Repertoire Feb 2024

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vol.32 no.2 • February 2024

Can’t Anything Be Done About Prior Authorization?

Physicians say they’ve had it up to here. But will that change anything?

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CONTENTS FEBRUARY 2024 • VOLUME 32 • ISSUE 2

Can’t Anything Be Done About Prior Authorization?

Physicians say they’ve had it up to here.

But will that change anything?  p. 30 ` PUBLISHER’S LETTER

2

` LEADERSHIP

26 The Power of a Career Mentor

Becoming the Trusted Source

How the PWH Mentor Program guides aspiring healthcare leaders throughout their careers.

` PHYSICIAN OFFICE LAB

4

PAMA on Pause

What has changed, and what future events can reps anticipate, when it comes to PAMA?

` COMMERCIAL HEALTHCARE

PROVIDERS

10 Omnichannel Personalization

How to optimize the HCP journey, engagement, and sales results.

14 The Ultimate Sales Lesson A Lyft ride I’ll never forget.

` INFECTION PREVENTION

16 Fit and Feel

Why it’s time to revisit your glove business.

Primary care provider focused on seniors sees growth after CVS Health acquisition.

43 CHPs in the News ` TRENDS

36 Senior-Focused CHPs

44 Heart Failure: It’s Complicated

37 ChenMed Well-Positioned in Healthcare Market

48 An Alarming Trend

Senior care presents a huge growth opportunity for market disruptors.

` SALES

42 Oak Street Health Could Add up to 60 More Centers in 2024

The Miami-based primary care company’s focus on senior care has it sought after by at least one major retailer.

40 Humana’s CenterWell Seeks Bold Growth

CenterWell Senior Primary Care treats over 270,000 seniors in 12 states and plans to open 50 more centers by 2025.

Primary care doctors are taking on more responsibility for a complex chronic condition.

What’s to blame for the prevalence of obesity in the United States?

` HEALTH

50 Respiratory Season

How healthcare providers and the population at large have fared this fall and winter.

52 Health News and Trends ` IDN INSIGHTS

54 Blended Plans

` LEADERSHIP

Formed from two S.C. health systems, Prisma Health tackled challenges of different approaches.

18 Leadership Journeys

57 IDN News ` HIDA

59 Questions to Ask When Vetting Suppliers

` READING LIST

Henry Schein’s Sanchia Patrick believes a person’s individual brand can have a transformational effect on organizations, and the client they serve.

22 A CustomerCentric Calling

Thermo Fisher Scientific’s Nick Urban believes the voice of the customer is critical to adapting to market changes.

24 The Human Element

How Midmark’s Sue Hulsmeyer works to foster an inviting company culture that will attract and retain exceptional employees.

60 The Transformational Power of Purpose

Finding your purpose in 2024.

` MARKETING MINUTE

63 Outlining Clear Marketing Goals ` NEWS

64 Industry News

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POSTMASTER: Send address changes to Repertoire, 350 Town Center Ave, Ste 201, Suwanee, GA 30024-6914. Please note: The acceptance of advertising or products mentioned by contributing authors does not constitute endorsement by the publisher. Publisher cannot accept responsibility for the correctness of an opinion expressed by contributing authors. Periodicals Postage Paid at Lawrenceville, GA and at additional mailing offices.

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February 2024

19 What Are You Known For?

1

Publisher’s Letter

Becoming the Trusted Source Henry Schein’s Sanchia Patrick believes a person’s individual brand can have a transformational effect on organizations, and the clients they serve.

In this month’s issue of Repertoire, Sanchia explains that highly visible brands in the marketplace are easy to spot and usually simple to define. Think Apple, Tesla, and Amazon.

As I read this article while proofing the February issue, it reminded me of how important branding is, even in today’s online buying world.

I regularly quote a survey we did a year or so ago where we asked the audience the reasons why they buy a product or service. Hands down, the top reason was “when recommended by a friend or family member.”

I took two things from Sanchia’s insights: 1. For the distribution reps, creating your own brand ensures you stay front and center with your clients so that you can be that “friend or family member” recommending those manufacturers you trust will bring value to practices.

2. For the manufacturers, ensuring your brand is front and center to the distribution reps on a regular basis is more important than ever. They tell us they will not sell a brand they do not trust or a product they have not been trained on.

February 2024

Manufacturers, I just painted the problem you must solve if you want to gain market share through the channel – staying in front of distribution regularly and educating them on how to talk about your product. Without being cheesy or sounding like I am trying to sell you on Share Moving Media, we can help. In fact, we have been helping best-in-class manufacturers for 30 years gain market share and mind share with the distribution reps. We provide a simple plan called ICE that allows you to be the “friend or family member” (i.e. the distribution sales rep) who can recommend your product to their customers: I – Information. Through RepConnect, we house the information reps need to sell your products.

C – Communication. Through ads and content in Repertoire, we promote your brand to the reps on a regular basis.

E – Education. We build short two-minute videos to train the reps on how to recommend your products.

2

If you would like to better understand how we can help you build your brand as well as your category, please contact me at sadams@sharemovingmedia.com and I will get you to one of our business development directors.

Dedicated to the Industry, R. Scott Adams Repertoire

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editorial staff editor

Mark Thill mthill@sharemovingmedia.com managing editor

Graham Garrison ggarrison@sharemovingmedia.com editor-in-chief, Dail-eNews

Jenna Hughes jhughes@sharemovingmedia.com art director

Brent Cashman bcashman@sharemovingmedia.com circulation

Laura Gantert lgantert@sharemovingmedia.com

senior sales executive

Amy Cochran (West Coast) acochran@sharemovingmedia.com (800) 536.5312 x5279 sales executive

Aili Casey (East Coast) acasey@sharemovingmedia.com (404) 625-9156 publisher

Scott Adams sadams@sharemovingmedia.com (800) 536.5312 x5256 founder

Brian Taylor btaylor@sharemovingmedia.com

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Repertoire is published monthly by Share Moving Media 350 Town Center Ave, Ste 201 Suwanee, GA 30024-6914 Phone: (800) 536-5312, FAX: (770) 709-5432; e-mail: info@sharemovingmedia.com; www.sharemovingmedia.com

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Physician Office Lab

PAMA on Pause What has changed, and what future events can reps anticipate, when it comes to PAMA? Â Each time we approach the end of a calendar year, I begin thinking of the coming year’s February

February 2024

physician office lab column on the Protecting Access to Medicare Act (PAMA) for Laboratories.

While some of the information may appear redundant or at least “no discernible change” from the prior year’s update, PAMA stands alone as the largest threat to the financial viability of labs large and small across the United States. As a consequence, it is also the subject of several legislative appeals by the National Independent Laboratory Association (NILA) and the Association for Diagnostics and Laboratory Medicine (formerly AACC).

So, where do we stand this year? What has changed and what future events can we anticipate?

As I approach PAMA this year, I also plan to shed some light on the overall private payer insurance landscape and shed some light on how it differs from Medicare coverage for lab tests.

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What has changed with PAMA? The good news is that PAMA reimbursement cuts have been delayed once again. 2024 marks the fifth consecutive year Congress has stalled planned PAMAmandated reimbursement cuts for tests covered by Medicare under the Clinical Lab Fee

By Jim Poggi

the link to the CMS CLFS site is: www.cms.gov/medicare/ payment/fee-schedules/clinicallaboratory-fee-schedule-clfs.

In addition to current and past CLFS fee schedules, there is a lot of useful information here.

It includes information related to the history of past PAMA cuts as well as an explanation for the current delay in reimbursement reductions. There are also links to a variety of other resources useful to you as you gain experience as a laboratory consultant and many items valuable to share with customers and prospects. Much of the information explains Medicare policies and procedures as they pertain to coverage under the CLFS. Another change since PAMA was enacted has been the

2024 marks the fifth consecutive year Congress has stalled planned PAMAmandated reimbursement cuts for tests covered by Medicare under the Clinical Lab Fee Schedule (CLFS). reintroduction of “local coverage decisions” back into the CLFS. As you may remember, PAMA eliminated the patchwork quilt of local coverage decisions for ALL lab tests covered under the CLFS when it was implemented. When PAMA was implemented all local coverage decisions were abolished, which increased payment under CLFS in certain markets. From the viewpoint of understanding Medicare payment amounts across the country, the virtual elimination of local coverage decisions made reimbursement

effect of cutting-edge assays into the physician office market, it is valuable to review the list of local coverage determination assays to see where the cuttingedge technology is leading us.

History indicates we will see many of these assays coming to the physician office market based on clinical utility as the technology becomes more readily adapted to the physician office market. The adoption of molecular respiratory assays shows the clear pathway for migration of complex technology into our market and customer base.

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February 2024

Schedule (CLFS). The legislation which avoided the decrease this year is the Further Continuing Appropriations and Other Extensions Act of 2024. It establishes the next data collection period where applicable laboratories must report private payer rates for lab CPT codes as calendar Q1, 2024, indicating there will be no further cuts in CLFS reimbursement in 2024. Any subsequent cuts in later years will be subject to the 15% decrease which is part of PAMA legislation. This information is subject to change, so it is advisable to stay in touch with your key lab suppliers and to review the CMS CLFS information frequently.

As most of you know the Centers for Medicare and Medicaid Services (CMS) manages the Clinical Lab Fee Schedule. For those newer to the lab business,

of CLFS tests far easier to understand and communicate.

But, as of the Q4 2023 version of the CLFS, local coverage decisions are creeping back into the CLFS again. There are currently 98 local coverage decision assays in the CLFS data base of 1,959 tests, 5% of the total number of covered tests. MOST of the assays subject to local coverage decisions are high complexity molecular and next generation sequencing assays and not typically performed by our customers.

As an example, CPT code 0333U is “Surveillance of liver cancer in high-risk patients using algorithm”. Most local coverage decisions involve similar assays with a molecular component and many that use large scale data to assess risk. But, given the trickle-down

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Physician Office Lab

Another big change in the current CLFS lab fee schedule is the number of covered tests.

With 1,959 reimbursable tests, the 2023 fee schedule covers 193 more tests than the 2021 CLFS did. That’s more than a 10% increase in only two years.

Interestingly, while there are COVID assays on the list as we would expect, many new tests are either molecular or molecular with risk assessment based on large scale data analysis. This tells me that we have a powerful research and development engine at work keeping new and more clinically valuable tests entering the pipeline. Innovation is clearly alive and well in the lab market.

Further proof of the proliferation of new high complexity and high reimbursement assays comes from two different sources. First, from the CLFS data base, there are now 119 molecular/next generation sequencing tests which reimburse $1,000 or more each. And secondly, spend under the CLFS which was intended to decrease under PAMA has increased steadily since 2018 to 2021. From a historical perspective, Medicare Part B paid out $9.3 billion in 2021 for lab compared to $6.8 billion in 2016.

Some of the increase is directly attributable to COVID tests, but a substantial portion is also due to new high value and high reimbursement molecular assays.

What has NOT changed?

Remember our old friend, SALSA (Saving Access to Laboratory Services Act)? Despite the clear rationale to delay payments under PAMA, extensive lobbying from the laboratory industry and multiple short term funding acts by Congress, SALSA has still not passed as of December 2023. It was originally proposed in June of 2022 and is still under active consideration but has not yet become law. Given the history of SALSA and other congressional funding acts related to PAMA it is hard to say whether SALSA will ever become law. But, overall, it is clear there is support from Congress to assure continuing access to laboratory tests and services in one way or another. This is certainly good news and the fact that substantial cuts in reimbursement have been delayed is a welcome relief to our customers and helps us add value as consultants to physician office laboratories.

What about private insurance?

February 2024

The threat posed by PAMA has largely been to reduce reimbursement levels to those typical of private insurance. Now that is has been established that we have a delay in PAMA reimbursement cuts, what about private insurance? Here is where the crystal ball becomes especially cloudy for many reasons. First, the diversity of private insurance carriers and the multiple local geographical coverage areas where private pay reimbursement is established provides a very complex network of carriers and rates.

Further complicating matters, large physician practices sometimes negotiate different rates within a payer coverage area.

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Physician Office Lab

From a practical viewpoint, it becomes nearly impossible to understand private insurance payments for lab tests on a national basis. The best the distribution account manager can do is to stay current with Medicare reimbursement and seek guidance from their home office and key lab suppliers around financial conversations with customers. From my perspective, it has always been advisable to refer customers and prospects to their practice billing experts and the insurance carriers they work with. There is a lot of risk in trying to understand private pay reimbursement at any specific practice level

February 2024

Another big change in the current CLFS lab fee schedule is the number of covered tests. With 1,959 reimbursable tests, the 2023 fee schedule covers 193 more tests than the 2021 CLFS did. That’s more than a 10% increase in only two years. and no real advantage in doing so. Keeping the conversation focused on clinical value, providing quality technical consulting from our trusted lab suppliers, and keeping a distance from conversations related to private pay reimbursement has been the approach that seems to work best.

As an interesting side note on private pay insurers, on an overall basis, Medicare’s CLFS has adopted cutting-edge molecular and next generation sequencing assays faster than the typical private insurance carrier. In my experience, private insurance companies tend to require more substantial proof that new

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cutting-edge assays reduce the cost of a covered life. In other words, the insurance companies tend to ask themselves “if we cover the cost of this expensive new lab test today, does it reduce our lifetime costs of covering this patient?” Often new tests need to be extensively proven to provide longer, more complication free quality of life free from substantial morbidities before the private pay insurance companies will provide more than token coverage. As risk analysis based on large scale data analysis and artificial intelligence takes hold, I expect changes in the viewpoint of private insurance companies.

Any time they can reduce lifetime costs of patient coverage, they will react and respond accordingly. Rapid changes are taking place in the ability to prove the worth of new cutting-edge assays.

Overall, as some things change, others remain the same.

The well-versed distribution account manager keeps their finger on the pulse of change and frequently engages their trusted lab suppliers for the best way to communicate the value of lab.

Practice and experience lead to confidence. Our customers want and need the information we can provide to make informed decisions on lab testing in their practices. The changing landscape regarding PAMA and reimbursement in general points to the need to stay informed to provide the best possible information to our customers and prospects. The best lab consultants tend to have the largest lab customer base and also the most satisfied customers.

Stay informed to be the best.

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This product has been authorized only for the detection of proteins from SARS-CoV-2, not for any other viruses or pathogens; and, in the USA, the emergency use of this product is only authorized for the duration of the declaration that circumstances exist justifying the authorization of emergency use of in vitro diagnostics for detection and/or diagnosis of COVID_19 under Section 564(b)(1) of the Federal Food, Drug and Cosmetic Act, 21 U.S.C. §360bbb-3(b)(1), unless the declaration is terminated or authorization is revoked sooner.Unt. Viverteatum dem vit atatimoente tionesta nitant? Etiam. Ox notili pes ego auterit anterfe ciocaeque furnia pultur, sum ina, unclest involudem, ut publicio et in stis culese perficiae patiamd ienatore, non vem deatiem Romnos, nesi sedius tem condit.

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Sales

Omnichannel Personalization How to optimize the HCP journey, engagement, and sales results

By Dan Snyder, Senior VP of Sales for Performance Development Group (PDG)

 One of the key strategies that has emerged in medical sales is adopting an omnichannel approach

February 2024

directed toward customers. Omnichannel loosely dates to about 2010 as a solution to improve sales performance through a unified customer experience. After over a decade, you might expect widespread omnichannel adoption, but a 2022 DHC Group study of 50 medical sales executives revealed otherwise. While 98% recognized Omnichannel’s importance, over half admitted not optimizing Healthcare Professional (HCP) engagement across touchpoints.

For medical sales companies, sales are not just about revenue but also about improving patient outcomes and delivering life-saving products and services. Sales reps play a pivotal role in ensuring HCPs have access to the latest and most effective solutions that can

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positively impact their patients and advance their practices.

The omnichannel experience is pivotal in achieving better sales performance. When HCPs have a consistent and positive experience across all touchpoints, they are more likely to have that brand top-of-mind and are more apt to

engage through their preferred channel when the need arises.

This article will explore how sales reps can leverage omnichannel to revolutionize the customer journey by creating a more personalized experience to improve HCP engagement and enhance sales performance.

