Wei-Hseng, MS, Bond, Amelia, PhD, and Dean, Emma B., PhD, “Consolidation of Hospital Affiliations with Group Purchasing Organizations, September 11, 2026, JAMA Health Forum, Vol. 7., No. 9. Condon, Alan, “Becker’s Hospital Review”, Wednesday, December 17, 2025.

Editor’s Note: John Strong is a 50-year veteran of the healthcare industry with executive leadership experience in healthcare providers, suppliers and service companies and group purchasing organizations. Strong was inducted into Bellwether League Foundation’s Healthcare Supply Chain Leadership Hall of Fame in 2011.

www.jhconline.com

 TRENDS

interjected their own opinions vs. what the public might think. They are probably best used for entertainment purposes unless they have solid quantification of how the results were achieved.

or sole source contracting may also skew results. When you see one “shootout” you have seen one shootout. Period. JHC: In your opinion, who might be “qualified” or even accepted as establishing any kind of “uniform reporting

JHC: How might AI assist or detract

requirements?” If the federal government

from sharing accurate (or as accurate

declined to do it, does it make sense for

as possible) data?

the group purchasing industry “police

Strong: It probably can’t because the technology “scrapes” information from various sources and then puts it together to reach a conclusion. Garbage in will result in AI garbage out, or hallucinations about what is happening.

themselves,” so to speak? Perhaps the Healthcare Supply Chain Association (HSCA) or the Healthcare Group Purchasing Industry Initiative (HGPII) could spearhead efforts? Strong: Either AHRMM, HSCA or HIGPII could all possibly seek to sort this out. However, there is little or no motivation for HSCA or HIGPII to do so. Plus, participation in any of these groups is voluntary, and usually involves fees. AHRMM used to survey members for certain metrics, but they abandoned that long ago. The bottom line here may be that no single organization has enough financial or other incentive to do this work, and the industry continues to use what is available.

JHC: How does one scrutinize lists like these with a scrupulous eye? Strong: Common sense. If you believe everything you read on the internet, there are politicians who want to meet you. While all the “best” lists are interesting, and provide room for conversation, you probably cannot put much stock in any of them. In some cases, in the past, publishers have taken artistic liberty with lists and

The bottom line here may be that no single organization has enough financial or other incentive to do this work, and the industry continues to use what is available.

JHC: If you’re reading a listicle, how do you determine whether the research conducted, methods used and conclusions reached are valid and reliable? Do all three have to be accurate to achieve reliability? If not, which one or two of the three could be sacrificed? Why? Strong: [Ask] yourself who conducted the survey or research and why. It becomes obvious very quickly why a list got created, and why. Although we have moved beyond the “Everyone is a winner.” stage of life in the U. S. (perhaps), folks cannot deny that they love to see these things in print, with their name, as evidence they are doing something right. It is also useful performance review as time rolls around. Everybody loves a winner, Jimmy!

[Editor’s Note: Strong concludes with a reference to the 1967 song written by William Bell and Booker T. Jones, recorded by Jimmy James & The Vagabonds a year later.]

November 2026 | The Journal of Healthcare Contracting

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