A New Era of Healing
Still Standing
If you’ve been in medical distribution sales for the last 25 years – or even just the last five – you know this job is not for the faint of heart. We’ve seen more than our fair share of storms, and yet here we are, still standing, still selling, still serving the caregivers who take care of this country.
Think back to the early 2000s. The dot-com scare that rattled our industry, making us all think the era of sales reps would be replaced by online ordering. Not long after that storm blew through, the economy took a nosedive in 2008. While the world was pulling back, we leaned in. Because the caregivers still needed supplies, and you were the ones they counted on.
Then came the Affordable Care Act. It reshaped how care was delivered and how supplies were purchased. We adapted. We worked smarter. We helped our customers navigate the unknown. You brought them value through educating them on all the change and how to maintain their practices and health systems.
And then – COVID.
In 2020, the entire world turned upside down. You weren’t just distribution reps anymore, you were lifelines. You hustled through PPE shortages, shipping delays, and an endless stream of uncertainty. And still, you and your organizations delivered. To this day one of the coolest things I’ve seen was the leaders of medical distributors pulling together as one and meeting with the President to ensure caregivers got what they needed.
Now, we face a new challenge: a tariff war that’s complicating the global supply chain and impacting our margins, our pricing, and our planning. But if the last 25 years have taught us anything, it’s that we are built for this. While you fight through this storm, remind yourself you’ve been through worse, and you always figure a way to win.
Every five to seven years, this industry gets tested. And every single time, we rise to the occasion. Not because it’s easy, but because it’s worth it. Because the people we serve – doctors, front-office staff, lab techs, supply chain professionals – depend on us to make their jobs easier. To make sure they never run out. To make sure they’re ready when a patient walks through the door.
Hope isn’t just a nice idea in our business, it’s a plan of action. It’s working harder, getting smarter, leaning on one another, and never losing sight of the mission: taking care of those who take care of us.
So, whatever comes next, or whatever the next five years throw at us, we’ll be ready. We’ve been tested. We’ve been stretched. And every time, we’ve come out stronger.
Here’s to driving forward with purpose, with excellence, and with a relentless commitment to serving the caregivers of America. Thank you for your work and your ability to fight through the tough times.
Dedicated
to the Industry,
R. Scott Adams Publisher
editorial staff
editor Graham Garrison ggarrison@sharemovingmedia.com
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Individualized Quality Control Program
Test your IQCP IQ
 This month, we are going to take a deep dive into Individualized Quality Control Program, or IQCP. I am going to abbreviate it to “IQC” for the balance of this column for simplicity. As moderate complexity labs develop experience and confidence in their analytical system, some look for opportunities to perform quality control, not just for their testing systems but across their entire lab under carefully controlled and managed parameters.
By Jim Poggi, Principal, Tested
Insights
There are leading manufacturers of lab equipment that provide specific programs for our customers to develop and successfully implement an IQC program. These manufacturer programs typically include guidance documents, software and/or on-site consultation to provide assistance as needed to make the IQC program a success. This column is not intended to provide a specific listing of manufacturers and instrument systems which provide IQC support. Rather, it is intended to familiarize you with the basics of IQC so you understand the fundamentals well enough to seek out expert assistance from your lab instrument manufacturer. In addition to manufacturer support, there are a number of excellent third party resources available to you and your customers including several reference materials from the Centers for Disease Control and Prevention (CDC), who offers a primer on IQC, a guide to understand the needed steps to implement a program and also a guide book to walk the customer step by step through the analytical process and evaluation of the lab’s readiness and risk assessment to implement an IQC program. When you encounter a customer with questions about IQC, your best option is to contact your trusted lab instrument manufacturer, learn more about the IQC options and support they offer to be prepared for customer discussions regarding this option along with their instrument manufacturer. Customers considering an IQC program are typically motivated by the desire to use the most up-to-date approach to daily QC (typically
recommend in the instructions for use of most lab instruments) while also recognizing and controlling all sources of error and variability in their lab to assure the highest quality of lab results. In my opinion, the most fundamental benefit to a lab considering an IQC program is the thoughtful analysis of its current performance and a systemby-system risk analysis, including pre-analytical steps, the analytical process, personnel standards and performance and finally result reporting. Whether an individual lab eventually decides to implement IQC or not, the results of this comprehensive analysis will result in a lab that preforms at a higher level of efficiency and confidence. Arguably, this process also helps the lab to identify any weaknesses in its overall system performance, correct them and provide exceptional patient results.
IQC program: Risk analysis, QC plan, and quality assessment.
Risk analysis
A proper analysis, often with the active assistance of your trusted lab instrument manufacturer, looks at each element of the lab’s performance, understands its strengths and needs for improvement, and uses the risk assessment to shore up areas of the lab where a greater level of control will lead to better results. The baseline analysis requires a complete in-depth understanding of the instructions for use for each of your lab instruments. This risk analysis typically begins by breaking down the lab’s performance into its three major components: pre-analytical, analytical and post analytical/result reporting. Each system is analyzed to assure it is properly managed. As an example, in the pre-analytical
The three elements of the IQC program work together. There is analysis as the first step. Corrective action is the second step. Assuring that the corrective action has resolved the issues uncovered in the analytical phase is the third step.
What is IQC?
IQC is known as an “Individualized Quality Control” Plan. It is recognized under CLIA as an acceptable adjunct to the quality control recommendations of your lab equipment manufacturer, utilizing a carefully conducted planning and implementation protocol to assure result quality by implementing such a program. There are three key elements of developing and implementing an
system assessment, is room temperature controlled in accordance with lab instrument manufacturers’ requirements? Are samples stored at the appropriate temperature and analyzed during the window required by the manufacturer’s instructions for use? In the analytical system assessment, is instrument maintenance performed at the right intervals? Have reagents been used and lots managed according to manufacturer
directions? Has lot to lot performance been consistent?
Testing personnel qualifications, training and assessment and conformance to the lab’s policies and procedures are also part of understanding and assessing the analytical process and its performance. While not specifically called out in some of the IQC protocols I have reviewed, an assessment of result reporting is also important. Are results reviewed according to the lab’s policies and by the appropriate personnel? How are quality control result issues rectified before reporting patient results? Is test result information maintained under HIPAA requirements and are results readily available to clinicians and patients in a convenient easy to understand format, such as the patient portal?
The QC plan
The quality control plan looks at the variables and sources of potential error identified in the risk analysis and builds policies, protocols and systems to address them and create a comprehensive quality program across the entire laboratory. The QC plan becomes the systematic backbone intended to create an assurance that lab test results are of the highest possible quality. It will address environmental issues, such as temperature control in the lab and quality of physical space for the testing performed. It needs to address maintenance of the large analytical instruments but also the preanalytical equipment. Maintenance of rockers, rotators, centrifuges, refrigerators and freezers are all considered in the quality control plan. Personnel qualification, duties, responsibilities, periodic
assessment and training and key elements of the plan as well. Finally, instrument quality control procedures, including acceptable QC variability, steps required to be taken when QC appears out of control, and result reporting are all considered in the quality control plan.
In essence, the QC plan is the lab’s overall policies, procedures and document of how it is managed under CLIA for optimal result quality. A lab with highly motivated and qualified staff may well develop a QC plan with limited assistance from the lab instrument manufacturer or other outside sources, but the best plans typically include input from a variety of sources. As an aid to documenting the quality control system and plan, there are several excellent software programs that highlight each needed policy and procedure required for high level lab performance and provide a simple and easy platform to create, review, and maintain this information for ready access to lab personnel at all times.
Quality assessment
The final element of a well designed and implemented IQC program is the creation of a feedback loop to answer the questions. Did the risk analysis uncover the key gaps in our quality program? Did the new Quality Control program successfully address those issues and are they resolved?
An important additional question needs to be “Have we uncovered any new issues that need to be addressed?” If so, we will need to revise our QC program and run the feedback loop over again.
As you can see, the three elements of the IQC program work together. There is analysis as the first step. Corrective action is the second step. Assuring that the corrective action has resolved the issues uncovered in the analytical phase is the third step.
In a perfect world, no IQC program would be static. It would be subject to review and revision from time to time as circumstances change or as the lab personnel determine that there are new issues to consider or even new solutions (such as new supplier recommendations or new software solutions) that can improve processes and documentation of the quality system.
The key to a well-functioning lab is change management. Be involved with your key lab manufacturers and your lab customers and work together to offer solutions to optimize their lab organization and results. Discussing IQC options first with your key lab manufacturers and then selecting the right customers to offer IQC as a solution will help you maintain your credibility as their preferred lab consultant.
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Tariffs, Turmoil and Tough Talks
Why the best reps thrive in chaos.
By Brian Sullivan, CSP –PRECISE Selling
 You don’t need me to tell you the world’s a little weird right now. Between trade wars, tariffs, shipping delays, cost spikes, and buyers who act like you’re personally responsible for it all, medical sales reps could be forgiven for waking up every day and muttering, “Really? What now?”
But here’s the truth: chaos is the best thing that can happen to a great salesperson. Why?
Because when the market gets confusing, buyers don’t want vendors. They want guides. They want calm, confident, well-prepared pros who can bring clarity, stability and maybe even a little hope to the madness. In short, they want YOU – if you’re ready to step up.
So, let’s unpack how the best reps not only survive during turmoil … they become indispensable.
1 The best reps sell stability When prices shift and availability changes weekly, your product sheet isn’t what gets you in the door. Your poise does. Your insight does. Your calm does.
You become the voice of reason in an unreasonable world. The rep who says, “Hey, I know it’s wild
out there, but here’s what we’re seeing across the board, and here’s how we’re helping others navigate it.” You don’t need all the answers. You need better questions, and a plan that shows your client you’re not running from the storm –you’re walking them through it.
2 While others panic, you prepare
In times of chaos, average reps react. Top reps prepare.
That means:
Anticipating pricing objections and having a new script ready
Preparing value-based conversations instead of cost comparisons
Doing your homework on what this specific client’s challenges are, not just throwing out “we’re all in this together” clichés.
Want to stand out right now?
Be the rep who brings ideas, not excuses.
3 Price sensitivity? Shift the conversation
Sure, your client is watching costs like a hawk. But instead of competing on price, compete on value, outcomes and risk mitigation.
Try this: “I know you’re getting pressure to cut costs. The real question is, what would a delay in this product line cost your patients, your team or your reputation?”
Tariffs are real. So is the cost of inaction.
The best reps are moving the conversation upstream from price to impact. From product to partnership.
4 “Too much going on” = The best time to call Look, nobody’s answering their phone right now. And even when they do, they’re stressed, distracted, or six Zooms deep into the day.
You know what that means?
Less competition.
More opportunity.
When the crowd stops selling, your voice carries farther. And buyers remember the rep who kept showing up with empathy, clarity, and useful ideas when everyone else ghosted.
5 Reputations are built in the hard seasons
The market will calm down eventually. Prices will settle. Supply chains will stabilize.
And when that day comes, your buyers will remember one thing: Who showed up when things were hard?
This is when reputations are made.
Not when everything’s going great, but when the game is ugly, confusing, and everyone’s looking for a leader.
You don’t need a perfect pitch. You need courage, clarity and consistency.