Unifies sales and marketing channels and messaging

Omnichannel strategies in the medical sales industry redefine the landscape of HCP engagement by seamlessly integrating various communication channels.

Instead of having an assortment of disconnected channels, an omnichannel approach intricately weaves these platforms together, leveraging modern technology to merge previously separate online and offline platforms into a unified and manageable system.

From the standpoint of HCPs, this interconnectedness among channels eliminates the sensation of being overwhelmed by redundant or sometimes inconsistent messages across different platforms (such as representatives, emails, messaging apps, social media, and websites). Instead, it fosters a unified, coherent interaction that enriches the brand experience.

Improves sales strategy and execution

Adopting an omnichannel approach can also significantly bolster life science sales strategies and execution.

Omnichannel helps streamline the sales process by empowering sales reps with comprehensive insights into HCP interactions across various channels. Armed with this enriched understanding, reps can craft tailored conversations and offerings, leveraging a nuanced comprehension of the HCP’s preferences and engagement history. This personalized approach not only nurtures ongoing relationships between sales reps

and HCPs – instilling a sense of reliability and trust that is pivotal for nurturing long-term partnerships – but also heightens engagement and markedly improves the overall efficacy of the sales process, leading to higher conversion rates and repeat sales.

approach ensures that HCP interactions are aligned across all channels, creating a unified and satisfying experience. This not only fosters customer loyalty but also drives sales growth and the adoption of life science solutions.

Creates a customercentric focus

Effective communication is critical in healthcare and life science sales, both externally with HCPs and internally among team members. Omnichannel is pivotal in streamlining communication to improve the customer experience.

Externally, HCPs may have questions about product details, clinical studies, or patient outcomes that need prompt responses. Through integrated communication platforms, such

Medical sales companies recognize the evolving expectations of HCPs. These professionals have limited time and diverse needs and preferences, so it is essential to meet them where they are, whether online, on social media, through email, or in person. Omnichannel enables life science companies to focus on creating a personalized, customer-centric journey.

Streamlines communication

A 2023 Veeva report on HCP omnichannel engagement trends revealed that brands with greater synchronization between digital media and field force interactions saw a 23% boost in marketing effectiveness, outperforming all HCP campaigns.

By leveraging an omnichannel approach, medical sales companies can track HCP behavior, preferences, and feedback across all channels.

This information can then be used to create personalized experiences and touchpoints for each HCP. For example, the sales rep can schedule regular face-to-face meetings if a particular HCP prefers in-person visits. If another HCP is more comfortable with email communication, tailored emails can be sent with relevant product information.

HCPs expect consistency in how they are treated and the information they receive. An omnichannel

as online chat, video conferencing, and CRM systems, life science sales teams can respond quickly and provide the information HCPs seek. This enhanced communication can convert a skeptical HCP into an informed and satisfied one, increasing engagement and sales.

Internally, omnichannel can improve collaboration among customer-facing teams such as sales, medical affairs, market access, operations, and regulatory.

This collaboration ensures all departments are aligned to engage effectively with HCPs and drive life science sales performance.

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February 2024

How Omnichannel builds HCP engagement

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Sales

Improves the customer journey

Adopting an omnichannel approach has proven instrumental in refining the customer journey. By seamlessly integrating various touchpoints, medical sales companies can curate a tailored experience for HCPs, optimizing engagement.

It ensures a more cohesive and personalized journey for HCPs, meeting them at every stage of their decision-making process. By leveraging data insights on HCP preferences and behaviors across various platforms, companies can craft seamless and relevant experiences. This customized approach, empowered by the omnichannel strategy, not only strengthens the brand’s value but also facilitates smoother progress toward mutually beneficial outcomes.

Scenario: Dr. Patel, a busy cardi-

ologist, has been exploring different treatment options for his COPD patients. Amidst a demanding schedule, he frequently engages with medical sales representatives and accesses medical information through various channels, seeking the most relevant and up-to-date data to support his patient treatment decision-making.

AI’s role in omnichannel strategies significantly enhances the sales process by enabling sales reps to deliver more relevant and valuable information to HCPs, ultimately strengthening relationships and improving overall outcomes in the life sciences sector.

Traditional approach: In the past,

Dr. Patel’s experience included frequent visits from multiple reps.

This led to a higher propensity for inconsistent messaging, thus creating frustration for Dr. Patel.

Omnichannel approach: After deploying an omnichannel approach, Dr. Patel now receives synchronized messaging from a multitude of modalities. This approach augments the sales reps’ efforts of engagement. It allows the sales rep to understand what resonated with the doctor and the potential next best steps for future engagements.

This integrated approach ensures Dr. Patel receives consistent and relevant information across all touchpoints. It empowers him to make informed decisions

swiftly, leading to improved patient care and treatment outcomes.

AI is the name of the game, and sales reps are the quarterbacks Artificial Intelligence (AI) is an integral component in revolutionizing omnichannel strategies. Like a quarterback orchestrates plays on the field, sales reps use AI-driven intelligence as their playbook. AI’s advanced algorithms analyze vast amounts of data from various sources, including HCP interactions, historical data, preferences, and market trends. It then generates prescriptive insights for sales reps, offering tailored suggestions on the most appropriate next steps to engage with the HCP. These insights range from personalized communication strategies to recommending specific content or services. AI’s role in omnichannel strategies significantly enhances the sales process by enabling sales reps to deliver more relevant and valuable information to HCPs, ultimately strengthening relationships and improving overall outcomes in the life sciences sector.

Omnichannel adoption: Four success challenges February 2024

Despite the evolution and advancements in digital technologies, the journey toward widespread omnichannel deployment has encountered unexpected hurdles.

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Here are four of the primary reasons, according to the DHC Group study:

1. Data and Technology Integration – 45% of medical

sales executives cited difficulties arising from the intricate nature of data integration and management.

2. People, Structure & Culture – An even more substantial 54% of executives indicated the challenge of internal adoption of omnichannel.

3. Lack of Personalized Content – Content remains a substantial

obstacle in brand marketing, with 62% of survey participants expressing a lack of personalized content for the HCP.

4. Unified Platform Aligned with KPIs – Nearly 67% of respon-

dents reported an unfulfilled requirement for a unified interface that oversees and regulates omnichannel engagement organization-wide.

Conclusion Adopting an omnichannel approach is pivotal for life science

companies trying to remain competitive in an evolving market.

However, the path to success is not without challenges. Life science companies’ mission should include a commitment to ensuring that innovative solutions meet HCPs’ needs and positively impact the patients they serve. By addressing these challenges headon, life science companies can take full advantage of the benefits of omnichannel and forge a path to enhanced HCP engagement and sustained growth.

Dan Snyder is a seasoned sales and business leader with a rich background in the pharmaceutical/biotech industry. Currently serving as the Senior VP of Sales for Performance Development Group (PDG), Dan has held leadership roles at Astra USA, Diachii Sankyo, Shire, Nitromed, Clarus Therapeutics, Syneos Health, and Delta Point. Adept at overcoming challenges, Dan is known for his passion for sales, commitment to coaching excellence, building high-performing teams, and ability to achieve outstanding results.

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Sales

The Ultimate Sales Lesson A Lyft ride I’ll never forget. By Brian Sullivan

 Alright, folks. Buckle up for a story that’s worth more than a year’s subscription to any sales train-

February 2024

ing program. This isn’t your typical rags-to-riches spiel. It’s about a Lyft ride.

Yeah, you heard that right.

A simple ride from the Houston airport to a cruise ship in Galveston. But here’s the twist – the driver, Jeremiah, gave me the kind of lesson in sales and life that you can’t get in a classroom.

There we were, my family and I, exhausted from our flight, waiting for our Lyft. And what rolls up? Not some shiny, highend sedan. No, sir. It was a Ford pickup that looked like it had been through every backroad in Texas. This thing had ‘character’ written all over it – rust spots like badges of honor, seats that had more stories than a library, and a dashboard that was a testament to its years of service.

Then came Jeremiah. Picture this – an old man, but with a spark in his eye that could put a twinkle in a diamond. He was thin, with hands that told tales of hard work. He wore this cap – oh, this cap – it was purple, faded, and had “Ask Me About Jesus” written on it. That cap wasn’t just a piece of clothing; it was an invitation to a world of stories.

As we embarked on our journey, Jeremiah started talking. But this wasn’t your run-of-the-mill small talk. This was a masterclass in engagement. He asked questions – real, deep, meaningful questions. He listened – not just heard, but really listened – to what

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we had to say. In those moments, we weren’t just passengers; we were the center of his universe.

Now, let’s talk about the truck. Every creak of the seats and hum of the engine was like a note in a symphony of simplicity. It was hot – Texas sun beating down on a metal box kind of hot. But Jeremiah’s stories made us forget about the sweat and the discomfort. He talked about his life, his faith, his love for

fishing. He described this fishing spot of his – it sounded like a slice of paradise – with such vivid detail that I could almost see the sun setting over the water.

Captivating your audience But here’s the kicker – the way Jeremiah talked, with passion, with sincerity, with a joy that was infectious, it was a lesson in authenticity. This guy wasn’t just telling stories; he

it’s the people and the stories that make the trip memorable.”

Throughout the cruise, I found myself reflecting on Jeremiah’s words. I sent him pictures of the trip, not out of pity, but out of a newfound appreciation for sharing joy. Jeremiah wasn’t just a Lyft driver; he was a teacher, a philosopher, a master salesman without even trying to be.

pickup, taught me that the most powerful tool in sales – and in life – is genuine human connection. It’s about making the person in front of you feel like the most important person in the world.

And that’s the secret, folks. In a world where everyone’s trying to sell something, the key to success is not just understanding your product; it’s understanding people. It’s about

Jeremiah, in his beat-up Ford pickup, taught me that the most powerful tool in sales – and in life – is genuine human connection.

So here’s the lesson: Sales isn’t about the pitch, the close, or the product. It’s about connection, authenticity, and joy.

Jeremiah, in his beat-up Ford

listening, engaging, and connecting on a human level. That’s how you make a lasting impression. That’s how you turn a customer into a friend. And that’s how you turn a simple sale into a lifelong relationship.

In the end, this journey with Jeremiah was a Lyft ride and a wake-up call. It reminded me that in the hustle of closing deals and hitting targets, the real value lies in the stories we share and the connections we make. So next time you’re out there, remember Jeremiah and his old Ford pickup. Remember that the best sales pitch is not always about selling; sometimes, it’s simply about being real, being human, and spreading a little joy.

Brian Sullivan, CSP, is the founder of PRECISE Selling and a leading voice in the field of sales training and development. He believes in the potential of every salesperson to achieve their best and continually challenges sales professionals to reach new heights. To have Brian Sullivan or one of his stable of trainers and coaches help your team get to the top, visit him at www.preciseselling.com.

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February 2024

was sharing pieces of his soul.

And every word, every gesture, every laugh was genuine. He wasn’t selling us anything, but we were buying every word.

As the city gave way to open roads, and the hustle of Houston faded into the background, Jeremiah kept us captivated with his perspective on life. He had faced hardships, sure – the dialysis, the struggles – but his outlook was like a beacon in the fog of negativity. He found joy in the little things, in the connections he made, in the stories he shared.

When we finally arrived at the cruise ship, Jeremiah looked at that massive vessel with a sense of wonder that was almost childlike. And in that moment, he said something I’ll never forget: “You’re about to embark on a wonderful journey, but remember,

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Fit and Feel Why it’s time to revisit your glove business. By Paul Girouard

 Have you been asked if you are a “glass half full or half empty person?” I am a glass half full

February 2024

person when talking about the glove category. I know it’s easy to groan and get caught up in all the complexity and moving parts from the past few years, but I see opportunity and would like to present my case.

When you look at the infection prevention category and what products might fit into it, gloves would be the largest component. The market potential in units is an estimated 48 billion gloves per year for

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healthcare. If you were to pull them out of infection prevention and they were their own category, they would be ranked the fourth largest in the physician market segment, and second in the long-term care segment.

Put on a pair of exam gloves and wear them as long as you can.

Then remove them and repeat.

Spend some time doing this again and again. Now you will experience what clinicians do throughout their entire career. You can

We see gloves from a business and logistical perspective, but we forget that this might be one of the most highly emotional and personal product categories there is.

Customers don’t like change; they don’t want to switch gloves unless there is good reason. They are loyal to their brands. than pre-pandemic rates. Besides supply and demand issues, freight has impacted cost and those issues lasted well beyond the pandemic. During this time facilities used what was available, choice and preference weren’t options. End-users were compliant with hand hygiene and glove use and double gloving became common practice.

So here’s the opportunity.

Just like you are revisiting the glove category, your customers are as well. End-users had to wear gloves that were available through some pretty tough times.

They saw what bad looked like and they were educated the hard

Educated the hard way Over the last three years the market was tight, then flooded.

Product costs skyrocketed, then plummeted. Pricing has now leveled off and is slightly higher

Important factors What is important to end-users when making the right glove choices? The following are important things they will consider: ` Glove materials – Nitrile has become the material of choice in healthcare. ` Glove characteristics – Gloves have become thinner, softer, and more comfortable to wear. ` Country of Origin – Manufacturers have moved production.

There was a shift from Malaysia to China, Thailand, and the United States. ` Logistics – Service levels and visibility to inventory is now extremely important. ` Sustainability – The company and its ability to support the brand with sales support, clinical support, and marketing.

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February 2024

understand quickly that they know what is comfortable, and what they trust with their personal safety. We see gloves from a business and logistical perspective, but we forget that this might be one of the most highly emotional and personal product categories there is. Customers don’t like change; they don’t want to switch gloves unless there is good reason.

They are loyal to their brands.

way on what is important when making the right glove choices.

Use this as your time to revisit the category and pivot to what customers are looking for, not what they had used in the past.

Ease their pain points. Take time to review your glove business.

What might have gone away, or what accounts never bought but might be an opportunity. Work with your glove manufacturers to sample where necessary. Clinicians need to see, feel, try-on and feel comfortable with the glove.

This is the time to be an educated resource to your customers for an important category.

Wash your hands.

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Leadership Journeys

February 2024

A successful career in the med/surg industry takes determination, grit, and a willingness to learn.

Repertoire Magazine sat down with current med/surg leaders to learn more about their career journeys, their perspective on best strategies to lead teams through marketplace changes, mentorship, and advice for new sales reps.

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What Are You Known For? Henry Schein’s Sanchia Patrick believes a person’s individual brand can have a transformational effect on organizations, and the client they serve.

 Highly visible brands in the marketplace are easy to spot and usually simple to define. Think Apple, Tesla, and Amazon. Because behind each of those brands is an incredible purpose, mission, and vision. are they could be described by a single word: effective, memorable, intentional, etc. Those are elements of their brand.

They also have a purpose behind their brand, the thing that drives them.

For example, Patrick’s purpose is exhortation. She takes an interest in those she interacts with by thanking them for their time and displays a posture of curiosity about their lives and the work they do.

February 2024

The same can be true of personal brands, said Sanchia Patrick, Vice President of U.S. Medical Commercial Marketing for Henry Schein Medical. Think of the most successful leaders you’ve come across. Chances

Sanchia Patrick

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“When I start feeling negative or critical, I know that I’m deviating from my purpose,” Patrick said. “I’m showing ‘off brand’ in those instances. I might need some time away to recenter and reclaim who I’m supposed to be and what I’m called to do, whether it’s professionally or personally.”

Patrick learned this lesson during a difficult experience early on in her career. As a product manager in her 20s, Patrick had been heavily involved in a new product launch that had failed in the marketplace. It was excruciatingly painful to spend six to nine months of her life apologizing to clinicians about the product failure. “It was one of the few times I’ve ever gone platinum with Delta,” she said.

“I was flying all around the country and going into operating rooms, trying to explain to surgeons what had happened.”

Yet during the difficult conversations, Patrick started mastering the art of apologizing to customers genuinely, authentically, and transparently. While it was painful, it taught her how to show up, look customers in the eye, and have the courage to discuss failure with them.

“It led me to believe I could actually thrive in dark times,” she said. By trying to encourage customers when they were upset, many of them thanked her for the frank discussions and dialogue on what their options were moving forward.

“It taught me to be a lot more courageous in the line of fire,” she said. “In marketing, you learn that you are the brand, and you account for the experiences. “That was probably the worst time of my career, but it led to some of the best growth professionally and personally in terms of humility and courage.”

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“Employee” carries a more transactional connotation. As a Team Schein Member, an individual is part of the fabric of the company, Patrick said. “You matter. We really are all about our people, whether it be holiday parties, back-to-school events and other ways to give back to the community.

It’s a company that’s defined by the people.”

Patrick can remember thinking she couldn’t handle the critical remarks and that she was being asked to be the prime chief apologizer for a multi-billiondollar brand. Not only that, it was a product launch that she had believed in, had spent countless hours working on, but had failed.

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Looking back on that experience and her leadership journey overall, Patrick said she would tell her younger self to do what’s right and stand by what she knew to be true, versus being concerned about what everybody else is thinking and saying.

“We live in a workaholic culture,

a performance-based culture, and a culture that sometimes values superficial things,” she said. “When you really know who you are and you can stand in your being, you can find joy in every single day and every single moment without getting caught up in what everybody else is doing,” Patrick said. We spend too much time worrying about what other people think.

“I think my younger self would’ve really appreciated my now self saying, ‘Stand in your truth. Stand in your purpose,’” Patrick continued.

“And do the best that you possibly can and no more.”

The makings of a team There are several attributes Patrick is looking for when adding to or promoting within her team. The first trait is humility.

“I love strong people and present people, and I love people that can own a room. But if you’re not humble and you don’t know you can fall just as fast as you climbed, if you don’t have the ability to allow someone else to shine, you’re probably not going to be a good fit within my team,” she said.

“So, humility is huge. Humility evolves over time and experiences give you that opportunity.”

Curiosity is another trait.

“All great leaders are curious.

They’re learners who want to ask all sorts of questions. Curiosity is demonstrated in listening and the ability to ask questions.”

Patrick also looks for diversity. Her team varies in age, race, political beliefs, religious beliefs, and geography. “In marketing, everybody can’t be a New Yorker. Our customers

Culture’s contribution As an organization, Henry Schein’s respected brand is fostered by its positive workforce culture. “We’re not employees

at Team Schein,” Patrick said.

“We’re Team Schein Members.”

“Employee” carries a more transactional connotation. As a Team Schein Member, an individual is part of the fabric of the company, Patrick said. “You matter. We really are all about our people, whether it be holiday parties, back-to-school events and other ways to give back to the community. It’s a company that’s defined by the people.”

A role to play Patrick believes the med/ surg industry as a whole has a unique opportunity in front of it. While med/surg stakeholders understand the healthcare landscape, they don’t quite know how they fit into the mental or behavioral health market yet. Outside of pharma, there are no products to throw at the problem, she said. What products are being

Demonstrated competence is a key trait.

It’s great to have someone who is likable and lovable, but Patrick also highly values skill and competence. You’ve got to be able to get the job done, do it well and be able to work well with others. “I don’t compromise on competence.”

Team Schein Members will often hear directly from the Company’s chairman and CEO, Stanley Bergman, about successful projects and accomplishments.

“There are so many people on my team that have heard directly from him over email.

Leadership is saying: ‘I saw you; I see you, and you matter.’”

When Patrick interviewed to join the company as a Marketing Director, Stephanie Shen, the company’s Chief Product Officer, told her that while Henry Schein is a big company, Team Schein Members have a chance to make their mark. “She told me, ‘If you have an idea or recommendation, if you contribute, you can actually put your fingerprint on it and people will know that it was you.’ Not all big companies are that way.”

used for depression, besides medication? What products do you treat anxiety with? Face masks? Gloves? Lab tests?

Today’s mental health crisis can’t be understated.

One in three adults, according to the CDC, has had a depressive episode in a 12-month period. Anxiety disorders and substance abuse are at record highs – and that’s just for adults.

“I think this is an enormous challenge in the conditions that are treated in healthcare,” she said. “Every company that purports to have a healthcare mission and vision needs to play a part.”

It’s a topic Patrick is passionate about and will be putting her purpose and brand behind in the years to come.

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February 2024

are everywhere. Our customers look, feel, and sound different.”

There’s a diversity of thought to consider as well. Someone who has the courage to express their point of view, especially when it is counter to what a leader might be saying, is essential.

Demonstrated competence is a key trait. It’s great to have someone who is likable and lovable, but Patrick also highly values skill and competence.

You’ve got to be able to get the job done, do it well and be able to work well with others. “I don’t compromise on competence.”

Finally, Patrick looks for drive – the drive to do excellent things, and the hunger to want to do excellent things, and to contribute meaningfully.

Patrick’s team is 17 strong, and if one were to glimpse into a meeting or project, these attributes would clearly be on display in each individual. “There is a combination of humility and drive that’s evident,” she said.

“These folks ask amazing questions in very different ways, are highly competent, and continue to learn through continuing education and certifications to sharpen their saw. The combination of these attributes is highly attractive in marketing. They create a team full of A-plus players that could go anywhere. You want to be with people who could choose to be anywhere, but they’re choosing you because they believe in your brand and purpose.”

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A Customer-Centric Calling Thermo Fisher Scientific’s Nick Urban believes the voice of the customer is critical to adapting to market changes.

 In unprecedented times, Nick Urban, Vice President of Sales, Thermo Fisher Scientific, learned the conviction it takes to change business strategies to adapt to the market, all while remaining focused on how to best support Thermo Fisher’s customers.

“During the pandemic, I got heavily involved in the day-today operations of the supply chain, supporting my commercial organization, increasing my visibility with all customers, and also really hearing first-hand how the company could better support these customers,” he said. “We then infused the voice of our customers to make real-time adjustments to adapt to the market.”

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Successful transitions Urban stepped into the role of VP at a time when the company was navigating both pandemic and post-pandemic strategies, such as real-time inventory, supply chain KPIs, and increased tolerance for overhead/stock to further support customers – all of which changed Urban’s leadership focus to increase partnerships with both customers and colleagues.

Moving into a new role can be an intimidating experience for any business professional, no matter the market conditions. Fortunately, Urban has had experience taking on new tasks.

Earlier in his career, Urban made the move from sales rep to sales leader. According to Urban, the

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Nick Urban

biggest impact he experienced from moving from a sales rep to leader was the jump from being an individual contributor to leading people. “Instead of influencing your own ‘outcome’; coaching, developing, and driving others toward outcomes becomes the most critical aspect of the job.”

Guiding, coaching, and driving others toward success means knowing when to step in and knowing when to let an individual learn. It also means that positive feedback and recognition for teams, as opposed

to seeking recognition as a leader, is most important, said Urban.

To be successful and gain recognition as a sales rep, key business tactics include confidence, readiness and ability to learn, being willing to win, and exceptional presentation skills are all intangibles.

As for other keys to developing teams of high-performing sales reps, “As a VP, I operate with transparency and with the mindset of ‘I will not ask you to do something you

won’t see me do,’” said Urban.

“Leaders have the responsibility to develop high-performing individuals.” For Urban, that includes increasing exposure and responsibilities for high performers, tasking them with a stretch assignment, and shadowing and mentoring opportunities.

Navigating the current marketplace Today’s marketplace is constantly changing because of post-pandemic disruptions, trends, and technology. To be successful in gaining a customer’s attention and trust, companies must recognize this,

and tailor their messaging to fit the customer experience.

“To be successful in the industry, employees must incorporate the customer (and colleagues) experience and voice; they cannot be static, they must constantly be adapting to the market trends, especially in healthcare which has been quite dynamic over the last few years,” he said. “Our customers are at the tip of the spear, infusing firsthand knowledge into shaping the business is critical.”

Industry challenges including labor shortages, wage inflation, and healthcare aggregation continue to reshape the market. The introduction of new technologies

such as artificial intelligence (AI), lab automation, and products that support point of care testing are also forcing organizations to rethink the way business is done.

Companies must evolve in the face of those changes and challenges to meet customers’ needs.

As for advice for sales reps in the industry, Urban said: “Increase your connectivity, relationships across the continuum of care are extremely valuable, never take for granted the breadth, scale, and complexity of supporting the supply chain of a healthcare system or customer, always be a partner, and be visible and be fully entrenched in the industry.”

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Leadership

The Human Element How Midmark’s Sue Hulsmeyer works to foster an inviting company culture that will attract and retain exceptional employees.

 A company’s culture is a crucial measure of its success. A culture that stands out in the marketplace depends on both its values and the people who make up the organization, said Sue Hulsmeyer, who joined Midmark in 2001 and was recently promoted to the role of Chief People and Administrative Officer. “For employees to perform well and take care of their customers, they must feel supported and heard at work.”

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A successful company culture Midmark strives to create a company culture that retains and supports its employees throughout their career journey. In her position, Hulsmeyer leads talent management, succession planning, and leadership development. Hulsmeyer also oversees the implementation of Midmark culture, values, and the teammate experience to ensure that all people functions align with policies and programs.

“This role reflects our leadership’s belief that we need to take care of our teammates (employees) so that they can take care of our customers,” said Hulsmeyer. “We invest in our people, our most important assets, and foster a culture of health, safety and well-being. My team, which includes HR, corporate communications, enterprise learning, corporate events, philanthropy, and the executive administrative assistants, is inspired by this vision.”

Many businesses faced challenges throughout 2020 and 2021, with the pandemic requiring quick reactions and dynamic problem-solving from

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Sue Hulsmeyer

Attracting top talent The pandemic resulted in significant changes within the workplace, and the job market is now more competitive than ever, especially for employers trying to attract top talent. In the industry of healthcare especially, it is crucial to create an inviting culture to attract exceptional employees.

“It’s vital to our industry to maintain a successful, inviting culture in the workplace so that we can continue the work to improve healthcare experiences, patient outcomes and quality of care within the medical, dental and animal health environments,” said Hulsmeyer.

Young people decide to take jobs for a multitude of reasons and have greatly different expectations for their employers now than before the pandemic. A Forbes article titled, “What Do Newer Generations of Employees Want, And Can Your Business Adjust?” discusses how companies can adapt their practices to attract the next generation of employees. The article highlights four workplace factors that matter to younger workers, including that they expect their views to be noticed and acted on, they want a personalized and

easy-to-use work experience, they want to believe in the value of their work and their company’s purpose, and they seek shared experiences but want the flexibility to support their interests.

To meet these expectations, you must listen to your employees and offer the work environment and tools that spur innovation and excitement, said Hulsmeyer.

“By providing a work environment that fosters innovation and creativity, you can empower your employees to make a difference in the healthcare industry.”

foster a culture of collaboration and innovation across the organization and with our customers.

By working closely with customers, leaders can better understand their needs and provide them with the best possible solutions.

Midmark introduced “The Human Deal,” a development program with the goal of maintaining a better focus on workplace culture to better align with corporate values. The Human Deal consists of elements including personal growth, ensuring that employees feel supported

“ It’s vital to our industry to maintain a successful, inviting culture in the workplace so that we can continue the work to improve healthcare experiences, patient outcomes and quality of care within the medical, dental and animal health environments.”

Growth in a role Today’s marketplace is highly competitive, and employees are demanding better workplace cultures to meet their professional and personal goals. Many new job seekers within healthcare are entering an entirely different industry than the one that existed 10 years ago.

“To grow as leaders, professionals in the healthcare industry need several things from their organizations,” Hulsmeyer said.

“They need to adopt a strategic mindset and holistic view of healthcare. They need to master the use of technology to optimize their work, align their objectives with the organization’s mission, vision and values, and

and that they are continuing to grow as people, not just professionals, as well as holistic well-being and shared purpose (making sure that employees feel invested in the organization on societal and cultural issues).

As for advice for leaders in the industry, Hulsmeyer says, “As a company, we believe in fostering a positive work environment and strive to create a culture that is not only supportive, but also engaging and enjoyable.

As leaders, we need to help our employees learn to be agile and courageous, which is part of our core values at Midmark. To grow as a leader, you need to learn how to adapt to changing situations and customer needs.”

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February 2024

leaders. According to Hulsmeyer, “During this time, we faced a multitude of challenges that were medical, emotional, physical, political, and religious in nature. However, I learned that in high-pressure situations like these, it is essential to lead with empathy and respect. Trusting the leaders around you to make the most educated decisions for your employees and your company is also crucial.”

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The Power of a Career Mentor February 2024

How the PWH Mentor Program guides aspiring healthcare leaders throughout their careers. By Jenna Hughes

 Beginning a career in healthcare presents an individual with many aspects of the industry to

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learn, understand, and feel comfortable with in order to be successful. This is especially true postpandemic, as the healthcare industry has experienced many changes that industry professionals must continue to adapt to. www.repertoiremag.com

in their mentee’s personal and professional growth.”

Importance of mentorship The goal of mentorship is to guide an individual throughout their career, and so a mentor relationship can be especially impactful for individuals that have just begun a career in the healthcare industry.

“Mentorship is a vital part of being able to keep up with the professional we want to be in our industry,” said Dr. Weber. These career-long professional relationships have the potential to benefit both the mentor and the mentee.

within the industry to help carry all of those complexities and those competing priorities that exist in healthcare.”

Mentors are defined as trusted advisors, and therefore, the sharing of experiences and insight within the relationship allows individuals with different skill sets, positions, and roles to share with one another, grow from a better understanding of the industry, and learn something new.

Critical business skills such as communication, how to differentiate from competitors, resiliency, etc. – and lessons related to these skills – can all be shared and gained within a mentor/mentee relationship.

“What a mentoring relationship does for both a mentee and a mentor is help build that total self-awareness, because with a mentor you’ve got an external view, and we all need that to really continue to grow and develop as people,” said Dr. Weber.

The beginning of the PWH Mentor Program Dr. Khaki Weber

“Mentors get as much out of the relationship as mentees do, and what mentors also gain is the self-satisfaction and intrinsic motivation that exists within people who stand back to watch a person blossom and grow in their career,” said Dr. Weber. “We have to make sure that we feed our own, right in our own backyard, and build a pipeline of talent so that we can grow broad shoulders

The Professional Women in Healthcare (PWH) Organization allows women entering the healthcare industry to seek guidance and advice through many different forms of industry-related programming.

PWH started in 2004, when two of the founders attended the Health Industry Distributors Association (HIDA) Conference and noted to each other that there were few women attending. The healthcare supply chain industry has historically been a largely male-dominated industry.

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Seasoned industry professionals have continued to work throughout these changes, and through experience have discovered new ways to work, overcome obstacles, and remain confident throughout challenges. However, for individuals who have recently entered the industry, these skills may take time to learn and develop.

That’s where having a trusted mentor comes in. A mentor, or an experienced and trusted professional advisor, guides an individual throughout their career. Mentors take on a role that differs greatly from the role of a manager, boss, coworker, or friend. Instead, mentors provide more personalized, focused guidance that is free of evaluation or judgement.

“In the industry today, healthcare professionals face provider and staff shortages, supply chain disruptions, financial strain, and more; and as professionals in the industry, we’re left trying to juggle all of those balls, regardless of what role we’re in,” said Khaki Weber, DBA, RN, MBA, MHA, Partner at Weber & Associates Consulting, Inc., and PWH Member.

There is a distinct difference between the role of a mentor and a coach. According to Dr. Weber, a boss or manager should take on the role of a coach: “they may give an individual similar insights, feedback, or constructive criticism as a mentor would, but ultimately, they are in charge of you to judge and evaluate work within the parameters of success or failure. A mentor, however, does not evaluate your work, and therefore has a vested interest

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be a professional organization that brings together women professionals in healthcare.

The three tenants of PWH’s founding included (and remain today) mentorship, networking, and education. Mentoring is a significant part of the organization’s core structure, and has become much more formal and structured throughout the years.

At the beginning of the PWH Mentorship program, the mentorship committee was using software that used an algorithm to match mentors with mentees, which proved to be old, clunky, and ineffective in creating long-lasting matches.