6 Need a reset? Start with these three questions
If you’ve felt yourself going into “wait-and-see” mode lately, let’s shake that off. Ask yourself:
1. What conversations have I been avoiding because I don’t have perfect answers?
2. What new value can I offer right now that my competitors aren’t thinking of?
3. Who needs me to check in –not to sell, but to help?
Remember, uncertainty isn’t your enemy. It’s your differentiator.
Final thought:
This is your moment
If you’ve been in this game long enough, you’ve seen cycles come and go. But this one is special –not because of how hard it is, but because of what it reveals.
It reveals who’s just taking orders, and who’s earning trust. Who’s making excuses and who’s making calls. Who’s hiding behind “market conditions” and who’s leaning in with a solution mindset. So here’s the challenge: Be the rep your client talks about at dinner.
The one who showed up. The one who made sense.
The one who thrived in chaos.
Brian Sullivan, CSP is the author of 20 Days to the Top and founder of PRECISE Selling and PRECISE Performers, where he trains and supplies sales champions to medical companies across the U.S. Learn more at www.preciseselling.com.
The Value Analysis Whisperer
Mark Copeland on what it takes to get your products through the value analysis filter in a healthcare setting.
By Pete Mercer
 Whether you are in over your head or simply don’t understand the lingo, it’s not uncommon to feel like you need a translator for a meeting with clinicians. Even when you know your product lineup front to back, it might feel as if you and the other party are not matching up on what they need and what you can provide.
Value analysis is one of those departments in healthcare that can feel like it has its own special language that is a struggle to understand. This is why you need a translator, or even a value analysis whisperer.
Repertoire Magazine recently sat down with Mark Copeland, the Value Analysis Whisperer, to discuss the role of value analysis in medical sales, what a good pitch should look like, and how medical sales reps can get past gatekeepers.
Becoming the Value Analysis Whisperer
Copeland has been in medical sales for 28 years and selling medical devices in hospitals and ambulatory surgery centers for 20 years. Along the way, he developed a sort of aptitude for navigating value analysis in healthcare.
“About 10 years ago, I got really good at getting products approved through value analysis committees, which didn’t exist in a lot of places at the time. While Harrisburg, Pennsylvania wasn’t ground zero for value analysis, I experienced it in its earlier iterations.” he said.
His ability to get things through value analysis proved to be beneficial for his company and the healthcare partners he was working with at the time. Copeland remembered speaking to a surgeon at a scrub sink, where the surgeon marveled at his ability to get medical products approved by the value analysis committee. “He said, ‘You’re like that guy who talks to horses, but you’re like the value analysis whisperer.”
Because Copeland worked hard to develop a business case for the product and formulated a plan to get the product approved,
the name ‘Value Analysis Whisperer’ stuck. While he’s adamant that, were it up to him, he would’ve come up with something much cooler, the name ‘Value Analysis Whisperer’ speaks to the efficacy of Copeland’s process. In other words: if it works, it works.
What to know about value analysis
Value analysis works as a sort of filter for major hospitals and health systems. Think of it as a quality assurance team that is measuring the effectiveness of the product against its cost, while also having to consider whether it brings enough value to the
This new style of selling involves a bit of sophistication in its execution, but it still requires an understanding of the clinical benefits to the patients, doctors, and nurses. From there, you have to create a simple business case for the product. If you can develop a justification for why hospitals and patients would benefit from your product, it’s much easier to get it through value analysis.
“I spend a lot of time convincing reps and their companies that they can build a simple business case and that they likely have everything they need already,” Copeland said. “They just need to know how to put
Copeland looks at value analysis as the prefrontal cortex of the health system: the high-level executive function decision maker. “I don’t see them as gatekeepers, I see them as the brains of the place, and you just have to learn their language. If you do it right, they will respond and they will buy your product because it does make sense.
equation to justify any changes to what the hospital is already using.
“It’s been driven by two market things: hospitals and health systems merging and doctors becoming employees of those health systems. About 70% of all doctors are employed by health systems now. While that may change, those two shifting dynamics have created this new filter that sales reps have to go through,” Copeland said.
According to Copeland, it’s important for sales reps to understand and reconcile that the theoretical “good old days” are gone.
everything into a package that makes sense to the non-clinicians who are major stakeholders in the decision-making process.”
Another approach Copeland uses in conversations with sales reps is to help them understand the role of the clinician. His go-to analogy for doctors is to liken them to a three-star chef at a Michelin restaurant.
He said, “How many of those three-star chefs, who even have their name on the restaurant, actually run the business? Very few. They might know what the best ingredients are, but about
three quarters of them put the restaurant out of business in a year because they don’t have business sense. That’s who you’re calling on – you’re calling on the chef and value analysis is running the business side of the restaurant.”
Navigating gatekeepers in healthcare
One of the biggest challenges most medical sales reps have to overcome is navigating gatekeepers in healthcare. Many are going into meetings with “a foot in the door” mentality, hoping that a meeting can pave the way for future partnerships. Copeland believes the best way to get your foot in the door is by creating a sense of urgency.
“If you say, ‘Hey, you’re wasting money, you have a problem, you have an issue,’ it accelerates it because they may not know that they’re wasting money each month. Now, there’s an urgency –it’s not about the product or the service, it’s about the problem. All of a sudden, they’re asking you to send a sample over.”
By leveraging the urgency of a healthcare organization, you are starting in the same place as you would with another approach, but with a different perspective of the solution that you can provide.
While some might consider value analysis as a gatekeeper, Copeland disagrees. He looks at value analysis as the prefrontal cortex of the health system: the high-level executive function decision maker. “I don’t see them as gatekeepers, I see them as the brains of the place, and you just have to learn their language. If you do it right, they will respond and they will buy your product because it does make sense.
Recontextualizing the role of value analysis in healthcare can bring a sense of clarity to how you approach your products. He said, “What I have found is when you put together a decent business case and you start asking at the clinician level who runs the service line, you will usually end up at a nurse who is at the director or VP level. The higher on the chain you get, the more effective you can be.”
Understanding the opportunities and challenges with value analysis
When you are trying to navigate the value analysis filter, it’s important to understand the challenges and opportunities that healthcare facilities are facing right now. We are several years removed from the pandemic, but the effects of COVID are still very real and prevalent today. We can see that manifest in certain parts of the care continuum before it trickles down to affect things like the quality of patient care.
“Health systems are struggling with, not decreases in revenue, but decreases in profitability. I just
saw on Becker’s that the average hospital margin is about $4.9, which is pretty slim. Another major issue is that they don’t have enough staff – they cannot afford to lose doctors or nurses, although doctors and nurses will complain they are not being treated very well,” Copeland said.
Developing an understanding and appreciation for the sheer volume of the challenges facing healthcare gives you a better perspective of how your solution can help. It’s all about how you position your product in the pitch – understanding the value that you bring to the equation is an essential part of the sales pitch.
“Being able to get people in and out of these facilities safely and healthily with good quality outcomes is important,” Copeland said. “If the product helps them get people out the door, especially complex patients, that really matters right now. Even if the product helps with those things secondarily, sales reps need to highlight that and have their champions talking about it while they are not there. That makes it more likely to get approved.”
Delivering Exceptional Results
Cardinal Health’s Mary Place believes true success comes when the team thrives.
By Pete Mercer
 Mary Place is a national vice president, corporate accounts/acute care for Cardinal Health’s U.S. medical products and distribution business. In a recent interview with Repertoire Magazine , she discussed her career at Cardinal Health, the challenges facing the industry, and what she looks for when she’s building a team.
Place joined Cardinal Health as a vice president, strategic accounts, non-acute markets, in 2017 after building decades of experience in healthcare. By 2022, she had been promoted to her current position, where she is responsible for driving sales strategy, revenue growth and market expansion within national IDNs. For this role, Place said that she has to balance strategic vision with tactical execution to ensure long-term success in an everchanging market.
Building a med/surg sales career
A registered dietitian, with a master’s degree in clinical nutrition and experience in the acute care setting, Place explored opportunities that would combine her clinical background with her interests in business. Between networking with colleagues and broadening her exposure to companies in the healthcare industry, she began carving out a career in medical sales.
In the early days of her career, one of Place’s mentors
tasked her with identifying her leadership core values. For Place, qualities like integrity, trust, inclusivity, clarity of goals, curiosity, and adaptability help guide her through the day-to-day as a leader in this space.
She said, “I strive to create an environment where team members feel valued and motivated, understanding that true success comes when the team thrives. Fostering a culture of collaboration, growth and positive change is at the core of my leadership approach.”
Through formal leadership training and development opportunities, Place experienced ways to step outside of her comfort zone. “My career trajectory has reinforced the importance of continuous personal growth and self-development in becoming an effective and impactful leader.”
Place stated that taking that leap into a position of leadership was a challenging and transformative move. Even though it took her time to find her footing, voice, and confidence, Place understands that those are all a part of that greater journey in leadership.
For those who are also on the journey, Place recommends seeking out one or two altruistic mentors and leaders who believe in your potential and are invested in your success. “These trusted voices can provide guidance and support you as you navigate the complexities of leadership, which is a continuous learning process that will push you in new and unexpected ways.”
Navigating industry M&As
There is no facet of the healthcare industry that is immune
Mary Place
from challenges, which leaves it up to those operating within the industry to successfully and deftly navigate those challenges.
Place said, “In today’s fastpaced healthcare environment, one of the biggest challenges we encounter is navigating an industry driven by mergers and acquisitions, where business models and evolving purchasing decisions are constantly reshaping the landscape.”
Each health system customer has a different set of needs, leaving Place and her team to develop strategies to meet and satisfy each of those needs. She said, “We have to adapt strategies in real time to meet their needs effectively. By maintaining this flexibility and understanding, we can ensure our solutions align with our customer’s shifting goals and expectations.”
Despite the numerous challenges that Place and her team face, there are plenty of opportunities to celebrate accomplishments and look forward to the future for Cardinal Health’s medical products and distribution business.
“One thing I’m energized about is the push for increased clinical standardization and optimization within clinically integrated networks,” Place said. “I find that it drives consistency, improved outcomes, and operational efficiency across care delivery models. However, no matter the environment, our team remains focused on providing tailored products and solutions to support our customers in achieving their value-based goals and advancing their cost containment initiatives.”
Additionally, Place said that Cardinal Health has been making ongoing investments to better
support their customers and promote resiliency across the supply chain. This includes expanding its U.S. distribution network, modernizing facilities, and introducing innovative products that complement Cardinal Health’s already broad portfolio.
She said, “I am excited about the organization of our teams and resources, which positions us to deliver unparalleled value to our customers through a seamless experience across the continuum of care.”
Building a team
Building an effective team is a crucial component of any leadership position. Companies rely on the creativity and experience each team member brings to the table.
A part of Place’s responsibility includes building teams of highperforming individuals to carry out the mission and vision of Cardinal Health. To build her team, she looks for people who are resultsoriented, have integrity, demonstrate strong communications
skills, operate with an innovative mindset, are open to inclusivity, and can be strategically agile. With these intangible qualities, these team members have an increased likelihood of driving meaningful and sustainable success.
Place strives to lead by example, demonstrating the values, work ethic, and behaviors that she expects from her team members, hoping to create a foundation of trust and respect. She believes that by embracing diverse perspectives, she can spark creative thinking and help her teams navigate challenging situations.
“Building and leading a highperforming team that consistently delivers exceptional results requires discipline and focus on my core leadership principles,” Place said. “This means establishing clear goals and expectations to drive alignment and accountability, promoting autonomy while offering guidance as needed, and empowering individuals to reach their full potential.”