The mentorship committee, as a result, considered a more personalized approach to mentorship matching, “talking with those who wanted to be mentees, and then going about making those matches with other PWH members. To this day, we’ve been using this personalized approach to the program for over three years, and it seems to be working. We have record mentoring relationships,” said Dr. Weber.

others, and encourage other members along their career journeys.

“I had the ability to connect with other individuals in small group settings through the PWH Mentor Circle Program,” McCann said. “In one group, we discussed the qualities that make a good leader. The perspectives shared helped me to learn so much not only about myself, but also how to interact with different leadership characteristics and qualities to be successful. I walked away with a higher level of knowledge to put into practice in my career and personal life. I then went on to lead a Mentor Circle, where we discussed how to best communicate within the professional and personal avenues of our lives.”

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Career-long mentorship Many women (and men) in the industry have benefitted from a space to share experiences and an opportunity to learn from other professionals through the PWH Mentor Circle Program, made up of a circle leader and 10-15 circle members.

Lauren McCann, Senior Ambulatory Care Specialist, B. Braun Medical, chose to participate in the PWH Mentor Circle Program so she could connect with other members of PWH, grow her perspectives, learn from

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Karen Bergenholtz

Other individuals Repertoire spoke to have benefited from one-on-one mentorship. Karen Bergenholtz, Vice President of Customer Implementation and Education, Enclara Pharmacia (A Humana Company), serves as a mentor for two individuals through PWH. She meets with

the mentees every three to four weeks, and also on an as-needed basis for anything that may come up within their careers.

“As an aspiring female leader in healthcare and business, it is often very difficult to find another female leader who has already walked the path to upper leadership,” said Bergenholz. “I am fortunate to have progressed to such a role professionally, and I wanted to help other females navigate the difficulty of growing professionally in an often male-dominated world. I have learned a lot from decisions I have made, and I feel it is important to share this perspective to other women.”

Men also participate in mentorship within PWH. Scott Quilty, Principal and Founder of SIXPOINT Advisors, became interested in the program because of Dr. Khaki Weber.

“Motivated by the founders’ mission and with a personal connection of having four daughters – one of whom is now a company owner and PWH member – I saw the chance to make a meaningful impact in the industry,” said Quilty.

Quilty felt that his personal career experience could assist others in their own journey.

“As an executive in two large corporations, I recognized the opportunity to create opportunities for talented women within those organizations,” he said.

Impact of mentorship As a female nurse, Bergenholz said that even in today’s workforce, the number of leadership positions held by women in the industry decrease as one moves up the organizational ladder, despite

participants have made on the greater PWH community.”

“Being able to exchange ideas and hear the perspectives of others was very impactful. It is beneficial to hear thoughts of others that are outside of your organization,” said McCann.

“By sharing in a mentor environment, we can develop new ideas and experience personal growth to propel us into the next steps in our careers. Being in such an environment fosters growth for the mentors and mentees.”

Importance of mentorship in med/surg industry The importance of mentors to guide others in the med/ surg industry is crucial, as the industry has experienced many

Learning from others who have experienced industry changes is impactful, and even seasoned leaders can gain new knowledge from more recent industry entrants.

The relationship between mentor and mentee is interpersonal, guiding both parties through whatever challenges and accomplishments they may experience throughout their professional lives.

Many of the current mentors in the PWH program express gratitude and ample positive impacts from the experience of participating both as a mentor and in mentor circles.

Said Quilty, “It has been rewarding to witness the positive influence of PWH on these individuals, and equally gratifying to see the contributions these gifted

changes recently due to technology advancements, moving forward from the pandemic, and more. Having someone who has experienced all of this can be of great benefit to an individual within the industry.

“It’s crucial to provide a trusted space for today’s med/ surg professionals as they navigate important career decisions,” said Quilty. “Offering support to eager and talented individuals as they shape their path not only strengthens our industry but ultimately improves the products and services we deliver to healthcare professionals and their patients.”

Learning from others who have experienced industry changes is impactful, and even seasoned leaders can gain new knowledge from more recent industry entrants.

“This industry is constantly changing, and the best way to continue to adapt is to learn from others and find out new ways to look at situations and gain additional understanding.

Through mentorship, individuals are given the opportunity to learn from others that have more experience, and even those that may have less experience. The bottom line is we all have different experiences that we can share to learn from one another to put into action for our own growth,” said McCann.

A mentor can be anyone in an individual’s professional career that will continue to support them, listen, and provide advice. Throughout an individual’s career journey, they may encounter numerous mentors who shape their career path and encourage them through professional outcomes.

“As people continue to grow and follow their career paths, their circumstances change, and they need a mentor who comes with that experience that will help them continue to go. Even very highly seasoned professionals in the industry still have mentors that they confide in,” said Dr. Weber.

“Some PWH members refer to mentors as their ‘personal board of directors.’ In a nutshell, it is anyone you can go to professionally who will really listen, encourage, stretch you to think outside of the box, and expand our self-awareness.”

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February 2024

many entry level opportunities for women in healthcare. For this reason, she says, “It is important as women that we support our female peers by sponsoring them within our companies, coaching them, and mentoring them within the industry.”

Having a mentor that has already walked a similar professional path allows a mentee to ask questions about professional issues and obstacles that they may face in their career.

Within these relationships, mentors should discuss how to navigate work-life balance, how to effectively work with a team and provide feedback to peers, and next steps to take within a professional career journey, said Bergenholtz.

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Can’t Anything Be Done About Prior Authorization?

Physicians say they’ve had it up to here.

But will that change anything?

P

More than 35 million prior authorization requests were submitted to Medicare Advantage insurers. ` The volume of prior authorization determinations varied across Medicare Advantage insurers, ranging from 0.3 requests per Kaiser Permanente enrollee to 2.9 requests per Anthem enrollee. ` Over 2 million prior authorization requests were fully or partially denied

by Medicare Advantage insurers. ` Just 11% of prior authorization denials were appealed. ` The vast majority (82%) of appeals resulted in fully or partially overturning the initial prior authorization denial.

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rior authorization is the process by which physicians must obtain advance approval for a device, supply or medication from the patient’s insurance plan to ensure coverage for the recommended service, per the American Academy of Family Physicians. And it’s making family physicians – and a lot of other people – angry.

Many physicians believe it makes the insurer the ultimate arbiter on what medical care should or should not be provided to their patients. They resent that practices must complete prior authorizations via multiple platforms, including web portals, electronic portals, electronic medical records systems, fax, paper forms, and phone calls.

Much of the fuss is due to Medicare Advantage plans. KFF (formerly called the Kaiser Family Foundation) reports that in 2021:

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Can’t Anything Be Done About Prior Authorization?

Historically, traditional Medicare rarely required prior authorization, and that is still largely the case, according to KFF. But 99% of Medicare Advantage enrollees were enrolled in a plan that required prior authorization for some services in 2022. Most commonly, higher cost services, such as chemotherapy or skilled nursing facility stays, require prior authorization.

Even the Centers for Medicare & Medicaid Services admits the whole process needs fixing.

“Providers expend resources on staff to identify prior authorization requirements that vary across payers and navigate the submission and approval processes, which could otherwise be directed to clinical care,” wrote the agency in a proposed ruling in December 2022. “Patients may unnecessarily pay out-of-pocket or abandon treatment altogether when prior authorization is delayed.”

February 2024

Why so galling?

“In the past, prior authorization was generally used in regard to expensive procedures and medicines,” says Steven Furr, M.D., FAAFP, president of the American Academy of Family Physicians. “It has now markedly escalated so physicians are even having to do prior authorizations for routine tests such as cardiac stress testing and generic medications. This leads to a delay in patient care. It can also sometimes lead to a loss of control of difficult medical problems such as diabetes and hypertension.”

Dr. Furr cites American Medical Association data showing that physicians and their staff spend an average of 13 hours each week completing prior authorizations. “The bottom line is our patients’ medical care and health is being impacted without any proof that most prior authorizations are necessary or needed,” he says.

Anders Gilberg, senior vice president for government affairs for the Medical Group Management Association, says “the increase in utilization of overly burdensome prior authorization requirements by health plans leaves medical groups struggling to ensure patients continue to maintain access to medically necessary care. Medical groups cite delays in prior authorization decisions for routinely approved items and services, and inconsistent payer payment policies as their top challenges.”

In its 2023 Annual Regulatory Burden Report, published in November, MGMA reported that

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97% of its members report that their patients had experienced delays or denials for medically necessary care due to prior authorization requirements.

Ninety-two percent report that their practice had to hire or redistribute staff to work on prior authorizations due to the increase in requests.

“While prior authorization requirements are onerous for all types of practices, certain specialties are subject to more prior authorization requests, namely because of the high expenses tied to their treatments,” says Gilberg. Specialties that face the highest rates of prior authorization are radiation oncologists, cardiologists, and radiologists.

“Primary care also bears a significant brunt of the burden of responding to prior authorization requests from insurers,” he says. “When making referrals/orders for specialty care, inpatient procedures, ancillary services, and drugs, primary care practices must often justify the request despite not receiving payment for the services ordered or performed. In cases like this, primary care practices bear 100% of the administrative costs.”

In search of solutions In 2018, five groups signed a “Consensus Statement” on improving prior authorization: the American Hospital Association, America’s Health Insurance Plans, American Medical Association, American Pharmacists Association, BlueCross BlueShield Association and the Medical Group Management Association.

In their statement, the groups agreed to: ` Encourage the use of programs that selectively implement prior authorization requirements based on healthcare providers’ performance and adherence to evidence-based medicine. (Some call it a “gold card” system.) ` Encourage review of medical services and prescription drugs requiring prior authorization on at least an annual basis, with the input of healthcare providers. ` Improve communication channels among health plans, healthcare providers and patients; and encourage transparency and easy accessibility of prior authorization requirements, criteria, rationale, and program changes. ` Encourage sufficient protections for continuity of care during a transition period for patients when there is a formulary or treatment coverage change or change of health plan. (In other words, providers of patients on an approved course of

Can’t Anything Be Done About Prior Authorization?

treatment would not be required to go through the prior authorization process when that patient changes carriers.) ` Encourage healthcare providers, health systems, health plans, and pharmacy benefit managers to accelerate use of existing national standard transactions for electronic prior authorization.

Says Gilberg, “MGMA signed the consensus statement in 2018, alongside several provider groups and health plans, agreeing that selective application of prior authorization, volume adjustment, greater transparency and communication, and automation were areas of opportunity to improve upon. However, since the time this consensus statement was released, medical groups report little progress in any of these areas.”

So the search for solutions continues, much of it coming from the federal government, he says.

Earlier this year, CMS finalized its 2024 Medicare Advantage and Part D rule, which included proposals to rein in detrimental prior authorization practices in Medicare Advantage.

“MGMA was pleased that the agency heeded our call to finalize the continuity of care provision, as well as the requirement for MA plans to form Utilization Management Committees,” he says.

MGMA also supports CMS’ proposed Prior Authorization and Interoperability Rule, which would implement a process to facilitate electronic

prior authorizations, requiring affected payers to publicly publish aggregated prior authorization data. “Although MGMA’s principal goal is to reduce the number of prior authorization requests, an electronic program, if implemented appropriately, has the potential to alleviate administrative burden and allow practices to reinvest resources in patient care,” he says.

On the legislative front, in July 2023, the U.S. House Ways and Means Committee passed the “Improving Seniors’ Timely Access to Care Act, intended to modernize the prior authorization process in Medicare Advantage. The bill, led by U.S. Reps. Mike Kelly (R-Pennsylvania), Suzan DelBene (D-Washington), Larry Bucshon (R-Indiana) and Ami Bera (D-California) would: ` Establish an electronic prior authorization process. ` Require the U.S. Department of Health & Human Services to establish a process for “real-time decisions” for items and services that are routinely approved. ` Improve transparency by requiring Medicare Advantage plans to report to the Centers for Medicare & Medicaid Services on the extent of their use of prior authorization and the rate of approvals or denials. ` Encourage plans to adopt prior authorization programs that adhere to evidence-based medical guidelines in consultation with physicians.

Prior authorization: A glossary of terms

February 2024

Step therapy. A specific type

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of prior authorization requiring patients to try one or more insurer-preferred medications or treatments prior to implementing a physician recommendation. This tool, primarily designed to contain the cost of prescription drugs, is used for many conditions such as cancer, arthritis, diabetes, skin conditions, heart disease, mental illness, and more, says

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the American Academy of Family Physicians. (The AAFP believes step therapy protocols “delay access to treatments and hinder adherence while risking severe side effects and disease progression for patients.”)

Continuity of care. Protecting uninterrupted care (i.e., care without prior authorization) to patients in an active course of treatment when there is a

formulary or coverage change or change of health plan.

‘Gold card’. Formally referred to as “selective application of prior authorization,” the gold card system would fast-track prior authorization requests from physicians who rank high on quality measures and adherence to evidence-based medicine, or who engage in other contractual agreements, such as risk-sharing.

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Commercial Healthcare Providers

Senior-Focused CHPs Senior care presents a huge growth opportunity for market disruptors.

February 2024

With an aging population to take care of, organizations across the healthcare industry are acquiring and investing in providers in response to changing patient demographics and preferences.

The IDN Directory defines these entities as Commercial Healthcare Providers (CHPs), organizations formed to address patient populations outside the traditional Hospital and Health System network. CHPs have formed as a result of the shift from fee-for-service to fee-for-value reimbursement models, physician shortages, consumerism and digital disruption.

The following articles examine several senior-focused CHPs and their plans for growth in 2024 and beyond.

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ChenMed Well-Positioned in Healthcare Market The Miami-based primary care company’s focus on senior care has it sought after by at least one major retailer. By Daniel Beaird

 ChenMed is a Miami-based primary care company that runs 125 clinics led by physicians focused

In July, the company appointed former UnitedHealthcare CEO Steve Nelson as president to lead the day-to-day management and operations. Chris Chen, MD, serves as ChenMed CEO but has stepped back to supply support, guidance and board governance. Nelson was

hired in 2022 to lead ChenMed’s JenCare Senior Medical Centers.

Prior to joining ChenMed, Nelson served as Co-Chairman and CEO of Duly Health and Care, one of the largest multispecialty independent provider groups in the U.S. Earlier in his career, he led UnitedHealthcare as CEO,

contributing to its status as the largest Medicare Advantage business nationally, and driving efforts that increased employee engagement and customer satisfaction.

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February 2024

on providing services to moderate- to low-income seniors with complex chronic conditions. It’s been named one of Fortune’s “Change the World” companies, a “Most Loved Workplace” by Newsweek and a certified Great Place to Work ® by the Great Place to Work Institute.

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February 2024

Commercial Healthcare Providers

toward a distinctive future,” said Nelson in a release. “The Chen family’s vision and goals have already improved the lives of thousands of seniors who had never experienced the quality of primary and coordinated health care that they deserve. We intend to build on and expand the reach of the exceptional health outcomes and experiences the Chen family has delivered to its patients, while offering the best possible environment for our teams, and achieving sustainable business results.”

ChenMed includes Chen Senior Medical Centers, Dedicated Senior Medical Centers, IntuneHealth and JenCare Senior Medical Centers. It also owns Curity, a technology company which was named a “Best Place to Work in IT” by Computerworld.

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Possible retail suitors In September, Bloomberg reported that Walmart was interested in buying majority ownership in ChenMed. The potential deal was valued at several billion dollars and would be Walmart’s biggest purchase in the healthcare sector. Retailers like Walmart are positioning themselves for the shift to value-based care to treat Medicare patients. For example, CVS Health bought Oak Street Health for $10.6 billion, and Amazon’s One Medical has almost 50 clinics for older adults.

ChenMed is the last scaled, multistate Medicare Advantage provider that has not sold to a major retailer, according to Rebecca Springer, a healthcare analyst for PitchBook.

Meanwhile, Walmart signed a 10-year deal with UnitedHealth Group in 2022 to treat its customers with Medicare Advantage, the plan

that ChenMed is focused on. Springer views Walmart as the best fit buyer but calls ChenMed a prize asset that other potential bidders could bid on.

Scaling ChenMed’s technology platform ChenMed has signed a multi-year agreement with Thoughtworks, a global technology consultancy, to maximize the speed and agility of its core operating system on AWS to support growth. ChenMed and Thoughtworks are working in streamlined product teams, using an event-driven microservices architecture and a cloud-native developer experience platform.