A New Era of Healing
How home care is changing the healthcare landscape.
Older adults often prefer receiving care in familiar surroundings, which enhances their comfort and quality of life. Home health services enable patients to age in place, reducing the need for institutional care, such as nursing homes.
Home health care is also often more affordable than hospital or long-term care facility stays. Providing care at home can reduce hospital readmissions, prevent unnecessary emergency room visits, and decrease overall healthcare costs, making it a more cost-effective option for both patients and the healthcare system.
Home health services allow for more personalized and individualized care. Healthcare providers can spend more time with patients, creating customized treatment plans that are tailored to the individual’s specific needs, preferences, and lifestyle.
For the May issue, Repertoire Magazine spoke to several experts – from distributors to providers – on the current realities of the home care market and what’s in store in the years to come.
To the Point
Henry Schein’s Adam Bries believes the ‘why’ must come before the ‘what’ of home care market solutions.
Adam Bries, vice president and general manager, Home Solutions at Henry Schein, believes U.S. healthcare stakeholders should ask themselves three key questions related to their products and services for the home care market:
Is there a strong patient preference and benefit?
Does it lower the overall cost of healthcare?
Does it improve outcomes and make us a healthier society?
“We have to ask ourselves whether we are solving one of those three things,” Bries said. “We must make sure whatever we’re doing, that it’s for the patient, lowers overall costs and improves outcomes.”
Bries joined Henry Schein a little over 18 months ago to leverage and integrate the Home Solutions division into the company. Henry Schein has made several large investments recently in the home health segment through acquisitions, including Prism Medical Products, Shield Healthcare, Mini Pharmacy, and Acentus.
“We’re looking to build through acquisition and organic growth, and then ultimately leverage Henry Schein’s capabilities in the market in terms of distribution channels to key customers,” said Bries. “Henry Schein has great relationships with health systems and believe that we can help advance support in the continuum of care. As a leading provider of supplies to non-acute businesses, we are well positioned to help with needs in home health, hospice and durable medical equipment businesses.”
Bries discussed the growing home care market with Repertoire Magazine, highlighting some of the main challenges providers face, and technology’s role in enhancing care coordination and recovery at home.
Repertoire: Why is home care an exciting market to be in right now?
Adam Bries: The home health market is one of the fastest-growing markets in healthcare, and it’s no surprise as we continue to see the shift away from an acute care setting or nursing home setting to home-based care. I attribute this to three main factors.
First, patients prefer the convenience to recover and receive long-term care in their homes rather than being in a facility.
Second, it’s more costeffective to treat patients in their homes, which is why we are seeing an increase in home healthcare. There are more outpatient procedures and hospital-at-home programs that lead to faster transitions from the hospital to home. Insurance plans like Medicare Advantage place significant value in home health. When patients elect for home healthcare vs. other alternatives, it helps save money as well.
Third, there are a lot of studies that show patients actually have better outcomes and results when they’re treated at home, which is critically important.
When you combine these three things – convenience, costeffective, and better outcomes – I believe that’s what is driving the growth and shift to home health. This is what makes it attractive and why you’ll continue to see the shift to the home over time.
Repertoire: What role is new technology playing in home care’s growth?
Bries: Technology has been an important part of the home healthcare industry for a while, and will continue to be vital in advancing both care coordination and improved overall health. We’ve seen a lot of advancements in terms of electronic medical record (EMR) integrations with home health as it becomes more integrated with an overall health system. Many health systems now own their own home health and hospice. We’re also seeing increases in
Adam Bries
remote patient monitoring across the industry.
From a medical supply standpoint, we are also seeing technological improvements such as continuous glucose monitors to better manage diabetes and advanced wound care dressings that allow wounds to heal faster. These technological improvements help providers and patients to not only manage their chronic conditions better, but also to enable a quicker and improved recovery from any procedure – all in the comfort of the patient’s home.
their time in the field as they travel from home to home.
Additionally, I think growing documentation and authorization requirements are challenges that providers face and can sometimes lead to delays in treatment and/or supplies.
Lastly, is reimbursement pressure. You hear about it all the time, and it continues to be a constant challenge as we’re trying to reduce the cost of healthcare. When you couple the reimbursement pressures with rising costs and staffing, it creates a real challenge
There’s a lot of coordination that must happen across many stakeholders, the hospitals, physicians, home health agencies, insurance companies, and the supply companies. I think we’re continuously getting better.
The other advancement we hear about a lot is artificial intelligence. It’s a hot topic across healthcare and in many industries, and this will likely play an important role in home health in the future, especially in areas such as documentation processes, workflow processes, and predictive analytics.
Repertoire: What are the biggest challenges facing home care providers in today’s market?
Bries: Staffing seems to commonly rise to the top for many providers in the home care industry. As a supplier and provider of home medical supplies, we continue to look for ways to help ease the burden for our customers, nurses, and care coordinators, so they can focus on the best care for their patients and optimize
for providers and suppliers in the home care industry.
Repertoire: What are the most common conditions or illnesses being treated in the home?
Bries: Home health is a very broad category with many conditions, therapies, and services, but I’ll simplify it into two main categories. First, home healthcare is central to chronic disease management and treatment in the home across all chronic conditions, including heart disease, diabetes, chronic obstructive pulmonary disease (COPD), kidney disease, etc.
Second, home healthcare is vital to post-procedure recovery in the home. This includes ongoing monitoring such as nursing care, physical therapy in the home, DME, and home medical supplies like wound care.
The supplies that Henry Schein’s Home Solutions business provides to patients and providers are critical to both segments. For example, for chronic care management we ensure patients receive their ongoing monthly supplies, support their home recovery after procedures and hospital discharge, and promptly deliver all necessary supplies.
Repertoire: Are we getting better at managing a patient’s care throughout the continuum, even though we’re talking about different providers, settings and services?
Bries: There’s a lot of coordination that must happen across many stakeholders, the hospitals, physicians, home health agencies, insurance companies, and the supply companies. I think we’re continuously getting better. As a supplier and provider for home medical supplies, our role is critical to ensuring patients receive the necessary equipment and supplies at home.
We typically focus on four main areas. One is helping assess the patient’s needs. This involves working closely with the physician and the home health agency to really understand the patient’s medical condition and requirements so they have the right supplies.
Second, and a big part, is navigating their health insurance. It’s a complex process, so we help patients, caregivers and providers by understanding their health benefits, what’s covered, what’s not covered, and what authorizations we need. We also make sure we have good compliance and documentation to prevent any delays.
Third, there’s constant coordination that must happen with providers. We help in communication with the hospital discharge planners, physicians, and home health agencies to verify prescriptions and supply needs, all have a smooth transition.
Last, time is of the essence. When you’re looking at that coordination of care and who is handing what off to whom, we must ensure supplies are delivered on time, provide ongoing support and assistance to patients, address any supply issues, and finally address reorders and ongoing adjustments that they may need for their supplies. By doing this efficiently, we can help streamline the discharge process, reduce hospital readmissions and empower patients to
manage their conditions effectively in their home.
Repertoire: For reps calling on these accounts, are there unique parts of their discussions that vary from traditional physician office clients?
Bries: While we provide a variety of ongoing supplies, our business is service- and patient-focused. We value providing the best level of service. Providing the best patient and provider experience is crucial to our success because very little of our business is contracted. We must earn our customers’ trust and deliver the best-in-class offering every single day. Since it’s a patient-focused business, it’s not all about the price. In a lot of cases, it’s about providing the best quality support to patients and providers.
Repertoire: How do you see the market evolving?
Bries: We’ll continue to see the shift toward home-based care, just as we have over the past decade or so. And we’ll probably continue to see consolidation in the industry as well.
New technologies and technological advancements will help us continue to evolve in how we assess the overall health of an individual.
As we evolve, it’s important that we connect all the dots –behavioral health, social determinants of health, eating and living habits, chronic conditions, etc. I’m optimistic that we’ll continue to see improved outcomes and improved health of individuals in society, and hopefully this can all be done at a lower overall cost.
Home Care and Technology
How promising innovations will help improve personalized health management in the years to come.
Technology is reshaping home health care by revolutionizing services, enhancing patient experience and expanding accessibility, all while empowering individuals to manage their health comfortably from home, said Perry Bernocchi, EVP and CEO, Patient Direct, Owens & Minor.
ByramConnect™, powered by the Welldoc App®, exemplifies this transformation by restructuring care for individuals living with diabetes and other related chronic diseases, Bernocchi said. The more information input by the user, the more help the app can provide.
Byram Healthcare, part of the Owens & Minor family, recently launched ByramConnect, a personalized digital health program powered by the Welldoc App.
Bernocchi discussed the benefits of the digital health platform with Repertoire Magazine
Repertoire: What specific data sources does ByramConnect integrate with to provide a holistic view of a patient’s health?
Perry Bernocchi: Armed with the Welldoc Advanced AI-engine, the app connects and correlates between six dimensions of health, which informs personalized guidance and digital coaching:
1. Symptoms
2. Nutrition
3. Medications
4. Individual Generated Health & Lab Data
5. Psycho-Social
6. Activity and sleep.
Additionally, the app allows individuals to connect to their vital health data across more than 400 devices and data sources, including fitness trackers, blood glucose meters, continuous glucose monitors and weight scales – allowing for highly personalized insights and recommendations tailored to everyone’s unique health needs.
By leveraging this data, ByramConnect, powered by the Welldoc App, offers truly personalized health management. It empowers patients with a customized approach to understanding and managing their diabetes and other chronic conditions and ensuring the incorporation of lab and pharmaceutical medication data – providing patients with total autonomy and on their path to better health.
Repertoire: Can you elaborate on how the AI-driven digital coaching works to personalize the experience for each user?
Bernocchi: Personalization is key when supporting patients living with chronic disease – like diabetes – especially as everyone has different lifestyle factors that can impact their journey. Welldoc’s proprietary AI excels by correlating insights across the broad spectrum of health data, surpassing the capabilities of other solutions.
Its dynamic, adaptive AI models, powered by evidence-based guidelines and our proprietary language learning model (LLM), deliver personalized insights and coaching within established regulatory guidelines. These models fuel advancements in predictive capabilities, supporting improved health outcomes across multiple conditions and driving a shift towards proactive, preventionfocused healthcare. Furthermore, Welldoc continues to advance AI through the integration of advanced sensor technologies. As we continue to empower individuals to gain more sophisticated insights and guidance beyond what is available via traditional data sets, ByramConnect, powered by the Welldoc App, works to seamlessly integrate into a patient’s daily routine, offering support and guidance tailored to their unique health needs and lifestyle.
This is successful through five key factors:
Personalized Medication Management: The AI-driven coaching tracks and organizes a patient’s medication schedule, sending reminders to ensure adherence. It also monitors for potential side effects, utilizing data from past experiences to alert users and informs healthcare providers with alternative recommendations.
Actionable Health Insights: By analyzing data trends and patterns from various health metrics (such as glucose levels, blood pressure, activity levels, etc.), the AI generates actionable insights. These insights help patients understand their current health status, highlighting areas
of concern and offering strategies to address them effectively.
Guidance on Healthy Eating Habits: The platform provides custom dietary recommendations based on individual nutritional needs and dietary restrictions. It considers preferences, medical conditions and lifestyle to suggest meals and snacks that support overall health, promote balanced nutrition and align with personal goals.