“We’re thrilled to bring Thoughtworks’ scaling capabilities to ChenMed as it continues to innovate with resolute focus on helping healthcare providers

deliver the best preventive primary care and value-based health outcomes for their patients,” said Tim Cochran, head of digital scaleups for Thoughtworks North America, in a statement.

ChenMed extended its relationship with Humana in 2023 ChenMed extended its longstanding relationship with

Humana in 2023, signing a new five-year agreement supplying in-network care for Humana’s Medicare Advantage members at all its locations. Humana and ChenMed first partnered in the 1990s in South Florida and strengthened the partnership in 2011 with the formation of joint venture JenCare Senior Medical Centers.

“ChenMed and our partners at Humana understand seniors, and together we have deep experience delivering on the spectrum of their primary care needs,” said Michael Redmond, CFO for ChenMed, in a statement. “This agreement guarantees our patients will continue to have access to Humana’s leading health plans, along with the personalized, high touch care we provide.”

ChenMed recently announced it has implemented an “ambitious” program to provide each of its patients with access to the services of a coordinated care team, across its more than 130 senior medical centers in 15 states throughout the country.

This company-wide integration coincides with the federal government’s unwinding of the Public Health Emergency it established during the COVID-19 pandemic, a process that now requires all Medicaid recipients to re-enroll in the program within state-by-state deadlines, or risk losing Medicaid benefits to which they might be entitled, according to a release.

Medicaid-eligible older adults are particularly vulnerable to this prospect, ChenMed said, citing a recent West Health-Gallup survey that found a sizable proportion of the older adult population in the U.S. skips treatments and cuts back on basic and essential needs due to healthcare costs. Twelve percent of those 65 and older say they or a member of their household had a health problem in the last year that they did not seek treatment for due to cost.

The survey found 11% of Americans in this age group report that they or a family member skipped prescribed pills to save money.

ChenMed’s patients are generally 65 and older and many live in underserved areas. By ensuring that those who are eligible for Medicaid successfully re-enroll within their particular state’s deadline, ChenMed’s care teams enable them to retain a variety of vital resources to support their health and wellness needs.

“We provide this service to supplement the unwinding efforts that are now underway and to make it as convenient as possible for the Medicaid-eligible seniors we serve to maintain their insurance,” said Dr. Say Salomon, ChenMed national chief medical officer, hospital and community care. “Without it, they run the risk of facing unaffordable medical bills and losing access to programs they need to stay healthy and secure.”

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ChenMed announces new coordinated care program

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Commercial Healthcare Providers

Humana’s CenterWell Seeks Bold Growth CenterWell Senior Primary Care treats over 270,000 seniors in 12 states and plans to open 50 more centers by 2025. By Daniel Beaird

 Humana introduced CenterWell in 2021 as the new brand for a range of its payor-agnostic

February 2024

healthcare services offerings. The senior-focused “Partners in Primary Care” and “Family Physicians Group” came together as “CenterWell Senior Primary Care.” Additional Humana healthcare services transitioned to the CenterWell brand over time.

It transitioned its Kindred at Home’s home health division to the CenterWell Home Health brand a year later, fully integrating home health operations into Humana. It acquired Kindred at Home in August 2021.

Now, it eyes aggressive growth for senior-focused primary care centers. Humana’s Erica Savage-Jeter, MD, division chief medical officer, told the Fierce Health Payer Summit in October that Humana plans to open 50 new senior-focused primary care centers by 2025.

CenterWell Senior Primary Care is one of the largest, fastest-growing senior-focused, value-based care providers in the country, Humana said. Together with its sister brand Conviva Care Center, the businesses make up Humana’s Primary Care Organization, delivering care to 285,000 seniors in nearly 300 centers as of Sept. 30, 2023. Centers are now open in 15 states.

Its CenterWell Primary Care Anywhere program was launched in August in Georgia and Louisiana for in-home primary care for seniors, mobilizing the capabilities

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CenterWell Home Health emergency room and hospital readmission rates in North Carolina and Virginia were more than 150 basis points lower than other providers, according to Broussard. of Heal, a home-based primary care and telehealth company recently acquired by Humana.

Patients receive services in the home that are traditionally performed in a doctor’s office as Primary Care Anywhere sends a team of clinicians to the home.

Automation, tech, AI and readmission rates Automation, consolidation, technology and AI solutions will be deployed across hundreds of branches of CenterWell Home Health, according to Humana CEO Bruce Broussard

on the company’s third quarter earnings call. “This will minimize administrative caps while improving clinician productivity – including optimizing their schedule,” he said. “We believe these initiatives will ultimately streamline our operations and lead to increased clinician productivity and satisfaction.”

CenterWell has reported an improvement in visit efficiency using a new AI digital wound management tool. “This has

been instrumental in clinical decision-making contributing to an accelerated wound healing time by 35%,” Broussard said.

CenterWell Home Health emergency room and hospital readmission rates in North Carolina and Virginia were more than 150 basis points lower than other providers, according to Broussard. And home solutions cover more than 800,000 Medicare Advantage members, driven by expansion in North Carolina and

Virginia, representing an increase of over 200% year-over-year.

According to the Kaiser Family Foundation, over 28 million people were enrolled in a Medicare Advantage plan in 2022, or 48% of the eligible Medicare population and $427 billion of total federal Medicare spending.

Medicare Advantage plans are a large part of Humana’s business and contract with the federal government to provide extra benefits and services to seniors.

Humana releases value-based care report

Based on data from Humana’s report, VBC enables: ` A team-based holistic approach to patient care, quarterbacked by their physician with greater support from a multi-disciplinary team including nurses, medical assistants, pharmacists, social workers, and others.

` Coordination across transitions in care, such as after hospital discharge, and collaborating closely with patients and their care team to minimize the risk of ending up back in the hospital. ` Technology and data usage to help catch and eliminate “gaps in care,” and make sure patients’ needs do not fall through the cracks or get lost or forgotten. ` More resources and incentives to manage health-related social needs, such as transportation benefits and community support programs.

Other key findings from the report: ` Patients receiving health care under value-based care arrangements grew by 2.3 million over the past decade. ` 2022 showed a record 70% of Individual Medicare Advantage patients aligned with value-based care providers. ` Value-based care patients were less likely to spend time in the hospital. There were 30.1%

fewer in-patient admissions for value-based care patients compared with Original Medicare beneficiaries in 2022. ` Value-based care patients were more likely to receive preventive care. Specifically, valuebased care patients completed preventive screenings at a 14.6% higher rate than Medicare Advantage members not in a value-based care arrangement.

“The data are clear: Valuebased care works,” said Dr. Kate Goodrich, Chief Medical Officer at Humana. “As our report shows, this smarter healthcare model improves outcomes for Medicare Advantage members and allows primary care physicians to practice medicine at the top of their license and develop meaningful relationships with patients. At Humana, we are proud to lead the way on value-based care for our Medicare Advantage members, and we will continue to look for ways to expand this approach into other lines of business.”

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February 2024

Value-based care is smarter healthcare that lowers costs and keeps Medicare Advantage members healthier, according to the tenth annual Value-Based Care Report released from Humana Inc. The 2023 report shows that Medicare Advantage (MA) patients receiving care under value-based arrangements spent more time with their primary care physician and were more likely to receive preventive care, with fewer hospitalizations. Meanwhile, physicians working under the value-based model are more empowered and better positioned to coordinate care while prioritizing outcomes over the quantity of services.

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Commercial Healthcare Providers

Oak Street Health Could Add up to 60 More Centers in 2024 Primary care provider focused on seniors sees growth after CVS Health acquisition.

By Daniel Beaird

 CVS Health acquired Oak Street Health last May for approximately $10.6 billion and Oak Street continues to operate as a multi-payor primary care provider as part of CVS Health. Its care model specializes in providing older adults comprehensive preventive care, including personalized wellness plans, integrated health services, and educational and social activities to support overall health and well-being.

February 2024

With plans to expand to 25 states, the primary care provider for seniors currently employs about 600 clinicians at over 170 medical centers with plans to add up to 60 more centers in 2024. Karen Lynch, CEO for CVS Health, told analysts and investors on an earnings call earlier this year that opportunities to drive higher patient growth will continue to increase as Oak Street expands to additional geographies.

“We will open new Oak Street clinics co-located with CVS pharmacies this year and have already identified additional locations for 2024,” she said. By 2026, Oak Street will have more than 300 centers, according to CVS Health, “each of which has the potential to contribute $7 million of Oak Street Health Adjusted EBITDA at maturity.”

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Few Americans feel healthcare is handled very well in U.S., especially for older adults Just 12% of Americans think healthcare in general is handled extremely well or very well in the Repertoire

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U.S., and fewer think the same about healthcare and community support for older adults, according to a poll from the Associated Press (AP) and the NORC Center for Public Affairs Research.

“When we think about primary care, it is the foundation of how we deliver healthcare in this country,” said Dr. Sree Chaguturu, executive vice president and CMO for CVS Health, in a statement. “It’s that trusted relationship that helps you navigate the complexity of the American healthcare system.”

CVS says value-based care aims to increase the focus on primary care by improving the quality of care. “We know that when you increase primary care access, good things happen,” Dr. Chaguturu added.

Oak Street is a Medicarefocused primary care provider that addresses senior patients, of which over 50% have a housing, food or isolation risk factor that impacts their access to quality care. In addition to Signify Health, a home healthcare

provider also recently acquired by CVS Health, Oak Street increases access to care for older adults.

Health services segment for CVS sees increase in third quarter CVS Health’s health services segment, including both Oak Street and Signify, increased total revenues by 8.4% in the third quarter of 2023 compared to the prior year driven by pharmacy drug mix, growth in specialty pharmacy, brand inflation and the acquisitions of Oak Street and Signify. During its third quarter earnings call, Lynch said CVS Health is scaling capabilities to accelerate growth at both Oak Street and Signify.

“Oak Street’s clinical model continues to demonstrate exceptional performance,” said Tom Cowhey, interim CFO for CVS Health, during the earnings call.

He said Oak Street was among the top 5% of ACO REACH program participants in the CMS 2022 savings performance, generating a gross savings rate of 21%.

CHP in the News GNC expands into virtual healthcare through GNC Health GNC, a U.S. health retailer, has expanded to provide healthcare services with GNC Health. GNC Health, a retailer entering the world of healthcare or a Commercial Healthcare Provider (CHP), now offers membership plans for individuals and families to make health and wellness services more readily available across the nation. Through GNC Health, patients can access virtual care services, free medications, and treatment for health conditions including allergies, flu,

earache, fever, migraine, stomach issues, UTI’s, and more, at no additional cost for members.

CVS health services business rebrands CVS announced it has rebranded its health services business as Healthspire™, bringing together its health care delivery, pharmacy and health services solutions, including: ` CVS Caremark ® and CVS Specialty® ` MinuteClinic®, Oak Street Health and Signify Health ` Cordavis™

“CVS Healthspire will enable us to deliver connected patient care, pharmacy benefits and innovative provider support solutions in communities across the country, making expert care simple, more accessible and more affordable,” the company said in a release. “From driving lower prescription drug costs to millions of Americans every day through CVS Caremark, to a fully integrated care delivery ecosystem utilizing digital, community, homebased and traditional channels, we’re transforming care to drive superior health outcomes and a seamless consumer experience.”

CenterWell Home Health announced it supplied more than a quarter-million meals in its latest drive to feed people in need in the communities it serves around the country last fall.

Thanks to the generosity of individuals and organizations, CenterWell last fall has collected food and financial donations equivalent to 289,490 meals, according to Susan Benoit, president of CenterWell Home Health.

“We are humbled by the kindness of the many people who gave this year,” Benoit said. “We finished nearly 40,000 meals ahead of last year. It’s so rewarding to be able to make a difference in the lives of people in need.”

With more than 350 branches in 38 states, CenterWell Home Health provides clinical care to help patients regain their confident, independent selves. Whether managing a chronic condition or recovering from illness, injury, surgery or hospitalization, CenterWell’s nurses and therapists work together with patients, their families and their health care providers to create a personalized care plan.

This fall marked CenterWell’s 19th annual Food/ Fund Drive, conceived to help fight against food insecurity – a known social factor that affects health – in the communities CenterWell Home Health serves.

Over the years, CenterWell Home Health (previously known as the home health division of Kindred at Home) has collected over 1.3 million meals.

Staff across the country were invited to participate in the 2023 drive, collecting a total of 139,400 meals to assist those in need. The top team was the Portland, Maine branch, bringing in 21,261 meals. The Atlanta regional operations team finished a close second with 21,250 meals, and the Wichita Falls, Texas branch chipped in 10,933 meals. The Humana Foundation contributed $15,000 in cash to the campaign, or $5,000 for each of the top three finishers.

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CenterWell Home Health collects 289,000 meals for needy Americans

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Trends

Heart Failure: It’s Complicated Primary care doctors are taking on more responsibility for a complex chronic condition.

 More than 6 million adults in the United States have heart failure, and primary care physicians are

February 2024

playing a bigger role in their care.

About 60% of people in the United States with heart failure are treated solely by primary care or internal medicine/family practice providers, says Nancy Albert, PhD, CCNS, CHFN, CCRN, NE-BC, FAHA, FCCM, FHFSA, FAAN, associate chief nursing officer, research and development, at Cleveland Clinic’s Stanley Shalom Zielony Institute for Nursing Excellence as well as past president of the Heart Failure Society of America.

Even when hospitalized, some providers choose not to consult with a cardiology provider.

Cardiologists continue to play an important role, of course.

Patients often seek a cardiologist’s care if they want a second opinion, or if they are hospitalized and a cardiologist is assigned to them. Nor are primary care physicians likely to lead the treatment of patients with heart failure that is due to genetic causes and high-risk, low-frequency causes.

“But there are not enough cardiologists to manage all heart failure patients in this country,” says Paul Heidenreich, M.D. professor and vice chair for quality, Department of Medicine, Stanford University School of Medicine. “Thus, many primary

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care physicians will help manage, or exclusively manage, those with mild heart failure.”

It’s something for Repertoire readers to keep in mind as they call on their customers during Heart Failure Awareness Week, Feb. 11-17.

What is heart failure?

Heart failure often results from poor left ventricular function. It is the contraction of left ventricle of the heart that forces oxygenated blood through the aortic valve to be distributed to the entire body. With such an important role, decreased function can induce symptoms of the disease.

The “ejection fraction” is the amount of blood that the heart

pumps each time it beats. It is measured as a percentage of the total amount of blood in the heart that is pumped out with each heartbeat. A normal ejection fraction is 50% or higher. An ejection fraction below 40% means the heart isn’t pumping enough blood and may be failing.

Adults may be at risk for heart failure when they have other forms of cardiovascular disease (e.g., high blood pressure, coronary heart disease, post myocardial infarction, valve disease, atrial fibrillation or other dysrhythmias), type 1 or 2 diabetes, obesity, chronic obstructive pulmonary disease or other conditions, says Nancy M. Albert PhD, CCNS, CHFN,

Avoiding hospitalization The primary care physician’s role in treating people with heart failure is like that of the cardiologist, if they are the

sole provider of heart failure care, says Dr. Albert. That role includes determining the cause of heart failure (and then treating it, if modifiable), conducting regular assessments, testing for improvement or worsening of the condition, and initiating and optimizing heart failure medications.

Adds Dr. Heidenreich, if a specialist is managing the condition, the primary care physician should monitor for a decline in the patient’s health status and notify the specialist of any change. The specialist’s treatment plan should be made clear

Some patients are hospitalized for acute decompensated heart failure because they fail to follow lifestyle recommendations, such as eating a heart-healthy diet, stopping smoking, walking every day, decreasing sodium content in foods eaten, getting a flu shot, managing high blood pressure or high lipid levels, or taking their medications as prescribed. “In these cases, it is very important for providers to educate patients on lifestyle and medications so that patients understand instructions (what, how, why, when...) and can be adherent,” says Dr. Albert.