Reinforcement of Mental Wellbeing: Recognizing the integral connection between mental and physical health, the AI-driven coaching emphasizes the importance of mental well-being. It tracks mood patterns, sleep quality, and anxiety levels – offering suggestions to improve mental health.
Holistic Support and Feedback: The AI adapts continuously, learning from ongoing interactions with the user to enhance its recommendations. It offers encouragement and feedback, celebrating milestones and motivating patients to stay committed to their health goals. This holistic approach ensures that patients receive comprehensive support that addresses all aspects of their wellbeing.
Repertoire: How does the ByramConnect platform measure success in managing chronic conditions like diabetes and hypertension?
Bernocchi: ByramConnect, powered by the Welldoc App, measures success through member engagement, member feedback and overall health outcome improvements over time. While success for users ranges based on personalized goals, specific areas we’re seeing initial results include
A1C improvement, weight loss and blood pressure reduction.
Repertoire: How does the platform assist in managing medications like GLP-1, and what are the key benefits for patients?
Bernocchi: Managing diabetes and other chronic diseases is a lifestyle change, inclusive of a variety of different factors. We wanted to provide users with a simple and easy way to manage their medications alongside other changes, such as nutrition and fitness, to support their health journey.
The program supports a member’s holistic weight loss journey whether or not they are using GLP-1 medications for obesity. Neither Byram Healthcare nor Welldoc are a prescriber. However, we support GLP-1 usage by educating, coaching and creating a seamless user experience to help members track their medication adherence, side effects, protein intake, muscle retention and other metrics related to overall weight management.
A few of the key benefits for patients include:
Enhanced Responsiveness: Continuous monitoring to help patients and healthcare providers quickly address issues as they occur – to optimize patient care.
Optimized Treatment
Outcomes: Tailored nutrition support and adherence tracking contribute to more effective management of diabetes, maximizing the benefits of GLP-1 medications.
Comprehensive Health Support: The holistic approach ensures that all aspects of a patient’s health, including diet, medication, and general well-being, are managed effectively.
Where Healthcare’s Future Will Reside
Why Supreme Medical’s Colton Mason believes the home will continue to be the major catalyst for growth within the healthcare industry.
The home health market continues to grow at a rapid pace year over year. At their 2024 Summit, Vizient projected a 22% growth rate for Home Health Care over the next 10 years. Coupled with their growth projection for telehealth (+25%), we are looking at the demand for care received in the home almost doubling within the next decade.
This is a stark contrast to markets like skilled nursing facilities and urgent care clinics, which are projecting declines in care volumes, said Colton Mason senior vice president, Supreme Medical. The reason for this is simple.
people want to be at home –surrounded by their loved ones, their pets, and their things. It’s where they want to receive care, recover from surgery, and have end of life.
“Dorothy got it right 85 years ago with five simple words –there’s no place like home,” Mason continued. “And that is why the home will continue to be the major catalyst for growth within the healthcare industry.”
Repertoire Magazine asked Mason to share his insights as an independent specialty distributor serving the home health market.
The Research Institute for Home Care reported in their most recent chartbook that 45% of all Medicare home health users have five or more chronic conditions.
“I could spout data points outlining the costs savings that home care delivers to payers or recite statistics that show the drastic reduction of infection rates when you receive care in your home versus being in a facility surrounded by sick people, but the fact of the matter is, all of that is irrelevant,” he said. “Regardless of costs, reimbursement rates, or even outcomes,
Repertoire: How do you see the home medical equipment market evolving over the next five to ten years?
Mason: The HME market is projected to grow over 50% by 2031. Why? Because 10,000 Americans turn 65 every day and these folks are going to need products to help them walk, stand, sit, and remain active and independent as they grow older. The main
evolution in this key segment of the home care market has been the unseating of Medicare and Medicaid as the major payer for goods and services. As of this year, out-of-pocket payments represent the largest revenue stream within the home medical equipment payer mix – accounting for nearly 50% of the share of payments – more than Medicare and Medicaid combined!
How many of us have become caregivers for a family member in recent years? More and more, you see this rising trend of adult children taking care of their aging parents at home. And when Mom and Dad need a walker, a wheelchair, or hospital bed – they’re not filling out insurance paperwork anymore. They’re pulling out their credit cards and going shopping for what they need. The manufacturers and distributors within the healthcare industry that understand this and work to deliver the best products at the best price to this new class of trade will be the winners of the next decade.
Repertoire: What challenges do providers face in providing quality care at home?
Mason: One word – Staffing. Over the past two years, it is estimated that between 10% to 25% of care that was being delivered in hospitals,
outpatient clinics, physician offices, skilled nursing facilities, and urgent care has shifted to care delivered at home. To put it frankly – there are simply not enough nurses, therapists, delivery technicians, or caregivers available to meet this increasing demand. Thankfully, the home care workforce is projected to be the fastest growing profession and add almost 1 million new jobs by 2031.
As an industry, we must coalesce to capture the attention of kids in high school as well as upcoming college graduates and educate them on the opportunities that exist to them in healthcare outside of the four walls of a hospital.
Repertoire: What are the most common conditions or services managed in home care?
Mason: As a home care distributor, Supreme Medical serves the needs
of thousands of individuals managing chronic conditions at home.
The Research Institute for Home Care reported in their most recent chartbook that 45% of all Medicare home health users have five or more chronic conditions. This data underscores the important role that home health plays in protecting and caring for our most vulnerable seniors. Thanks to quality home health services, these at-risk vulnerable patients can remain in their homes and receive necessary skilled nursing and therapy services, while avoiding unnecessary inpatient care and hospital stays.
Whether it’s supplying bandages and dressings for those suffering from a wound, adult diapers and urological supplies for those dealing with incontinence, or oxygen concentrators to help those diagnosed with COPD to breathe easier – home care providers continually step up to
the plate to meet the needs of our chronically ill population.
Over 3 million patients annually are now receiving home infusion therapy, with the top modality being enteral nutrition – a product category that continues to innovate. Long gone are the days of formula for old people. Based on consumer demand, these products have been enhanced to contain peptides, real foods, and organic plant-based nutrients to help provide nourishment to seniors and children who require a feeding tube. Pain Management products are also a top category, ranging from a brace to support someone suffering from back pain or compression socks to help improve circulation and reduce foot and leg swelling due to diabetes.
As you can see, basically any chronic condition can now be managed from the comfort of your home.
Courtesy of Sg2, a Vizient company
A North Star for Home Care
Cardinal Health’s Rob Schlissberg believes finding tomorrow’s home care advancements will only happen if U.S. healthcare stakeholders continue to let patient preference be their guide.
When you think about why home care is growing in popularity, there are certainly a lot of demographic and technology related factors, said Rob Schlissberg, president, Cardinal Health at-Home Solutions. “But really it comes down to this – people like it.”
It also takes significant cost out of the system. And in many cases, outcomes are proving to be better, Schlissberg said.
Technology has helped enhance the care provided in the home, whether it’s remote patient monitoring or diagnostic devices that can connect to a smartphone.
The last factor is reimbursement. The industry is seeing an increased level of support when it comes to payor reimbursement for care that’s provided inside the home. For example, hospitalat-home programs provide true acute-level care in the home, and today, are covered under Medicare through the Acute Hospital Care at Home waiver, which is awaiting Congressional renewal this spring.
As a result of these advancements, there are new home care providers popping up constantly. “New ones are starting, but there’s also a lot of consolidation happening,”
Schlissberg told Repertoire Magazine. “It’s a fast-moving industry sector. You have different types of companies across the healthcare continuum that are acquiring various home care companies or acquiring different elements of that ecosystem.”
In the following discussion, Schlissberg provided more insights into the emerging home care market.
Repertoire: How is technology changing the way home care is provided?
Schlissberg: For me, it starts not necessarily with new technologies, but current technologies that are able to work together. Can our operating system talk to a hospital’s operating system, then talk to a home care agency’s operating system? It’s that connectivity that creates an ecosystem that when a patient is “remote” in their home, everybody is viewing the same information and able to provide the right care. That is the most critical thing.
For us specifically, we’ve invested a fair amount in technology around our distribution capabilities so we can more quickly and efficiently get patients the critical medical supplies they need, delivered directly to their homes. Our customers are durable medical equipment providers and home care agencies – and they may not have the infrastructure in place to deliver medical supplies that their caregivers and patients need. It’s too costly – and that’s where we come in.
We have nearly a dozen buildings around the country, some fully automated with robotics and technology to get medical supplies directly to people’s homes in a very timely fashion. Our customers only need to worry about doing what they do best – caring for a patient. So, we believe deeply in investing
in the type of technology that is specific to our type of distribution. We only do small medical supplies – not giant pallets. We don’t deliver to hospitals or health systems. We are only focused on getting medical supplies onto the doorstep of somebody’s home. That focus helps us design the best possible systems and network to be great at that.
Repertoire: So, boxes instead of pallets?
Schlissberg: Yes. We focus on small medical supplies that can fit into small, shippable boxes. Others in the durable medical equipment space may do bent metal or larger equipment – like wheelchairs. We are only focused on medical supplies that help treat chronic conditions. Diabetes, for example, is a key focus area for us and one we know will continue to grow.
So, in our distribution centers, we pack medical supplies directly into a box that’s either going to show up at the home of a patient or, sometimes, at a home health agency.
We have been on a multi-year transformation journey with our nationwide distribution network. This transformation is really focused on two things: Expanding our space and capacity so we can support industry growth and bringing in key automation technologies that help us get packages out the door and to patients faster. In the last couple of years, we opened two brand-new distribution centers – one in Grove City, Ohio, and one in Greenville, South Carolina. This summer, we will open a new facility in Fort Worth, Texas, which will consolidate two existing buildings into one, larger space. We continue to add space, capacity and technology to our network for direct-to-home distribution. I’m proud to say that
because of our efficient and strategic locations throughout the country, we are able to deliver products to a large majority of the U.S. population in 24 hours, and that’s really the goal. The rest of Cardinal Health operates in a different distribution network – so, the at-Home Solutions business is incredibly unique to the rest of the enterprise.
Repertoire: That must be exciting to have that kind of national reach.
Schlissberg: It is. In the vast majority of the country, you can order from us mid- to late-afternoon and it’ll be there the next day, which is fantastic. Many of the things that we do are quality-of-life type products. If it doesn’t show up on time, accurately, and with the right product in the box, it could change somebody’s life. So, it’s something culturally we stress across our entire business, but specifically in our distribution centers. We want people to know that they are putting something in a box for a human being, and not just stacking boxes on top of each other, putting them on a pallet and shrink wrapping them.
Repertoire: The providers, in turn, would have to trust you at a higher level; it’s no longer just the supplies coming to them, it’s supplies coming to their patients. Schlissberg: That’s right. When we set out to transform how we think about distribution and how we think about our distribution network, the patient at the end of the shipment is always coming first. We’re committed to doing everything we can to provide the best possible patient and customer experience, priority one.
Second, we must do this in a way that creates a great employee
experience, because we can’t deliver that great customer experience if our employees don’t buy in and don’t have that same mission. Third, how do we get supplies to patients in the most productive way possible? How do we continue to take cost out of the system?
The patient’s needs are at the core of everything we do. Yes, that healthcare provider is effectively trusting us that we will deliver on their behalf to the best possible degree. And we are currently running at historically high service levels, fill rates and quality metrics. We couldn’t be more pleased with the team on the distribution side.
Repertoire: What are some of the most common conditions or illnesses being treated in the home?
Schlissberg: On the durable medical equipment (DME) side of our business, some of those conditions include diabetes, ostomy, urology, nutritional feeding, continence, respiratory (COPD), and sleep apnea (such as OSA). We carry a broad spectrum of products – because, for example, in the Cardinal Health at-Home side of our business, our primary customers are classified as DME providers. No two DME providers look the same. There are a lot of specializations. So, you might be a smaller pediatric nutritional formula focused provider in Greenville, South Carolina. That might be all you do. And then on the other side of the country, there might be a provider solely focused on respiratory conditions and patients diagnosed with COPD. Even though they’re all classified as the same type of provider from a Centers from Medicare & Medicaid Services (CMS) perspective, what they do is all very different.
Now, the hospital-at-home leg of our business, called Velocare™, is focused on the supply chain and logistics side of providing high acuity care in the home. This is serving a much different customer base that we normally serve within our Cardinal Health at-Home and Edgepark businesses, which are focused on the DME space. Our customers here are health systems across the country. In this care model, hospital-at-home patients are typically admitted for acute conditions like pneumonia or COPD, COVID-19, stroke, or a urinary tract infection, for example. As the supply chain and logistics provider of our customer’s hospital-at-home programs, we bring in all the supplies a patient would need to be treated inside the home, including remote monitoring technology, medically approved meals, medical gases waste disposal, and more. We also provide troubleshooting, courier services and more throughout a patient’s home-hospital stay. When a patient is admitted to a hospital-at-home program, we are able to get to their home and set up their hospital room in as little as two hours. We see these programs as the future of healthcare delivery – it’s really exciting to be able to be a part of this evolving model of care.
Repertoire: Tell us about your journey into this space. When did you start working in home care specifically, and what’s interested you about this part of the industry?
Schlissberg: I got into the homecare focused part of the business about a decade ago – I worked in this space for a while, then went to a different part of Cardinal Health. A few years ago, I was honored to be
asked to come back into at-Home Solutions to lead the entire business in totality. When I originally joined the at-Home Solutions business, the thing that most interested me was the customer base – not just that they are focused on caring for patients in the home, but that many of them are small, family-owned businesses. It’s incredibly rewarding to get to work with that type of customer. It’s not just that they’re home care type, but small businesses. I started my career at Cardinal Health in what we would call the retail independent pharmacy side of the business. So, the “Rob’s Pharmacies,” not the major retail pharmacies. What I grew to love about that part of the business was what we did as a big company really impacted them every day. With these small businesses, we can really drive value and help them in turn care for the patient to a greater degree.
As I learned more about the value of home care, I experienced family members going into it. I could see firsthand how home care is a valuable part of our healthcare system.
The third element would be it’s hard to coordinate real quality care in a simplified, easy to access and user-friendly way. And that’s a great spot to be as a business leader. It’s a great spot to be in amid a challenging industry. Because you can, again, add value. We like to say we’re trying to simplify and empower quality care in the home. That’s our north star.
Repertoire: How different are conversations for territory managers calling on home health service providers versus today’s physician offices, and even IDNs?
Schlissberg: For a sales leader out in the field, you’re going to
talk to somebody who’s usually a business owner. They may have a clinical background. Maybe they went to business school, maybe they grew up in a business and rose through the ranks, but they’re not the CEO of a large IDN. You get to talk to the people that are really affecting the business every day and have real, value-driven conversations. It’s important to find somebody who embraces that as a rep. Someone who takes pride in the value which we can provide. We’re not just a vendor; we become an extension of healthcare. They trust us with the care of their customer, their patient. If you don’t take pride in doing that, it will be a difficult job.
Repertoire: What keeps home health care providers up at night?
Schlissberg: For that true home health agency (those providing nursing care in the home), I think they would all say labor. More broadly though, most would say reimbursement is something that keeps them up at night. There’s uncertainty right now. Home care providers want to know there will be fair reimbursement so they can continue to provide the type of care that they know is important.
Specifically, on the DME side of the business, there’s a lot of administrative burden to not just take an order and ship, but take an order, verify insurance, process the order, make sure the prescription and medical necessity is there – all those important steps along the journey. It’s a difficult and complicated thing to do.
In certain areas though, I give CMS a lot of credit. There have been many improvements in access to care, deregulation and reduction of administrative burden.
Transitional Care Program Shows Promise
Ochsner Health’s Acute Care at Home™ program has achieved some “significant” early outcomes, the IDN says.
Ochsner Health launched the Acute Care at Home™ program at Ochsner Medical Center –New Orleans in March of 2024 to enhance patient outcomes, streamline ED operational flow and observation unit throughput, shorten the length of stay, reduce unnecessary hospital utilization, and decrease readmissions. To accomplish these goals, the New Orleans-based hospital partnered with myLaurel, a home-based acute and transitional care company tailored to the needs of frail, elderly, and complex patients.
Late last year, Ochsner Health revealed “significant early outcomes,” preventing either initial admission or 15-day readmissions for 92% of patients referred to the program from the emergency department and observation units.
As a result of the partnership, providers can discharge eligible patients from the ED and observation units with myLaurel’s at-home services, avoiding an observation stay or inpatient admission. This approach results in over 1,000 bed days saved and has the potential to allow for 200+ new admissions. Patients are seen the same or next day at home by a virtual physician leading an in-home care
team, ensuring continuity of IV medications, managing point-ofcare labs, treating symptoms, providing in-home education about treatment plans, and performing medication reconciliation.
For patients to qualify, several eligibility criteria must be satisfied:
Value based payer with Ochsner
Discharging to a home / homelike dispo (ALF, Group home, Medical Shelter)
Live within Ochsner service radius.
Clinical criteria includes:
ED program. Prevention of admission for a low acuity, stable problem.
Readmission program. Have an Epic assigned HIGH readmission risk score and / or preceding 30-day admission.
Remote check-ins with a registered nurse are conducted for seven days, during which care plans are communicated with the Ochsner team and the patient’s primary care physician to coordinate treatment and reduce care gaps. Monitoring patients in the home allows myLaurel to closely track symptoms, even those unrelated to their ED visit, effectively avoiding unnecessary hospital utilization.
“This is not a home health program,” noted Dr. Logan Davies, medical director of hospital access and throughput, Ochsner Medical Center – New Orleans. “This is a transitional care program within home provider visits providing post ED and post hospital care.”
The program has improved care by durably moving care closer to the patient, reducing ED and hospital visits for those enrolled by 33% and 38%, respectively, Dr. Davies said.
All outcomes are monitored and measured for weekly reports. Quarterly reviews exist between Ochsner and myLaurel. KPIs include utilization (ED, observation, admissions), quality / safety (patient safety events, mortality), patient / provider engagement / satisfaction, and financial.
During the program patients and caregivers are the beneficiaries of a 24/7 staffed hotline for any clinical questions or concerns.
Patient and family decision making is key, Dr. Davies said.
“Enrollment is never forced upon patients and as a requirement patients must agree to enrollment,” she said. Ochsner provides in-home education and training to patients and caregivers including medication reconciliation, falls prevention, and disease specific education.
Meeting the Demand
With an influx of patients and continued labor challenges, home health providers will need their distributor partners and the solutions they provide now more than ever.
The team at TwinMed sees two divergent trends happening that will affect the home care market for years to come. First, there is a “gray tsunami” of aging Baby Boomers coming that will want and need care in the home.
But the question is, will home health providers have enough nurses and staff to properly care for them?
“We’ve seen a huge struggle for home health and hospice agencies in retaining employees, specifically nurses,” said TwinMed’s Billy Bindel. “There’s a nursing shortage, but we’re also seeing a huge influx of nurses either stepping away from the profession or going into sales roles, such as working for manufacturers. That’s hurt our customer base being able to service
their patients … Every customer I speak with either has nurses with overwhelming schedules, or they don’t have enough staff to care for the increase in patients. It’s definitely been a big struggle.”
Repertoire Magazine asked Bindel, VP Hospice Sales, and Scott Williams, Senior VP Alternate Sites, TwinMed and President of the GroveMed division of TwinMed, about how the market is evolving and what home health and hospice providers need from their distribution partners.
Repertoire: What are some unique things about servicing your customers in extended care that may differ from other traditional med/surg relationships?
Scott Williams: First, you’re shipping product directly to the
patient’s home, which brings up a multitude of different challenges from delivery, freight, shipping, to set-up once the product is there, etc.
Billy Bindel: Smaller orders, smaller volumes, more shipping costs, just like Scott said. In addition you have delivery challenges with product being shipped directly to these patients and their caregivers. We sell in the lowest unit of measure which can be more costly and labor intensive.
Repertoire: How do you see the market evolving in the next 5 to 10 years?
Bindel: Technology is going to play a big part in the coming years. We’ve seen AI start to get involved and implemented within the EMRs. And that’s a big piece for the next step, where nurses can save time and have more visits. Take into consideration that a home health nurse or hospice nurse, if they have a caseload of 15 patients, they could be making 30 visits in a week and could be driving a few hundred miles. So, having AI involved and being able to chart faster, or see a patient on a screen, could be a lot more beneficial for the hospice/ home health agency, as well as the nurse’s time.
Repertoire: Of home agencies that are doing home care well, are there any common themes or best practices that you see?
Bindel: Culture and training. I have a customer whose company culture is amazing, and they’re growing. They’re rocking and rolling. Their nurses and staff love who they work for. You can tell the company cares. They care about the patients, and they care
about the families. They provide phenomenal patient care. And I think that company culture goes a long way.
Repertoire: Are big health systems and local home health agencies doing a better job of coordinating care for the patient who may move between those entities?
Williams: There is a transition taking place. Everybody is aware that the care is going to the house. So, they’re all trying to find a path there, to build a sustainable revenue stream as they go forward.
I believe the volume of businesses – it’s close to a $300 billion business today – is expected to grow by 30% to 40% over the next five to 10 years. So, the home is going to be a giant source of where the volume and revenue is going to come from.
But, how does a hospital transition? How does a doctor’s office transition? How does a private insurer transition? I think we’re all trying to figure that out right now. I’m not sure anybody has the right answer. Even nursing homes are looking at whether there is a path for them to get into home care.
Hospitals, obviously, are buying home care offices. Home care and hospice companies are all expanding and growing their businesses. The average hospice or home care business is probably 100 patients across the country. Then you have the Goliaths and everything in between.
So, I think we’re all in a great mixing bowl trying to figure it out.
Bindel: I’ve got some prior experience working for a company involved with IDNs. I can tell you that hospitals and IDNs don’t
want to lose sight of that patient. They would love to have that patient from time of birth all the way through time of death.
I do feel that the IDNs struggle with end-of-life care and hospice services, it’s a different philosophy of care they often aren’t familiar with.
Williams: Billy, to your point, there are so many volunteer people involved in the hospice side, that they don’t see a revenue path to build that out on the IDN side.
Bindel: It’s two completely different animals. And that’s one thing that sets TwinMed apart from our competition. We have 100% focus on the non-acute care business, the full extended care market. We understand the extended care market. It is completely different than the IDNs, and completely different than the acute care market. It’s end of life care, home care, home health.