The other way providers can help patients avoid hospitalization

‘ There are not enough cardiologists to manage all heart failure patients in this country.’ to the primary care physician, and if there is concern that this plan is not following recommended guidelines, the primary care provider should raise these concerns with the specialist.

An important goal for any doctor treating patients with heart failure is to help them avoid hospitalization.

Says Dr. Albert, in general, neurohormones are produced when the heart is under stress, during “decompensation.” The neurohormones that are released make the heart work harder and affect the kidney as well, leading to worsening heart and kidney function. They also cause symptoms (e.g., difficulty breathing) that bring the patient into the hospital. Even after reducing symptoms of an acute episode, the neurohormones in the body may still be activated and can lead to worsening outcomes.

is by prescribing evidence-based heart failure medications, she says.

There are four classes of medications patients with heart failure and reduced ejection fraction should be on: renin-angiotensin system inhibitors (ACEi, ARB or ARNI), beta-blockers (evidencebased), mineralocorticoid receptor blockers, and sodium glucose co-transporter inhibitors.

Not for lone wolves Managing treatment for people with heart failure calls for continual monitoring by the primary care team and ongoing collaboration with specialists and the patients (and/or their caregivers) themselves. The reason is, heart failure is complicated.

According to the American College of Cardiology, more than 50% of Medicare patients with heart failure have four or Repertoire

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February 2024

CCRN, NE-BC, FAHA, FCCM, FHFSA, FAAN, associate chief nursing officer, research and innovation, at Cleveland Clinic’s Stanley Shalom Zielony Institute for Nursing Excellence.

Heart failure often displays itself with shortness of breath, fatigue, irregular heartbeat, abdominal discomfort and swelling in the legs and feet. Doctors are likely to order tests – most often, echocardiography – to determine ejection fraction, but they also rely on cardiac catheterization, magnetic resonance imaging, nuclear medicine scan or computerized tomography.

For their patients with shortness of breath and fatigue or leg weakness, primary care providers should obtain a NTproBNP lab test, which provides data on stress to the walls of the left ventricle, says Dr. Albert. If that test is elevated, they should order a 2-D echocardiogram and other lab (serum and urine) tests plus an electrocardiogram (12-led ECG) to rule heart failure in or out. The echocardiogram can also provide data on valve function and may help the provider understand the etiology of the heart failure.

There is evidence from a randomized trial that patients 40 and older with risk factors for heart failure (e.g., hypertension, diabetes, vascular disease including coronary artery disease) benefit from BNP screening to identify and treat unrecognized left ventricular dysfunction, adds Dr. Heidenreich.

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“Providing guidelinerecommended care, such as the 2022 ACC/AHA/HFSA Heart Failure Guideline, will help keep patients living healthier with fewer hospitalizations and greater survival,” adds Dr. Heidenreich.

“Often the doctor needs help, and if they have team members able to prescribe and manage medications (nurse, pharmacist), they should optimize care.”

What’s coming up?

Drugs that lower blood pressure, improve the heart’s ability to pump blood, slow the heart rate and prevent scarring of the heart muscles play a big role in the treatment of heart failure.

And there has been progress in recent years, including the introduction of drugs such as Verquvo, Entresto and Corlanor.

A group of drugs called sodiumglucose cotransporter-2 (SGLT2) inhibitors is also showing promise for heart failure treatment.

Physicians have many non-medical options to ensure their patients adhere to an agreed-upon treatment regimen, according to the American College of Cardiology.

They include: ` Understanding reasons for nonadherence, including patient factors (such as poor health literacy, perceived lack of effect, depression, social isolation, cognitive and physical impairment), medical condition (polypharmacy due to multiple comorbidities), therapy (frequency of dosing, side effects), socioeconomics (out-of-pocket cost, difficulty accessing a pharmacy), and shortcomings of the health system (poor communication, silos of care, lack of automatic refills). ` Shifting language away from patient “compliance” to “adherence,” “activation,” “engagement” or “empowerment,” emphasizing support, not blame. ` Starting guideline-directed medical therapy before the patient is discharged from the hospital, simplifying medication regimens, communicating with other clinicians involved in care, considering the impact of costs and access on their patients, recommending tools that support adherence in real-time (such as pillboxes filled by caregivers), anticipating problems (such as refills), and promoting motivational interviewing). ` Providing medication education, disease education, teaching of self-monitoring and self-management, and taking advantage of mobile health, such as reminders, warnings, and adherence tracking.

February 2024

more non-cardiovascular comorbidities (e.g., obesity, chronic lung disease, diabetes, chronic renal disease, etc.). More than 25% have six or more, raising the risk of inefficiencies of care delivery, miscommunication, potential drug-drug interactions and drug-disease interactions, and missed opportunities to achieve optimal outcomes.

Says Dr. Albert, the primary care doctor should consult with an electrophysiologist cardiologist if a device is needed (pacemaker or implantable cardioverterdefibrillator); a structural heart disease cardiologist if valve repair is needed; an interventional cardiologist if a cardiac catheterization procedure is needed; or a cardiac surgeon if surgery is needed. If the patient’s condition matches criteria for advanced heart failure, the primary care provider should consult a heart failure specialty cardiologist or, at minimum, a general cardiologist.

Editor’s note: The 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines, can be found at https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000001063

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An Alarming Trend What’s to blame for the prevalence of obesity in the United States?

 America’s busy lifestyles, food and diet habits, and societal influences are leading to poor health

February 2024

outcomes. As a result, obesity has become an increasing concern throughout the United States.

Case in point: the prevalence of adult obesity in 22 states rose above 35% of their respective populations in 2022, according to the Centers for Disease Control (CDC). Yet, ten years ago, there weren’t any states that had an adult obesity prevalence above 35%.

The impacts of obesity are costly for the American healthcare system. Health conditions associated with obesity include heart disease, stroke, type 2 diabetes, and certain types of cancer, according to the CDC. These conditions, when associated with obesity, require patients to seek healthcare for preventable chronic disease. The estimated annual medical cost of obesity, according to the CDC in 2019, was nearly $173 billion.

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Causes The dramatic increase in the prevalence of obesity within the last 10 years is a result of a variety of factors, including national mental health issues, changes in the American lifestyle, diet culture, socioeconomic status, and more. A 2023 study conducted

by Batash Endoscopic Wellness, titled “Beyond the Scale: Insights Into Weight Loss Trends and Challenges,” explored the causes of the obesity crisis in the U.S.

by surveying 1,000 U.S. adults who identify as overweight.

“This alarming trend of increasing obesity rates is the result of a confluence of factors. Sedentary lifestyles, highcalorie diets, and an abundance of processed foods have become the norm,” said Dr. Batash.

Survey respondents were asked about their experiences with weight loss, weight gain, and the challenges associated with being overweight.

Proper management Obesity is a very complex disease, with a variety of social and environmental factors contributing to a greater risk for some individuals, according to a National Library of Medicine Study, “Social and Environmental Factors Influencing Obesity.” Effectively addressing obesity in the U.S. requires an understanding of these complex relationships.

According to Dr. Batash, obesity doesn’t just hurt the body; it also makes it harder for people to be productive in their personal lives and at work.

“To address this issue, we need to teach people about healthy choices, and help each person adjust to a healthy lifestyle in a way that works for them,” he said.

Nearly 50% of individuals surveyed in the study struggled with personal control their over weight loss journeys, indicating that genetics, activity levels, and environmental factors are critical considerations in weight management.

“Individuals embarking on a weight loss journey navigate several personal factors. To determine the individual factors impacting weight loss, one must assess their dietary habits, exercise routines, and psychological barriers such as stress and emotional eating,” said Dr. Batash. “Understanding these personal influences is crucial, as 35% of overweight Americans avoid healthcare scenarios due to the negative impact on their mental health, highlighting the need for personalized and compassionate weight management strategies.”

Achieving a healthy weight reduces an individual’s risk for developing serious disease.

According to the CDC, some ways to maintain a healthy weight include physical activity, proper sleep, stress reduction, and healthy eating. Behavior

changes such as walking, swimming, making nutritious food choices, and getting enough rest, when combined, can assist patients with the journey of weight management.

According to Dr. Batash, “It is important to approach weight loss with a multi-pronged approach, and to make lasting, long-term changes in how we eat, exercise, and take care of our mental health.”

Managing weight is critical to an individual’s overall health, as it directly impacts both personal and communitywide well-being. With the prevalence of weight-related illness increasing in the U.S., healthcare professionals must consider the root cause of obesity, and address risk factors and concerns with patients during doctor’s visits.

“Weight loss contributes to better mental health and overall energy levels,” said Dr. Steven Batash of Batash Endoscopic Wellness. “Proper weight management supports joint health, decreases the likelihood of sleep apnea, and enhances mobility.”

Weight’s emotional toll Recently, doctors and health systems have begun considering the emotional and environmental impacts associated with obesity and have integrated lifestyle changes and emotional well-being into care routines for patients with obesity.

“Additionally, achieving and maintaining a healthy weight often leads to improved self-esteem and a positive body image,” according to Dr. Batash. “By adopting healthy lifestyle habits, individuals not only prevent health complications but also promote a higher quality of life and longevity.”

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February 2024

The study provided a nuanced look at weight loss to include stress, perception, and societal trends to have a large influence on weight gain and loss struggles. For example, over 60% of respondents said they wanted to lose weight to address both mental and physical concerns, and over half of survey respondents reported stress as the number one reason they struggle to successfully lose weight, according to the Batash Endoscopic Wellness study.

“The result that nearly half of overweight Americans are uncertain about their control over weight gain suggests that there is a significant role of perceived helplessness in the face of obesity. Additionally, mental health challenges, including stress and depression, contribute to weight gain by promoting behaviors like emotional eating,” said Dr. Batash.

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Respiratory Season How healthcare providers and the population at large have fared this fall and winter.

CDC respiratory disease season outlook

February 2024

The Centers for Disease Control (CDC) have been continuing to monitor statistics and data during respiratory season, for signs that respiratory disease season could be worse than expected.

The CDC tracks numerous factors in relation to respiratory disease, including data indicating the possibility of an unusually severe influenza season, multiple respiratory disease peaks happening at the same time, or the emergence of a new coronavirus variant that causes severe illness.

As of mid-January, the CDC continued to expect that the 2024 respiratory season will likely have a similar number of total hospitalizations as last year. In 2023/2022, the number of hospitalizations remained higher than previous respiratory seasons prior to COVID-19 pandemic. With the incidence of widespread illness and healthcare system strain, this year’s hospitalizations from COVID-19, flu, and RSV may even be higher.

According to the CDC, vaccination is best way to protect yourself against severe disease. Vaccination is especially important for people who are at higher risk of developing serious complications.

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Getting COVID-19 and flu vaccines at the same time is safe As the respiratory season reaches its peak, the CDC recommends Repertoire

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that everyone five years and older receive one dose of the “updated vaccine.” A person who has never received a COVID-19 vaccine in the past can still get the protective benefit of the one updated shot, according to the CDC. According to UCLA Health, it is safe and convenient for an individual to get both the flu and COVID vaccine at the same time. With COVID and flu seasons both currently underway, it is more important than ever to get vaccinated.

The vaccines both lower an

individual’s risk of getting sick and protects against severe disease.

Cases of new COVID-19 variant tick up It has been nearly four years since the pandemic emerged, and the winter respiratory season has brought on a new variant of the disease. There has been an increase nationally in emergency room visits and hospitalizations for COVID-19, the flu, and RSV, which began mid- December and has been continuing throughout early 2024, according to KFF Health News.

staying home, resting, and testing for COVID-19.

Respiratory illness and coinfection risk The 2023/2024 respiratory season has looked much different this year than in the past. COVID-19, the flu, and RSV numbers have continued to rise across the United States. Last winter, flu and RSV infections were already declining by the time hospitalizations from the omicron virus started to spike in December 2022. With the high number of respiratory illnesses circulating, how worried should an individual be about getting multiple at the same time, or coinfection?

Fortunately, while it is possible to be infected with multiple viruses at the same time, the risk isn’t the same for everyone,

according to a report from NPR. Viral interference, a phenomenon where infection with one virus ramps up the body’s immune system, can make it less likely to get infected with another virus.

According to an NBC News article, while respiratory disease is on the rise, physicians are not seeing notably increased rates of patients with both the flu and COVID.

Pediatric cases of RSV lead to more hospitalizations than omicron, flu This year’s respiratory season has seen increased cases of respiratory syncytial virus (RSV) nationally. Young children are at an increased risk for developing severe cases of RSV. According to a study published in late 2023 in The Journal of The American Medical Association (JAMA), pediatric cases of respiratory syncytial virus have led to more emergency hospitalizations than the omicron variant of COVID-19 and the flu.

JAMA researchers analyzed data from over 500,000 patients (under 18) who were hospitalized with the virus between August 2021 and September 2022. It was found that the hospitalization rate for children who tested positive for RSV was 81.7% while the rate was 31.5% for omicron and 27.7% for the flu. RSV is a common respiratory virus that causes mild, cold-like symptoms, according to the CDC, but can progress to severe and fatal in infants and older adults. Parents should take precautions to prevent severe illness in children, including RSV vaccination, keeping children home when sick, washing hands often, and encouraging kids to cover coughs and sneezes.

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February 2024

The newest variant circulating is known as JN.1, a descendant of omicron. It is rapidly spreading, and represents between 39% to half of the cases, according to stats from the CDC. Fortunately, the variant “does not appear to pose additional risks to public health beyond that of other recent variants,” according to the CDC. New hospitalizations from COVID-19 are about one-third of what they were around the 2022 holidays. Weekly deaths dropped slightly at the end of 2023, and are also substantially below levels from a year ago.

Symptoms of the COVID variants currently circulating are likely familiar, including a runny nose, sore throat, cough, fatigue, fever, and muscle aches. If you feel sick, the CDC recommends

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Health News and Trends

February 2024

Smartphone app to analyze human motion A research team funded by the National Institutes of Health (NIH) developed a smart phone app, called OpenCap, that can track an individual’s ability to move from one place to another, also know as locomotion, in addition to other types of movements. The app analyzes human movement such as muscle activations, joint loads, and joint movements through artificial intelligence technology. Information gathered through the app assists physicians in understanding

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and evaluating patients with movement difficulties, planning surgeries, and assessing the results of treatment and procedures. According to researchers at NIH, the app costs about 1% of conventional motion analysis techniques while working 25 times faster. Traditionally, movement analysis requires a lab setting with expensive equipment and hours of analysis by a trained expert. The app could introduce a quicker, more effective way to screen patients for disease risk, track treatment improvements, and inform clinical decisions.

National Donor Day National Donor Day is observed each year in February to spread awareness and education about organ, eye, tissue, platelets, and blood donations, according to The Organ Donation and Transplantation Alliance. The observance recognizes those that have given and received an organ, tissue, or eye donation, and those currently waiting for a lifesaving transplant. According to The Alliance, on average, 20 people die each day waiting for an organ transplant, and one organ can save as many as

FDA implements more oversight of lab-made tests

eight lives. Nationally, there is a system that matches available organs from a donor to patients on a waiting list, and individuals of all ages and medical histories can register to be an organ donor to assist in saving lives.

Osteoarthritis and injury prevention Osteoarthritis is the most common form of arthritis, according to the Centers for Disease Control (CDC), and develops when a joint breaks down underlying bone. OA causes pain, stiffness, and swelling in patients that often gets worse over time. For some, it causes reduced function or disability, especially in older patients.

The Osteoarthritis Imaging Center

Diagnostic tests will now be held to a higher standard across the nation.

The Food and Drug Administration (FDA) announced a rule that aims to ensure the safety and effectiveness of laboratory developed tests (LDTs). Examples of the tests being regulated include diagnostic COVID-19, blood lead levels, breast cancer genes, etc., that are now being held to higher accuracy standards. Testing labs are primarily regulated by the Centers for Medicare and Medicaid Services, but the agency does not evaluate the accuracy of tests. According to the proposed FDA rule, the agency is concerned about the quality of lab tests, and is aiming to regulate tests made in labs the same way medical devices are regulated.

Dieting and health There are numerous diets that circulate online and throughout social media, from keto, whole 30, no-carb, and more, and it can be difficult to differentiate them and to know what nutrition decisions are right for your health. Healthy nutritional goals are an important part of living an overall healthy lifestyle, but how does one start

with so much media saturation?