Repertoire: Are home health agencies feeling the reimbursement squeeze?
Williams: I think everybody is feeling the squeeze. They got a little bump in rates last year. But the labor cost keeps going up. The cost to retain employees keeps going up. You’ve got product costs that keep going up. Freight that keeps going up. And now you have tariffs coming potentially.
Medicare/Medicaid is half of the reimbursement in this marketplace. Private pay is probably another quarter, and then random stuff to round it out. We are going to have to do something about it from a legislative and regulatory standpoint to increase the reimbursement rate.
Repertoire: What else is important to understand about the home health market?
Bindel: Over the last 20 or so years, the market has come a long way in educating the public on the benefits of home health and hospice. The government is finally understanding that a patient in home health and hospice or palliative care is much less costly than a patient who is readmitted to the hospital.
That’s a big development over the last dozen years or so. We’re making progress and seeing the public understand more of what home health and hospice can provide. Twenty years ago, you hear the terms home health and hospice, and people would think, “I can’t afford that.” But Medicare, Medicaid, and private insurance cover it. It’s definitely a lot less costly than a hospital admission or being readmitted to a hospital. So I think that’s been a big push, and somewhat successful.
But there is a lot more we have to do. Educating the public is important, and continuing to push what benefits people have, and how they can take advantage of those benefits.
At the end of the day, do people really want to go to the hospital or urgent care? People want to be comfortable in their own home with their family and friends at their side while receiving consistent care by a clinician. The technology that’s available adds a lot of advantages to care in the home, from patients being able to connect quickly via video calls to clinicians being able to order supplies with their mobile device.
That wasn’t something that we could do 20 years ago, we’ve come a long way and there’s even more opportunity to use technology.
Keeping Pace
To continue providing optimal care in the home, reimbursement rates must match market realities, says one national association.
HME suppliers and manufacturers are a critical part of the healthcare continuum, especially given the large and growing population who are especially dependent on home-based care, according to AAHomecare, a national association that represents providers and manufacturers of home medical equipment and services.
In the U.S., more than 70 million Americans have one or more disabilities. In addition, more than 51 million people are over the age of 65 and are eligible for Medicare, which provides reimbursement for home medical equipment and supplies. Every day, an
additional 10,000 individuals in the U.S. reach the age of 65.
“Without the support of the home medical equipment sector, this population segment would require more care in costlier settings, such as hospitals, short-term nursing facilities, and in long-term care facilities,” AAHomecare said. HME allows individuals to stay in their homes longer and remain active in their communities.
In an interview with Repertoire Magazine, AAHomecare provided insights into market trends and regulatory issues that suppliers and providers must navigate.
Repertoire: Please tell us about some of the key initiatives of AAHomecare. What are some wins from 2024 and what are your priorities for 2025?
Maintaining strong patient access to high quality equipment and care is a top priority for AAHomecare and the HME community, and much of our legislative, regulatory, and payer relations work is in support of that overarching goal. A major part of maintaining strong patient access is ensuring that reimbursement rates from Medicare, state Medicaid programs, and private insurers keep up with rising product and material costs. Since a large portion of HME products are provided under fixed rates by Medicare and other payers, suppliers can’t just charge their customers more when product or operating costs (like gas prices, which impact suppliers’ delivery costs) go up. It’s a constant effort to make sure that reimbursement rates match the market realities for HME suppliers.
Another top priority that impacts patient access is making sure that payers don’t implement burdensome authorizations and coverage restrictions for critically needed products. For patients with ALS or other severe respiratory issues, being forced to try a less effective respiratory assistance device instead of a ventilator that was prescribed by their doctor can be a distressing or devastating experience.
Over the last three years, we’ve helped boost reimbursement rates or prevent cuts to Medicare and other state and federal payers by about $4.5 billion, while also expanding
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coverage for mobility assistance devices and streamlining regulations related to several HME product categories.
Repertoire: What are the top challenges/issues for the HME community in today’s marketplace?
Securing sustainable reimbursement rates, making sure insurers allow patient choice and wide network access to their beneficiaries, and fighting burdensome regulations and authorization processes.
Repertoire: How has the HME industry changed over the last 5 years (post-pandemic)?
The biggest change has been the migration from Fee-for-Service (FFS) Medicare to Managed Care/ Medicare Advantage (MA). This had had traditionally been closer to 30% MA vs. 70% FFS, but now MA closer to 52% verse 48% FFS.
Utilization management and prior authorization challenges are greater in the MA space. Postpandemic we have seen some payment changes for acute care at home become permanent like oxygen coverage and a greater acceptance of telehealth.
Repertoire: Why is payment reform needed? What is the situation like now for HME providers?
Medicare reimbursement policy has not kept up with the cost environment that suppliers operate in. One salient issue is that Medicare implemented a highly flawed bidding process for major HME product categories more than a decade ago, but allowed low-ball bidders to influence the results without having to fulfill their bids. That drove prices down artificially.
We worked with Congress to ensure that CMS implemented reforms to the bidding process that drove non-serious bidders out of the process and utilized a better methodology to determine bid results. But when we finally had a rebid under the new rules in 2019, CMS rejected the results because they “did not achieve expected savings.” So, Medicare rates are based on results from the old, flawed program that was last re-bid in 2015, and have only enjoyed annual inflation-based increases that don’t take into account the flawed bidding methodology originally used or reflect the much higher cost increases in the medical sector over the last 10 years.
Since bidding program rates went into effect on a widespread basis in 2013, the total number of separate HME company locations serving Medicare beneficiaries has been reduced by 38% – even as the senior patient population that especially depends on HME grows rapidly.
Medicare rates – and rates from the other payer segments
that are influenced by Medicare rates – are simply not reflective of the cost structure our industry operates under.
Repertoire: How do you foresee home care changing over the next decade?
There’s tremendous opportunities ahead for HME suppliers to take advantage of technology advances that will allow more patients to remain at home, including remote-monitoring and telehealth. Stronger adoption of ePrescribing platforms by HME suppliers and clinicians can improve workflows, cut down on paperwork errors or missing information that requires additional follow-ups, reduce overall admin costs, speed up reimbursements, and prevent errors that may impact patients.
As overall healthcare costs rise and the share of older Americans continues to grow, HME can help meet the challenge with cost-effective, clinically proven, and patientpreferred care at home.
HME product examples
The HME industry directly serves millions of Americans who use HME products and related services, as well as helping the families and caregivers who also support them. Some examples of HME products include:
Home oxygen equipment, ventilators, and respiratory therapy
Sleep therapy technologies such as CPAP devices
Mobility assistive technologies, including power and manual wheelchairs
Diabetes therapy and related supplies
Urological and ostomy supplies
Home hospital beds
Integrating Home-based Services
Compassus, a provider of home-based healthcare services, announces joint venture with Providence to advance patient-centered at-home care.
As post-acute healthcare evolves, both patients and caregivers have begun to shift toward favoring high-quality, home-based care over institutional settings. Once a patient is discharged from an acute-care hospital setting, it may be necessary for some of those patients with ongoing conditions to receive further, advanced post-acute care within a long-term acute care hospital (LTACH), skilled nursing facility, or to receive home-based care.
Studies have repeatedly shown that patients and caregivers strongly prefer at-home care, as opposed to other types of postacute care, according to Kathy Winn, senior vice president, chief marketing and communications Officer for Compassus.
“In addition to patient preference, factors driving increased demand for home-based care include our aging population, hospital length-of-stay pressures, and new payment models, such as CMS’ new Transforming Episode Accountability Model, or TEAM, (an alternative, episode-based CMS payment model),” according to Winn.
Providence, a nonprofit health system serving the Western U.S., and Compassus, a national provider of integrated home-based care services, recently announced the first
phase of a joint venture for home health, hospice and communitybased palliative care in three states – Alaska, Texas and Washington. Operations in Oregon and California are expected to be finalized in the coming months, pending anticipated regulatory reviews and approvals.
Under the first phase of the agreement, Compassus will manage operations for the joint venture, which includes six home health locations in Alaska and Washington, and five hospice and palliative care locations in Alaska, Texas and Washington. The new entity will operate under the name Providence at Home with Compassus except in Lubbock, Texas, where the hospice program will be known as Covenant Health at Home with Compassus.
“Compassus offers a continuum of integrated home-based services,” said Winn. “We provide high-quality care and manage patients’ advanced illnesses in partnership with hospitals and longterm care partners whether they need medical care during recovery from a serious illness, in-home IV therapy or end-of-life care.”
A nuanced healthcare delivery model
Home health services include skilled nursing, therapy services, personalized care assistance, and other specialized treatment in the comfort of a patient’s home.
According to the National Library of Medicine survey “Preferences for Post Acute Care at Home vs Facilities,” respondents stated that they were
willing to pay an extra $51.81 per day for at-home care ($58.08 for patients and $45.54 for their caregivers) compared with staying in a shared room at a skilled nursing facility (SNF). Survey respondents’ prior experience with postacute care was associated with an increased willingness to pay for home-based options.
“Within the Compassus care home delivery model, we’ve developed 16 evidence-based management programs for the most frequently seen medical conditions, which include balance problems, chronic obstructive pulmonary disease, congestive heart failure, dementia, diabetes, orthopedic rehabilitation, pneumonia and stroke,” said Winn.
These programs allow Compassus to provide personalized care to fit each patient’s specific health needs. Compassus also partners with health systems to provide advanced care management to improve care and clinical outcomes for patients with serious illness.
For certain patients, home healthcare allows for a more tailored and patient-specific approach to treatment, the familiarity and comfort of home, reduced obstacles to gaining access to and traveling to receive care, and has the potential to reduce institutional care costs, according to The National Library of Medicine.
“Home is the preferred site of care for many patients because of its convenience, and it’s less expensive and just as effective as care received in a hospital or other facility setting. Patients treated at home are also significantly less likely to be readmitted to the hospital,” said Winn. “Our advanced
care management partners experience total cost of care reductions in the last year of life through increased access to high-quality hospice care and reductions in unnecessary emergency department visits, skilled nursing facility utilization and inpatient stays.”
The growth of home healthcare
CMS projects home health care will grow faster than other health sectors through at least 2032. In 2022 alone, home health spending increased by approximately 6%, according to a previous CMS report.
“Compassus is growing to help meet the projected needs of the home health sector,” said Winn. “Today, over 7,000 Compassus teammates provide care from more than 280 touchpoints across 32 states in partnership with hospitals and long-term care partners. We partner with leading health care systems that include Ascension, Bon Secours Mercy Health, OhioHealth and Providence, and view the homebased care a patient receives as fundamental to the overall care continuum to improve patient experience and lower overall costs of care.”
Winn says that Compassus’ multi-disciplinary teams complement in-home visits with telehealth technologies that offer a glimpse into the social determinants of health physicians use to address and support patients’ overall physical, emotional, spiritual and environmental well-being.
“Remote patient monitoring technology helps physicians recognize potential medication conflicts, changes in symptoms or patient condition, or the need
for medical stabilization to avert a health crisis and unnecessary ED visit,” said Winn.
“We use data and analytics to provide better advanced illness management, making sure patients receive the right care in the right place at the right time so we can make a meaningful impact on their health, safety and quality of life,” said Winn. “We also make strategic technological investments that alleviate administrative burdens so our team members can spend more time serving patients and less time on paperwork.”
The Compassus “Care for Who I am” culture reflects its unique care delivery model, which focuses on each person as an individual. Compassus’ brand promise, according to their website, is written in the first person (“I” rather than “you”) because it is guided by the patient’s perspective. The three domains of its Care Delivery Model are:
Who I Am – Emphasizing patient quality of life
How I Feel – Comfort, including total pain management and symptom management
What I Need – Safety, including the right medications at the right time and patient safety and autonomy
“The word “integrated” is key to our model because of our focus on seamless transitions of care from the hospital to the at-home setting,” said Winn. “Patient comfort, safety and quality of life are the cornerstones of our care delivery model. Improving outcomes for our patients is at the foundation of the care we provide.”
Home as a Place of Healing
For many patients, the environment can play a key role in their healing process, says AdventHealth.
Research shows that being in a familiar environment and surrounded by family can help in the healing process for many people, said Maura Nazario, vice president of clinical operations for AdventHealth home based services.
“By bringing the same wholeperson care found in our hospitals to your home, we can offer our patients a more comfortable and personalized healing experience increasing the patient’s autonomy.”
AdventHealth’s Hospital at Home program enables patients who would have required an inpatient stay at the facility to receive care at home instead. All the services that would be provided in the hospital are provided in the patient’s home. This includes things like nursing care, physical and respiratory therapy, and more.
Outside of the Hospital at Home program, AdventHealth also has an extensive home health
program that includes skilled nursing, physical therapy, home infusions, speech therapy and home health aides, Nazario said.
AdventHealth can provide services in the home for conditions like congestive heart failure, COPD exacerbations, uncontrolled diabetes, along with people needing IV antibiotics for conditions like skin and bone infections, and more can all be treated at home with a higher level of patient satisfaction.
Patients who have a qualifying condition can work with their hospital-based care team to determine if Hospital at Home is right for them. The care team will also help determine if the patient’s home environment is appropriate for this level of care.
“Through technology, patients can interact with their physician and patients’ electronic medical records are updated in
real time, just like they would be in the hospital,” Nazario said. Patients accepted into the program are provided with a computer tablet for video visits with their nurses and physicians, a telephone that connects directly to their care team, a personal emergency response bracelet, vital signs monitoring devices and a backup power supply. They are monitored 24/7 through a virtual command center.
Nazario said family support is important for many patients to heal at home and educational resources are provided to both patients and their families. “It’s important to note that care is being provided by trained healthcare providers,” Nazario said. “Family members are not asked to perform tasks that professional clinicians would provide. Having a caregiver or family member is not required and every patient is assessed on their particular condition and needs.”
If there is an emergency, the AdventHealth Hospital at Home team will immediately contact paramedics. Patients can also reach their care team in real time with the push of a button.
Patient satisfaction is already showing positive feedback from the patient and families, Nazario said. “Length of stay has also been positive. As we progress through adding patients to this model, we will have more outcomes to share.”
Tariffs and the U.S. Healthcare Supply Chain
What are the short-term effects? What about the long term?
 After the November 2024 election, LogicSource, a sourcing and procurement firm focused on indirect and non-clinical spend management, received a surge of calls from customers. With tariffs a key part of President Trump’s platform, clients were anxious to understand the potential impact on costs, including packaging, construction, and hardware.
“We knew tariffs were, at the very least, going to be used as negotiation leverage to drive policy, and at the most going to be used to bring manufacturing back into the U.S.,” said James Bouchard, associate partner, Center of Excellence at LogicSource. “But from November to early December, it wasn’t clear what the administration was planning and what we should expect relative to product-specific and country-specific tariffs.”
To prepare, LogicSource began laying the foundation for a reporting structure. It started with preliminary information provided by the Trump administration on country-specific tariffs for Mexico, Canada and China.
Then, LogicSource conducted an internal deep dive into the products its customers bought that were either directly imported from those countries or made up of raw materials imported from them. LogicSource also pooled information from external sources, including media outlets and government websites. The team created a tariff forecast, predicting impacts and price increases if the tariffs took effect as the administration was proposing.
“That is how we came up with an initial list of products that we expect to be impacted by these tariffs if they came into play,” Bouchard said.
In an interview with Repertoire Magazine, Bouchard shared some initial insights into how the tariffs already affected markets this spring – including healthcare – and potential long-term implications.
Repertoire: From your research, what do you see as the rationale behind the tariff policy? Where is the administration trying to steer economic policy?
Bouchard: If you were to ask me that in February, I might have had a different perspective. Initially, I thought the Mexico and Canada tariffs were a policy-driven ploy to curb illegal immigration and drug
trafficking. And when Mexico and Canada made concerted efforts to mitigate that from happening, I did not expect the tariffs to take effect in March. They were postponed a month because Mexico and Canada worked to address these challenges and appease the administration. So, I thought they would continue to be postponed because I had expected that the goal was to drive policy. I always expected China tariffs to take effect because of the focus on bringing domestic manufacturing back into the U.S. It was not policy-driven; it was more economic-driven.
If you ask me a month later, I still have the same point of view on China. The goal is to bring back more domestic manufacturing. However, with the initial Canada and Mexico tariffs, the administration achieved what they were trying to, at least on paper, regarding the policy changes from both countries.
Now that the tariffs are in effect, I would argue that the U.S. government wants to mitigate what we buy from Canada and Mexico to reduce reliance there. And this is all becoming an objective of bringing more ownership of these goods and services and manufacturing back into the country.
Repertoire: What do you think will be the long-term implications? Will this move the needle on domestic manufacturing?
Bouchard: It takes a long time to do that. We are hearing right now that there are many domestic manufacturers already for the products we typically import. For example, people can buy steel and aluminum from the U.S.
We just did a cost analysis where (as of press time) it was
still 30% to 60% higher to buy steel and aluminum from a U.S. manufacturer than if you were to import it from China with the compounded tariffs on top. And when those tariffs were made known and started to take effect, U.S. Steel started raising their prices, essentially keeping the same margin and delta they had before the tariffs. They raised their prices, assuming that current U.S. Steel buyers will continue purchasing domestically for convenience, lower transportation costs, and reduced risk of shipping delays.
I have not seen many new companies trying to strengthen domestic manufacturing operations yet. Part of it is that a lot of planning and investment goes into making a change like that. My guess is that most of the companies considering it are doing that cost-benefit analysis now, and they haven’t announced anything.
Repertoire: You mentioned steel and aluminum. What are some other areas where healthcare could be affected?
Bouchard: The pharmaceutical industry will be impacted, and we’re already seeing it. When you think specifically about China, it’s important to note that many active pharmaceutical ingredients (APIs) are sourced there – not only by pharmaceutical companies but also increasingly by large health systems, as specialty pharmacy becomes a major revenue opportunity for them. We import 30% of the raw ingredients that go into creating those specialty drugs from China. So those costs are increasing immediately now that the China tariffs have taken effect, and those tariffs
have doubled since the initial announcement. They started at 10% in February. We had another 10% added in March.
The other big area will be large clinical capital equipment and big medical devices such as X-rays, MRIs, CTs and other imaging diagnostic equipment. The parts, supplies and components that make those products often come from Mexico and China. The expectation is that the total cost will increase as component costs increase. We have not seen a ton ourselves yet from our healthcare customers who are buying a new piece of equipment, and the costs have skyrocketed, but we’re expecting that to be a trend that occurs very shortly.
Repertoire: What are you hearing from healthcare customers on how they are adapting?
Bouchard: Step one is understanding where the impacts will come from. And understanding that is not always easy because you don’t always know where or what you’re buying, where it originates from, how these tariffs will impact it, and whether your suppliers will pass through the entirety of that tariff. Our healthcare customers are getting their arms around the biggest spend buckets likely to be impacted by these tariffs, and then they’re taking a two-pronged approach to mitigate them. The first is focused on directly negotiating with their current suppliers and getting them to absorb part or all of the tariff increase or extend existing pricing for a set period of time until the tariff implications actually start applying to the price of the product.
There are many direct negotiations happening right now
with suppliers that already supply these goods. They’re dealing with the tariff impact directly, and it’s about how much leverage the healthcare system has in pushing those increases off for a period of time.
The second strategy is looking at alternative sourcing. Gloves are an example of a product that frequently comes from China, but there are many U.S. exam and surgical gloves manufacturers. The U.S.-based companies are now being evaluated more seriously than they have been in the past because those usually come with a cost premium. You pay extra to buy from the U.S. in those categories, but now those tariffs make their pricing model more attractive. So alternative sourcing, looking at domestic manufacturers of those goods, is a big play in healthcare.
70%, and they stayed there for a year. They eventually settled down, but they went up as an indirect impact from the tariffs because you have all these carriers who are used to running very specific routes. Now, they must send ships to different places without cargo to pick up something to distribute to a customer. So, they’re essentially spending all this extra money trying to ship because these companies are now trying to buy elsewhere and diversify their sourcing. So scheduled routes no longer are scheduled; they’re these ad hoc needs.
We’ve run multiple ocean freight projects for customers in the last few weeks. Currently, costs have increased 15%, so the suppliers are dealing with that. That’s one of their biggest issues because it’s now costing so much more, not just buying the product
The pharmaceutical industry will be impacted, and we’re already seeing it. When you think specifically about China, it’s important to note that many active pharmaceutical ingredients (APIs) are sourced there – not only by pharmaceutical companies but also increasingly by large health systems, as specialty pharmacy becomes a major revenue opportunity for them.
Repertoire: How is the vendor community responding?
Bouchard: One of the vendors’ biggest issues is the added distribution costs. Ocean freight is skyrocketing, similar to what happened in 2018. When all those tariffs took effect last time, ocean freight costs increased by about
but bringing it in. And they’re trying to find ways to mitigate that. That’s one of the reasons why we’re seeing a lot of ocean freight RFPs across our space and hearing from a lot of ocean freight carriers that they’re dealing with a tremendous amount of potential new business because everybody’s
trying to find a different way to bring supply into the U.S. That’s probably the biggest thing I see suppliers dealing with right now. The second biggest is deciding how to pass these tariffs through to their customers. Looking at the IT space, which will also indirectly impact healthcare, you will see that HP, Dell and Lenovo each say something very different about addressing tariff pass-through costs to their customers. One of those three had essentially raised their pricing equal to tariffs the day they took effect. Another offered orders for the next two to three weeks with pre-tariff pricing, and then the third held pricing until the summer. They were not passing through tariffs at all. So, there’s a lot of internal assessment being done at the supplier level to determine how they will treat their customers regarding these excess tariff costs.
Repertoire: It sounds like each company is handling it differently. There are going to be a lot of conversations in the supply chain. Bouchard: There are, and what makes it harder for everybody is that half of these tariffs could be gone in two months, or there could be a whole new bunch of tariffs that pop up that nobody considered in the past. There’s talk now of a U.S.-EU. trade war coming off the back of conversations around the U.S. and NATO and other foreign policy decisions that will bubble up into additional tariffs. It’s very hard to predict right now. There are talks around more focused tariffs on the auto and pharmaceutical industries, but you don’t know what will happen until the day of. It’s hard to plan.
“Stop the Cuts”
Medical groups and physician practices say cumulative cuts to Medicare Part B reimbursements are affecting the care they provide to patients.
 At a recent American Medical Group Association (AMGA) board meeting, several large, successful members shared something concerning to the group – they were running out of money.