According to Mayo Clinic, a healthy diet includes eating a variety of foods from the major food groups.

That includes fruits, vegetables, whole grains, dairy and protein, and healthy fats. When looking to start a diet, choose one that provides guidelines on how much food to choose from each group, one that has locally accessible items, and a program that fits with an individual’s lifestyle and budget. Always discuss the decision with a healthcare professional before starting a diet.

Aspirin-free medication regimen and heart health Abbott announced in a late-breaking data presentation in late 2023 at the American Heart Association’s Scientific Sessions that for the first time an aspirin-free regimen can improve outcomes for people living with its HeartMate 3 heart pump by reducing hospitalizations without increasing the risk of blood clot. The findings, which were simultaneously published in The Journal of the American Medical Association, could potentially shift how physicians manage patients with a heart pump and possibly other cardiac diseases. These findings are important because, according to experts, there is a consensus within the medical community that aspirin use should be a mandatory part of the treatment regimen for people with a heart pump however, those assumptions were largely driven by observational data that have rarely been challenged. The Abbott HeartMate 3 patients who did not take aspirin spent 47% fewer days in the hospital due to a nearly 40% decrease in bleeding events compared to patients who continued to take aspirin daily.

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February 2024

(OIC), housed at Cleveland Clinic through The Arthritis Foundation, is one of the largest repositories in the nation for imaging data from post-traumatic osteoarthritis clinical trials and therapies. The clinical trials done at the OIC at Cleveland Clinic will capture research images over time of patients who come to receive care for osteoarthritis.

These trials will allow researchers to better understand disease impacts and treatment effects going forward on comparable OA cases.

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Blended Plans Formed from two S.C. health systems, Prisma Health tackled challenges of different approaches. By Daniel Beaird

 Dylan Lawlor is the director of value analysis for Greenville, S.C.-based Prisma Health, which

was created by a merger between Greenville Health and Palmetto Health in 2017. He’s been with Prisma Health and Greenville Health since 2002.

“It’s almost guaranteed system to system to be different in the way value analysis is handled because the cultures of every system are different,” Lawlor told The Journal of Healthcare Contracting (JHC), a sister publication of Repertoire, in a recent interview. It was his team’s challenge to merge the two South Carolina health systems’ value analysis programs together and then take on the pandemic.

February 2024

JHC: Tell us about your professional background.

Lawlor: I’m a lab technologist

by trade. I started with 10 years in the military and moved to Greenville in 2002. I started with Greenville Health on third shift in the lab and within about a year was moved into a management position and spent another six years in the lab before moving to supply chain and taking the manager’s role in value analysis.

Back then, we didn’t have a formal program. When we introduced it, the program was very corporate-level and senior-level in terms of what ideas could be applied to find savings for the system. It was more project oriented.

Over the years, it morphed and grew as people realized the value we bring to an equipment

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Dylan Lawlor

review, new product review or capital review. Today, we do it all for Prisma Health. We are connected to anything new coming into the system, even service related. My team pulls together some of the benchmarking, standardizations and quality efforts – making sure that when we implement something, we are doing it as a system.

JHC: How’s it been since the merger between Greenville Health and Palmetto Health?

Lawlor: We’re getting everyone

on the same page. I mentioned how different each value analysis program is – well, I consider it fortunate that Prisma Health employs the bulk of our physicians. So, they have a vested stake in how we go about things. Our

JHC: Expand on physician engagement within the value analysis program since Greenville Health and Palmetto Health became Prisma Health.

Lawlor: We’ve had our challenges.

The program that Palmetto Health had in place was slightly different from the one Greenville Health had in place. Eventually, it all rolled up under me. It was standardized under one process, which made it easier. We’re still fighting cultural differences that were established in Columbia, S.C., and Greenville, S.C., but we’ve had great collaboration from both sides. I’m not worried about the Midlands market versus the Upstate market.

Our value analysis coordinators do a great job to make sure when physicians request product that they are looking at it from a true Prisma Health level. We don’t want to do it on a market level because we don’t get the standardization or the clinical advantages of standardized

outcomes across the system if we have multiple products in place.

Our teams are based on clinical swim lanes and during the initial merger, I also had the contracts team reporting to me. Tying those pieces together is integral so all parties know who buys the product to who contracts it to who works with the clinicians to drive the product choice. So, everybody is hopefully on the same sheet of music within supply chain driving these things home.

be engaged to help walk suppliers through the process.

Suppliers have a place to bring new products, new technology and new ideas to our clinicians for vetting. That’s their job. I support them in that.

The suppliers must understand our job is to vet a request and how it needs to be engaged at Prisma Health. How do we need to look at that new technology?

Is it evolutionary? Is it revolutionary? And what advantages is it going to bring to us?

Our value analysis coordinators do a great job to make sure when physicians request product that they are looking at it from a true Prisma Health level. We don’t want to do it on a market level because we don’t get the standardization or the clinical advantages of standardized outcomes across the system if we have multiple products in place.

JHC: How does Prisma Health integrate suppliers during the process and what parameters are set?

Lawlor: Our process is designed

so I don’t have to meet with the vendor prior to them talking to our clinicians. I don’t presume that I know everything or that I need to know everything or that I need to be part of the initial discussion between vendors and clinicians on products.

Our program ties in when the physician wants to look at something. That’s where my team will get engaged. That’s the standard we hold our suppliers to. It isn’t my team’s job to sell the product. But at the point of interest, we need to

Another parameter in recent years is we’ve been connected with our IT department. We’re the gatekeeper with IT when bringing in new equipment connecting to our networks or housing patient health information. We look at those connections to make sure we’re not the next ransomware victim. So, it’s not the vendor going to IT. It’s our department that connects the vendor and IT together to get the review done.

JHC: How has the value analysis process changed after the pandemic?

Lawlor: We’re a little bit differ-

ent because we own our own distribution center. My value analysis team is connected to Repertoire

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February 2024

value analysis program has been built on collaboration with our physicians in everything we do.

Many larger initiatives are brought to me by our physicians, or I go to our physician leadership to make sure a program like hip and knee is one that they’re going to support and help me drive compliance around it. Compliance helps keep the vendors accountable for the support and structure we’re putting in place.

We’ve won different awards for the value analysis program here through Vizient. We are progressive in our approach and in driving the savings and standardization initiatives we are able to get done.

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that group and the products we have in the warehouse and how we maintain it. The backorders, product substitutions and recalls during the past two to three years have been crazy and my team is the bridge between supply chain and the clinical teams.

It came with some opportunity, though, because some of the sacred cows we couldn’t touch went on backorder and we had to touch them. We had to work with the clinical teams on product change because we didn’t have a choice. It opened the door for us to challenge things and change the status of what was termed a commodity product.

We went from five vendors to one vendor. So, why do we want to go back to five? What advantages is that bringing us?

What clinical outcome improvements are we getting by going backwards in the standardization?

We’ve done bulk purchases and brought in products through our warehouse. We had to refocus, but we were always able to find something by working with the clinicians and different vendors to meet our needs.

February 2024

JHC: How did processes used during the pandemic improve value analysis for the future?

Lawlor: I’ll answer that in

two ways – something I’d like to see change on the value analysis side and something on the supplier side.

I’ll address the value analysis side first. We changed GPOs coming out of the pandemic. So, we’re using that as an opportunity to standardize products and standardize clinical outcomes. My team is now more directly involved with the

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quality team at Prisma Health to help make those connections.

We’re starting to look at physician choice in some products and how it’s driving costs and outcomes. We used to ask clinicians what it would replace. Is it truly a new product? Because 99% of the time it’s not. It’s an add on or a replacement.

look to reduce their costs and pass that back to the hospitals. We know there have been challenges with raw materials and transportation, but just passing that along to the hospitals isn’t plausible.

Companies that can do this are only helping themselves because it frees up money for us to purchase the capital we need going forward.

Hospitals can’t keep absorbing this cost for minor tweaks and improvements. Vendors must look to reduce their costs and pass that back to the hospitals. We know there have been challenges with raw materials and transportation, but just passing that along to the hospitals isn’t plausible.

But is there opportunity here to compare different vendors and their products to get a top-tobottom approach with subcategories? How do we categorize these to drive a better contract for system savings and standardizations across clinicians? That’s a more complete analysis instead of just Product A to Product B. On the supplier side, some of these evolutionary changes are not worth the cost that vendors are bringing to us. We can’t afford them. I’m asking vendors to go back to their companies and to save that money for the revolutionary changes. Take the money they’ve been using on the evolutionary changes, invest it back into the infrastructure and reduce the cost of producing the products they’re producing now?

Hospitals can’t keep absorbing this cost for minor tweaks and improvements. Vendors must

JHC: How much more transparency is there, if any, in supply chain processes post pandemic?

Lawlor: We do things differ-

ently because of our distribution center. We’ve established our own direct deals and cut out the middleman, and work with a vendor to cut their costs.

With our unique relationship with vendors, our physicians understand there’s a place for vendors and we can’t do this without them. But our physicians usually come to us before going to the vendors with requests. We’re transparent with our clinicians and our vendors.

This is a cyclical business.

The deal done today isn’t necessarily the deal done in three to five years. That business may circle around, so we do our best not to burn bridges. It’s all about timing and our evolution at Prisma Health.

IDN News CommonSpirit Health has selected Terika Richardson as Senior Executive Vice President and Chief Operating Officer, effective December 11, 2023.

Richardson will serve as a member of the organization’s Executive Leadership Team and report to CEO Wright Lassiter III. Richardson joins CommonSpirit with extensive executive operations experience and a rare blend of nonprofit and for profit as well as faith-based health care.

As the organization’s Chief Operating Officer, she will provide both strategic and operationsrelated leadership, ensuring optimal operating effectiveness for the organization and its operating regions. Richardson will help drive opportunities to innovate the system and lead the organization’s efforts to achieve its growth targets related to revenue and market share, identify opportunities for growth in operating regions, support regional executives and local leaders in pursuit of their goals and objectives, and help identify and implement physician alignment strategies to reach quality and patient safety goals.

“Terika’s experience in optimizing care delivery systems and commitment to innovation make her a valuable addition to the CommonSpirit Health Executive Leadership Team and to our organization,” said CommonSpirit Health CEO Wright Lassiter III. “I look forward to

working shoulder-to-shoulder with Terika to ensure that the care we provide our communities meets their needs today, tomorrow and for years to come.”

Prior to joining CommonSpirit, Richardson served as the Chief Operating Officer at Ardent Health Services in Tennessee, providing operational oversight of the system’s 30 hospitals and 200 care sites. While there, she realigned the service portfolio to better meet the needs of the communities the system served as well as the system’s overarching business priorities. Richardson also served as the president of Advocate Health Care’s Chicagoland market as well as the president of two of the health system’s hospitals, Lutheran General and Trinity/South Suburban. She also spent 14 years with HCA holding various leadership positions.

“CommonSpirit Health provides exceptional care in communities across this country, all with unique needs,” said Richardson.

“I look forward to collaborating with my colleagues and teammates to make our care even more relevant to the needs of our communities and in ensuring that we are fully optimizing all of our systems and resources to deliver expert, quality care every day.”

HCA Healthcare collects 13,136 Pounds of medication during fifth annual “Crush the Crisis” HCA Healthcare, Inc. announced that it collected 13,136 pounds of unused or expired medications

during its fifth annual “Crush the Crisis” prescription drug take back day on October 28, 2023. HCA Healthcare has now collected more than 67,500 pounds of medication since launching “Crush the Crisis” as an enterprise initiative in 2019.

This year, all 15 HCA Healthcare U.S. divisions participated alongside local law enforcement in a “Crush the Crisis” prescription drug take back day to raise awareness about the dangers of prescription drug misuse and the importance of proper disposal of unused or expired medications.

An estimated 9 million doses of medication were collected at 132 collection sites across 15 states. HCA Healthcare’s “Crush the Crisis” events were held in alignment with the Drug Enforcement Administration’s (DEA) National Prescription Drug Take Back Day, which collected 599,897 pounds of medication.

HCA Healthcare facility events with the greatest amount of medication collected this year include: ` The Medical Center of Aurora in Aurora, Colorado collected 670 pounds ` Centennial Hospital in Centennial, Colorado collected 602 pounds ` CJW Medical Center in Richmond, Virginia collected 601 pounds ` Medical City McKinney in McKinney, Texas collected 554 pounds ` StoneSprings Hospital Center in Dulles, Virginia collected 525 pounds Repertoire

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February 2024

CommonSpirit Health appoints Terika Richardson as Senior Executive VP and COO

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Community Health Systems completes divestiture of three Florida hospitals to Tampa General Hospital Community Health Systems, Inc. announced that certain subsidiaries of the Company have completed the divestiture of Bravera Health Brooksville (120 licensed beds) in Brooksville, Florida, Bravera Health Spring Hill (124 licensed beds) in Spring Hill, Florida, and Bravera Health Seven Rivers (128 licensed beds) in Crystal River, Florida, along with their associated assets, physician clinic operations and outpatient services, to Tampa General Hospital and certain of its affiliates for approximately $294 million in cash, inclusive of estimated working capital and other purchase price adjustments. The transaction is effective December 1, 2023.

February 2024

Premier, Inc.’s PINC AI™ Applied Sciences (PAS) and TFS HealthScience partner Premier, Inc.’s PINC AI Applied Sciences (PAS) and TFS HealthScience are announcing a collaboration to accelerate global clinical trials and research innovation, improve patient outcomes and reduce health disparities.

The partnership will combine TFS’ capabilities, systems and clinical development expertise with PAS’ AI-enabled technology and comprehensive healthcare database. The collaboration will help expedite site and patient enrollment, reduce trial costs, accelerate the journey to commercialization, and ensure equitable access to groundbreaking medical solutions across diverse patient populations.

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Eighty percent of all trials face premature termination or significant delays due to recruitment challenges – and marginalized populations, including Black and Hispanic individuals, remain historically underrepresented.

Leveraging comprehensive real-world data (RWD) and AI-enabled tools from PAS, TFS will gain enhanced capabilities to assess site suitability on a larger scale and focus on appropriate patient populations, investigator availability, therapeutic areas expertise and historical clinical trial performance metrics. This datadriven approach has already enabled PAS-supported trials to improve recruitment by 1800 percent and triple enrollment compared to baseline projections – significantly reducing enrollment periods and costs.

Two major Midwest health systems plan to combine BJC Health System of St. Louis (“BJC”) and Saint Luke’s Health System of Kansas City (“Saint Luke’s”) announced they have entered into a definitive agreement to combine as an integrated, academic and patient-centric Missouribased health system. The agreement follows a letter of intent signed in May 2023 by both organizations, and after satisfying all regulatory reviews. The transaction was expected to close Jan. 1, 2024.

As a combined system of approximately $10 billion in revenue with 28 hospitals and hundreds of clinics and service centers, BJC and Saint Luke’s will extend their shared commitment to deliver high-quality,

affordable patient care to the communities they serve across Missouri, southern Illinois and eastern Kansas.

At the time of closing, Saint Luke’s will officially join BJC, and together, operate as a single, integrated health care organization that serves two regions with a distinct brand in each: BJC HealthCare in the St. Louis region and Saint Luke’s in the Kansas City region.

New data added to NASHP’s hospital cost tool The National Academy for State Health Policy (NASHP) released an update to its Hospital Cost Tool to include 2022 data and new metrics on hospital labor expenses. As a result, users of this publicly available tool can access data on hospital costs such as operating profit margins, cost to charge ratios, breakeven points, and more for approximately 4,600 hospitals for 2011 through 2022.

As health care expenditures rise with the largest proportion of spending consistently on hospital care, state leaders are seeking assistance to understand and better address these high and rising prices and related costs. The hospital cost tool was developed as part of NASHP’s Center for Health System Costs, which is focused on supporting states to achieve increased affordability to ensure consumers have access to comprehensive, high quality health care.

States that are actively using the Hospital Cost Tool to inform state policymaking efforts include Texas, Indiana, and Rhode Island.

HIDA

Questions to Ask When Vetting Suppliers  When medical products are constrained or in short supply, offers from unknown sources fill

inboxes across the supply chain. Navigating these offers is difficult, especially during times of crisis. During the COVID-19 pandemic, providers reported receiving incorrect product, poor quality items, or counterfeit items that failed to protect staff from disease risks.

Fortunately, medical products distributors were there to help. Distributors have experience vetting suppliers and can be a resource for providers who wish to perform due diligence.

That is why HIDA recently launched a Supplier Checklist to help healthcare providers and public partners who also do not always have this type of expertise vet suppliers of healthcare products. The HIDA Supplier Checklist contains criteria and best practices to perform due diligence on prospective suppliers.

Key questions to ask include:

` Are you able to demonstrate proof agency regulatory compliance?

` Are you able/willing to host a site visit for

potential commercial or public sector partner?

` How long have you or your source manufactured medical supplies?

` Can you provide information on inventory? ` Can you provide samples of products from multiple lots?

The Supplier Checklist is a project of the HIDA Industrial Base Working Group. The Working Group collaborates with federal partners to provide industry perspectives on strategic and thoughtful approaches to increase domestic manufacturing capacity for critical medical products.

The checklist is one of many preparedness resources HIDA has created in partnership with other stakeholders.. HIDA provided subject matter expertise to ASPR TRACIE for the Disaster Available Supplies In Hospitals (DASH) tool. This is an interactive tool that helps hospital emergency planners and supply chain staff estimate supply needs during various public health scenarios. And in collaboration with ASPR, HIDA published a Preparedness Playbook to monitor the medical supply chain and coordinate production and distribution during a public health emergency.

By Linda Rouse O’Neill, Senior Vice President, Supply Chain Policy, Health Industry Distributors Association

` Can you provide copies of customer

invoices with specific products listed?

` Can you provide a copy of your quality manual?

` Can you provide the company’s W-9 and applicable business licenses in the states supplied?

` Can you provide documentation of financial health?

` Have you ever had to conduct a FDA recall? If so, for how long?

` When was your most recent FDA inspecFebruary 2024

tion? What was the result?

` Do you have an International

Organization for Standardization (ISO) registration number?

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Reading List

The Transformational Power of Purpose Finding your purpose in 2024. By Pete Mercer

 Do you know why you are here? Do you know what your purpose is? It can feel like a loaded ques-

February 2024

tion for anyone who has doubted any of their life choices at any point. If we are honest with ourselves, we have all been there at one point or another. Finding your purpose is no small task and it will likely even require a good bit of failure before you get there.

That’s exactly what Jim Whitt went through on the path to discovering his purpose. After years of searching for what he was meant to do with his life and his career, Whitt had an epiphany on March 21, 1988 – his purpose is to help people reach their full potential.

Repertoire Magazine recently spoke to Whitt, author and founding partner of Purpose Unlimited, about what it takes to find your purpose in a challenging and changing world. He started Purpose Unlimited, a consultation

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and coaching company, as a way to help people and organizations find their purpose. He has written two books, The Transformational Power of Purpose and Riding for the Brand, both of which cover how individuals and organizations can discover and fulfill their purpose.

Finding purpose in the process Part of what makes finding your purpose so difficult is enduring the process that it takes to get there. For example, you never plan on getting fired from

his first sales call. Whitt told him to write down a series of questions that would help to guide the conversation with the prospect.

These questions were designed to gain a better understanding of what sorts of challenges and pain points the prospect was facing.

Armed with the answers to those questions, Whitt developed a relationship with the prospect to help him solve his most pressing problems. It was this process that helped him become one of the top producers in the company.

Power of Purpose, which was published in 2002.

Whitt’s only prerequisite for people who are interested in discovering their purpose is to be willing to look inside themselves. He said, “I can’t tell you what your purpose is, but I’m going to give you a shovel and tell you where to dig. If you want to know, you’ll find it because you are acting on a spiritual principle – seek and you will find.”

Building off of the same process of finding purpose

Whitt’s only prerequisite for people who are interested in discovering their purpose is to be willing to look inside themselves. He said, “I can’t tell you what your purpose is, but I’m going to give you a shovel and tell you where to dig.”

“When I looked into the eyes of this young man,” Whitt said. “I saw tremendous potential. I remember thinking that he just needed somebody to help him get there. I had no idea how it would impact his life. That’s when I knew that my purpose was to help people reach their full potential.” Years later, that sales rep went on to start his own company, which he eventually sold for $180 million.

Building the process for the people With Purpose Unlimited, Whitt has taken a singular conversation with a green sales rep and manifested it into a more than 30-year journey of helping others find and fulfill their purpose in life. The process he developed was documented in, The Transformational

in his first book, Whitt wrote Riding for the Brand, which is a template for building a purpose driven organization.

The biggest challenge in getting everyone on board with organizational development is to get them to make a commitment to change. “We consider ourselves to be partners with clients in the process and we tell them that we will want to move faster than they will. Everyone wants things to change in the organization until they realize they have to change.

“Change is hard,” Whitt continued. “It’s uncomfortable. It requires a commitment to a process. Events don’t change behavior, processes do.

The process starts with the question of purpose because without a purpose our only motivation is reward and punishment.”

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February 2024

your job, but sometimes that sort of shake up is exactly what you need to get the ball rolling.

Whitt enlisted in the army after graduating high school but did not pass his physical. After three semesters as an art major at a community college he dropped out and eventually landed a job as foreman for the Oklahoma Methodist Boy’s Ranch. That too went sideways after Whitt got into a personality conflict with his superintendent and was fired.

He eventually found himself without a job, without a degree and without direction. He said, “What do you do when you’ve been rejected by the Army and the Methodists? I went to Oklahoma State, and they accepted me.”

Whitt said that “being fired was one of the greatest things that ever happened to me.” At Oklahoma State, he graduated with a degree in animal science, which completely changed his trajectory.

But his journey wasn’t done yet.

After graduating, he spent 10 years in sales with Ralston Purina working primarily with large commercial feeding operations, then became a marketing manager with the Central Soya company before resigning to do contract marketing with a couple of his former customers. That venture ended in failure but in the aftermath, he discovered some notes he had taken during a seminar while he was still employed by Central Soya. At the top of the first page, he had recorded the date, March 21, 1988, and had written this question underneath – “What is your purpose in life?”

While reading that, he remembered working with a young salesman who was feeling anxious about what to ask a prospect on

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Reading List

The Science of Axiology: How do you see yourself?

Editor’s note: The following is an excerpt from Chapter 6 of Jim Whitt’s The Transformational Power of Purpose: Finding & Fulfilling Your Purpose in Life.

Having personally witnessed the inhumanity accompanying Hitler’s rise to power in prewar Germany, Dr. Robert S. Hartman envisioned a science which could organize good as effectively as the Nazis organized evil. After years of research, Hartman created a new mathematical system called Axiology which successfully orders the values of our everyday experiences. Derived from two Greek words – xios (worth or value) and logos (logic or theory) – Axiology examines “how we think” and helps us to understand the patterns we use to make judgments.

February 2024

Hartman identified three distinct dimensions of how we judge and value things: ` Systemic – The dimension of formal concepts, ideals, goals, structured thinking, policies, procedures, rules, laws, “oughts” and “shoulds.” It is one of perfection. ` Extrinsic – This is the dimension of comparisons, relative and practical thinking. It includes the elements of the real, material world, comparisons of good/better/best, and seeing things as they compare with other things in their class. ` Intrinsic – The dimension of uniqueness and singularity. It includes people, love, feelings, etc. ` Everyone has different strengths and weaknesses in their ability to apply these three dimensions when making decisions. No one uses each dimension equally to make a decision.

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From a systemic point of view, we measure people against a standard. It can be a system of policies, procedures, rules, laws or a religion. This is a black or white comparison. It’s either pass or fail.

When we examine people extrinsically, we see them comparatively. They are better than, worse than or about the same as someone else, relatively speaking If we view people intrinsically we value them for their uniqueness, their essence, their spiritual being. They are the one and only.

We not only view others but ourselves through the prism of these same three dimensions. If we see ourselves purely through systemic eyes, we’ll be frustrated failures. No one can live up to all the rules of any system – even if we get to make the rules.

From an extrinsic viewpoint, we either think more highly of ourselves than we ought or find ourselves lacking.

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By Jim Whitt

It is only when you look into the eyes of your soul and view yourself intrinsically that you understand your true value. When viewed from an intrinsic point of view you see yourself exactly as your Creator sees you. You are the one and only. Just as no two snowflakes are alike, you are singularly unique.

Dr. Hartman devoted his life to answering the question, “What is good?” The conclusion he reached was, “A thing is good when it fulfills its definition.” Good can be defined as “certain to elicit a specific result” and “something conforming to the moral order of the universe.”

Your purpose is God’s definition of you. You were created to elicit a specific result. When you are fulfilling your purpose you are conforming to the moral order of the universe.

That is good.

Marketing Minute

Outlining Clear Marketing Goals  Every successful plan takes steps, strategies, and goals to achieve a desired outcome, and creating a marketing campaign is no different.

No. 1: Foster Customer Relationships

Brands are most likely to advertise to gain more customers and to improve customer understanding of a product or service. Advertising campaigns are an opportunity for a brand to engage with customers and detail the features of its products. Brands can foster customer

relationships through social media campaigns, detailed website information, interactive customer ad experiences, and more.

No. 2: Market More Effectively

Marketing more effectively can include a deep research dive into a brand’s buyers/audience, focusing on the creation of content that is unique to a brand, gaining a better understanding industry competitors, and more.

No. 3: Brand Awareness

Brand awareness is familiarity with a brand, and increasing brand awareness includes digital marketing including social media, emails, newsletters, webinars, and more. Digital marketing efforts streamline product messaging directly to consumers, allowing brands to gain better overall circulation.

No. 4: Brand Development

Brand development is the process of refining a brand’s advertising strategy. Brands can evaluate marketing strategies that did and did not work, and from there, increase focus on the advertising strategies that were the strongest.

If your brand could use assistance with outlining its 2024 marketing goals, Share Moving Media can assist with content marketing guidance informed by over 30 years of experience in the supply chain industry. SMM can also help your company achieve marketing goals by helping create engaging ad content such as blogs, podcasts, written content, etc. Contact Scott Adams at sadams@sharemovingmedia.com to set up a time for a 10-minute marketing planning session today.

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February 2024

To successfully advertise, it is important for companies in the supply chain industry to set marketing goals. Marketing goals track advertising progress and define a clear brand purpose in its advertising efforts. As 2024 begins, it is necessary for companies to reevaluate marketing strategies, determine campaign strengths and weaknesses, and plan accordingly for the new year’s marketing campaigns.

To properly do this, a company should understand what they are trying to accomplish with their marketing efforts. Goals could include increasing revenue, gaining a greater brand following, improving customer exposure to a brand’s products, and more.

Identifying a brand’s marketing goals is a process that is refined over time. Read on for the most common marketing goals to begin outlining your business’ marketing strategy:

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News

Industry News

February 2024

Brad Hilton to lead HIDA board for 2024 Brad Hilton has officially assumed the role of Chair of the HIDA Brad Hilton Board of Directors for “Our industry is special,” said Hilton. “What we do matters.

We help providers on the front lines of healthcare that are taking care of our family, friends, and neighbors. I enjoy connecting and engaging with our colleagues and suppliers. I don’t think that is common in most industries. And that feels good!” 2024. He succeeds outgoing Chair Cara Skowronski, President of Delasco.

Brad Hilton has nearly 30 years of experience in the healthcare distribution industry, including 11 years at McKesson, currently as Senior Vice President of Primary Care sales and previously as SVP of Operations and Customer Experience.

Prior to that, Hilton spent 18 years at PSS World Medical as Chief Service Officer and SVP of Operations. He began his medical supply career at Hilton Surgical Supply in Houston, Texas, working for his father. He is a graduate of Texas A& M University and earned an MBA from the Kellogg School of Management at Northwestern University.

“Brad is an exceptional leader who has devoted his career to medical distribution,” said HIDA President & CEO Matthew J. Rowan. “His in-depth industry

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knowledge is a tremendous asset that will benefit HIDA and the industry as a whole.”

“Brad brings an up close and personal understanding of this industry’s growth,” said outgoing Chair Cara Skowronski. “He has lived it and played an important role in leading the change to what is now a world class supply chain. With his years of experience as a leader in medical distribution, he has the vision and experience to guide HIDA into the future. He is the right person to continue our momentum and serve our membership.”

Mercy acquires SoutheastHEALTH SoutheastHEALTH has joined Mercy after receiving all necessary third-party regulatory approvals. The first noticeable change for patients and the community of these organizations moving forward together starts this week with the placement of new Mercy signage at locations across southeast Missouri.

The two health care systems signed a definitive agreement in August for SoutheastHEALTH to become a member of the Mercy system strengthening health care delivery across southeast Missouri through increased patient access to high quality care.

Co-workers with SoutheastHEALTH are now Mercy coworkers. Southeast Hospital in Cape Girardeau is now called Mercy Hospital Southeast, while Southeast Health Center of Stoddard is now Mercy Hospital Stoddard.

Henry Schein enters extremity segment of orthopedic market Henry Schein, Inc. announced plans to enter the upper- and lower-extremities specialty segment of the orthopedic market in line with its longstanding strategy.

Henry Schein announced that it has signed an agreement to acquire a majority interest in TriMed, Inc., a global developer of solutions for the orthopedic treatment of lower extremities (foot and ankle) and upper extremities (primarily hand and wrist).

Headquartered in Santa Clarita, CA, TriMed had 2022 net sales of approximately $48 million. The transaction is subject to certain regulatory approvals and closing conditions, and is expected to be completed in the first quarter of 2024. Henry Schein expects the transaction to be neutral to 2024 non-GAAP earnings per share and accretive thereafter. Financial terms were not disclosed.

In addition, Henry Schein has entered into a strategic relationship with Extremity Medical LLC, an innovative medical device company focused on developing new products for fusion, fixation, and motion preservation in the orthopedic treatment of the lower extremities and wrist. Headquartered in Parsippany, NJ, Extremity Medical will operate as a separate, stand-alone company.

Improving Patient Health Better BP ®

Did you know high systolic blood pressure (BP) is a leading modifiable risk factor for death worldwide?1 Proper patient positioning alone can lower resting blood pressure (BP) measurements by 7 mmHg systolic and 4.5 mmHg diastolic.2 That’s why, Midmark designed the first and only fully integrated point of care ecosystem that has been clinically validated to achieve improved accuracy for a resting BP. 01 Low-height exam chair helps patients keep their back supported and feet flat on the floor

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02 Articulating arm rail supports the patient’s arm and cuff at heart height

3

03 Automated vital signs promote consistency and data accuracy 04 EMR connectivity improves workflow efficiency and reduces errors

Share with your customers at: midmark.com/betterBPin3

2

1

Scan to explore the latest study reporting the cumulative effect of poor positioning that occurs when BP is taken with the patient sitting on a typical clinical exam room table.

1 https://www.ahajournals.org/doi/10.1161/HYP.0000000000000065 2 https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00396-6/fulltext © 2024 Midmark Corporation, Versailles, Ohio USA

WELCH ALLYN AND BAXTER ARE NOW ONE TEAM

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Heart disease is the leading cause of death in the US.1

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46.7% of US adults ages 20 and over have high blood pressure.3

Check out our current promotional offers on screening devices that can help your customers combat these conditions.

References: 1.

2.

3.

National Center for Health Statistics. Multiple Cause of Death 2018–2021 on CDC WONDER Database. Accessed February 2, 2023.

Diabetic Retinopathy Preferred Practice Pattern® from the American Academy of Ophthalmology, http://dx.doi.org/10.1016/j.ophtha.2019.09.025, ISSN 0161-6420/19. Accessed July 29, 2020.

Tsao, et al. Heart Disease and Stroke Statistics--2023 Update. Circulation. 2023;147:e93–e621. DOI: 10.1161/CIR.000000000000112.

Baxter, Hillrom, and Welch Allyn are trademarks of Baxter International Inc. US-FLC45-240001 (v1.0) 01/2024