“These are seasoned leaders,” said Chet Speed, chief policy officer. “They’re not alarmists. They don’t panic. They’re reasonable. They take measured moves as far as their operation’s concerned. But this is what they say is happening.”
It’s happening in large part because over the past four years, medical groups and health systems have experienced almost 8% in cumulative cuts to Medicare Part B reimbursements, which is not factoring in the 2.8% cut that implemented in early 2025. That’s essentially a half-decade of cuts totaling 11% over those years.
“How many industries can take on 11% cuts over five years?” asked Speed. “This constant drip, drip of cuts is becoming problematic for our members.”
According to data from the recent AMGA 2024 Medical Group Operations and Finance
Survey, medical groups continue to face challenges related to providing quality, cost-effective care in a constantly evolving healthcare environment. Medical groups are
strained from internal and external pressures, such as rising labor costs, increasing demand/access issues, and regulatory changes, including those from the Centers
Expense percent of net revenue per provider system-affiliated organizations
for Medicare & Medicaid Services (CMS). With a stifled reimbursement environment and continued financial pressures, medical groups are forced to double down on operations and expense management, the AMGA said.
In the survey, respondents were asked what they did in 2024 because of the cuts, and what they might do in 2025 if the cuts were not eliminated. “We were actually surprised by the severity of the impact that these cuts are having on the group practices that we represent,” Speed said. “These aren’t just superficial cuts. These are getting into the meat of the operations of patient delivery and employment.”
Speed identified two areas where the cuts were forcing members to make particularly difficult decisions. The first is related to patient-level services. Approximately 42% of AMGA members surveyed revealed they had eliminated some type of patientfacing service in 2024; two-thirds indicated they might be forced to eliminate patient-facing services in 2025. A total of 15% of AMGA members stopped accepting new Medicare beneficiaries, and a quarter said they’ll do that in 2025 if nothing changes.
The second category affected is employment. Approximately 55% of AMGA members surveyed said they implemented hiring freezes in 2024, and 67% said they’d have to do it in 2025 if the cuts continued. What’s more, 25% of respondents furloughed administrative staff last year, and 40% said they’d do it this year.
“If you’re a member of Congress, you’re concerned about two things; one, your Medicare beneficiaries having access to care, and secondly, that there is
Total revenue and expenses per physician system affiliated organizations
robust employment in the health sector within your state or district,” Speed said. “It’s pretty clear these cuts are having the opposite impact, that you do have beneficiary access issues becoming a consistent problem and hiring and firing becoming an issue as well.”
‘A compounding effect’
For a brief moment in December 2024 there seemed to be a resolution at hand. Speed said members of Congress had agreed to eliminate almost the entire 2.8% cut set to go into effect January 1, extend telehealth services for two years, and offer an ACOlike bonus for an additional year. “Those were all agreed to,” he said. “Those were all in legislation. They were all in a budget bill that was going to be passed.”
But the legislation fell apart in the span of 24 hours due to some fierce debate about the overall proposed budget between legislators and political commentators (including Billionaire Elon Musk).
And in late March 2025, AMGA expressed “deep disappointment” in Congress’ failure to address the 2.8% cut to the Medicare conversion factor, saying that legislators were missing “a key opportunity to protect patient access and the healthcare workforce during [the] Continuing Resolution vote.”
In a letter to House and Senate leadership, AMGA underscored the urgent need to alleviate their members’ financial pressures resulting from the cuts that took effect on January 1.
“These Medicare cuts are having an immediate and detrimental impact on patients and providers,” said Jerry Penso, MD, MBA, AMGA president and CEO. “Reversing these cuts will significantly enhance patient access to care and provide essential financial relief, ensuring that AMGA members can maintain staffing levels and continue delivering the high-quality care their patients expect. Congress must act now to restore stability to our healthcare system.”
Still, many House of Representatives members have indicated they would support getting rid of the cuts, so the AMGA and other like-minded organizations are hopeful the issue will be addressed in future legislation.
AMGA COO Mike Coppola said one of the often-overlooked challenges related to the Medicare Fee Schedule is that most commercial reimbursement rates are tied to it. So, for example, if a group practice is being paid 125% of Medicare from a commercial payer, over the last five years as the Medicare rate has shrunk, so too has the commercial side.
“It’s a compounding effect,” Coppola said. “It’s not just the Medicare rate. It’s the commercial payers and tying their fee schedules to the same Medicare rate that keeps declining. The cuts have created a snowball effect of declining reimbursement overall. Every time the Medicare fee schedule is reduced, the commercial fee schedule is also reduced.”
It’s this double-edged sword that Medicare groups are faced with, declining reimbursement across the board and increasing operating costs. “If you look at inflation over wages over the last several years, those costs aren’t coming back down,” Coppola said. “The funding mechanisms aren’t there to support the inflationary increases.”
When it comes to rising operating costs, the labor market remains the most disruptive to a medical group’s bottom line. Physician practices are having trouble maintaining staff at two key positions – the individual who sits at the front desk and the medical assistant who supports the doctors in provision of clinical care. Their turnover rate is anywhere from 20% to 30%, Coppola said. These employees are often leaving physician practices for 25 cents to a $1 an hour more for a retail job just so they don’t have to deal with the challenges and complexities of healthcare.
“They don’t want to have to ask, ‘Did I get the group ID number right?’ ‘Did the doctor code the visit appropriately so we can get paid a declining amount from every payer?’ To many employees, it’s not worth the stress,” Coppola said.
Potential fixes
In the next budget bill, AMGA would like to see three main things addressed:
First, the Part B conversion factor cut must be reversed.
Second, waivers to existing telehealth services regulations should be extended for another two years at least.
Third, the Advanced Alternative Payment Models (APMs) bonus that rewards value-based care must be maintained.
But to truly reform physician reimbursement beyond the budget bill, legislators and healthcare stakeholders will have to start with the basics, said Darryl Drevna, senior director, Regulatory Affairs, AMGA. “The first thing you need is a stable, predictable fee schedule update,” he said. “That’s why you need a predictability inflationary aspect or component of the fee schedule. If you don’t have that right, it’s going to be very difficult to do all the other exciting things that you could do with value-based care. So, step one is an inflationary piece that should be baked into the Medicare physician payments reimbursement system.”
AMGA has also continued to advocate for regulatory administrative relief. Physician practices believe there are too many burdens and criteria currently in place for quality measure reporting. A few years ago, an AMGA task force identified 14 simply but effective measures they believe would work well in a value-based arrangement, and could be used across programs, “so you’re reporting on a smaller set of more relevant outcomes-based measures,” said Drevna.
Prior authorization, specifically in Medicare Advantage, has been another massive headache for physician practices in recent years and something they call the AMGA office about frequently to ask about potential reforms. “This isn’t so much of a factor on the fee-for-service side of things, but in MA and then commercial payers as well, we are seeing providers appealing the denials, winning on appeal and that care eventually getting delivered, but it’s just slowing the process down,” Drevna said. “It’s delaying the ability of patients to get care they need.”
A lot of the work needed involves simply bringing rules and regulations into the modern era. There are plenty of other statutory things to address, many that don’t make sense when delivering care in 2025 because they came out of a program that was built in the 1960s, Drevna said. One example is the three-day stay requirement for skilled nursing care. “This was put in place because back in the day you were an inpatient for two weeks and they wanted to make sure that you got the care you needed as an inpatient before you were discharged into a post-acute care setting,” he said.
“That is just not how care is delivered anymore. So now you’ve got this crazy game that providers, patients, payers pay to make sure patients are getting to the right spot. It’s those types of things that we’re looking to eliminate.”
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Going Green
Optimizing sustainable practices through ASCs.
By Pete Mercer
 Sustainability is a hot-button topic that every organization in every industry has to reckon with right now. This is especially true for healthcare. By embracing sustainability, ASCs and other healthcare facilities can not only contribute to environmental preservation but also improve operational efficiency, reduce costs, and enhance patient satisfaction.
Repertoire Magazine recently spoke to Julie Moyle, MSN, RN, Sustainability Strategy Manager for Practice Greenhealth about sustainability in the ASC space, the misconceptions about what sustainability means, and how ASCs can implement greener practices.
About Practice Greenhealth
Practice Greenhealth is a national nonprofit that supports healthcare
organizations across the country in building lasting sustainability programs. The team at Practice Greenhealth works in many areas of sustainability, but two of their core areas of focus with their healthcare partners are reducing greenhouse gas emissions and building climate resilience plans. Through these initiatives, ASCs can work towards reducing their environmental impact and
ensuring continuity of care in the face of extreme weather events or supply chain disruptions.
“We work with large healthcare systems, academic medical centers, community health centers, federally qualified health centers, clinics, and ASCs,” Moyle said. “Because the health sector’s impact on the environment is so broad, our programming is equally comprehensive, supporting partners in areas ranging from waste reduction and safer chemicals to climate action.”
Sustainability in the ASC space
As an agile player in the care continuum, ASCs are uniquely primed to foster an environment for sustainability. Because they don’t operate on a 24/7 basis, ambulatory facilities consume less energy and resources than an in-patient facility. Most close at 5 p.m. and aren’t open during the weekends, or working with emergencies after hours.
“ASCs tend to be more agile and flexible. There’s no such thing as ‘it’s not my job’ in an ASC –there is no shift coming to relieve you, so staff incentive is high to get the job done, whatever it takes,” Moyle said.
The procedures performed in ASCSs are typically less intensive than an inpatient surgery in a hospital, which helps with patient turnover and increases overall efficiency. Additionally, most of the patients are considered “walking well,” which means they are generally healthier and lower risk patients than would be seen in a traditional hospital setting. They are intentionally serving this patient population because there are no overnight stays in an ASC,
thus a lower risk of any complications. This helps with patient turnover – getting healthy patients out the door improves efficiency and frees up resources and space for the next procedure.
Moyle said, “From room turnover to restocking drugs and supplies to sterile processing and familiarity with biomedical equipment: ASC nurses have a diverse skillset and an expectation that everybody is responsible for the work until the work is done.”
The misunderstood truth about sustainability
As with any major movement, there are a lot of misconceptions around sustainability, especially in healthcare. Moyle argues that a common misconception is that sustainability and climate action aren’t a priority for the healthcare industry, but this couldn’t be further from the truth.
“The climate crisis is a public health crisis and is considered the greatest public health threat of the 21st century, according to The Lancet and the WHO. The healthcare sector is on the frontline of the climate crisis, with patients bearing the shifting burden of disease attributable to climate change along with injuries and illnesses related to extreme weather events.”
Just within the last year, we have seen how drastically significant weather events can affect healthcare – many communities are still rebuilding from the devastation caused by the unprecedented dual hurricanes, Helene and Milton, in the fall of 2024.
A study conducted by Health Affairs found that the health sector is responsible for 8.5% of U.S. greenhouse gas emissions.
Moyle said, “When we consider the impact of the supply chain on healthcare’s climate footprint, the energy intensity of the OR, which is three to six times more per square foot than the rest of the hospital, and the inordinate footprint of anesthesia gases, it is safe to say that operating rooms are the epicenter of the healthcare carbon footprint.”
Fortunately, the ASC model is a practical solution for reducing the carbon footprint left by these larger healthcare facilities. Outpatient surgeries allow patients to safely and efficiently receive the care that they need, while also contributing to healthcare sustainability.
That type of change can generate cost savings from the avoided purchase of disposable containers and avoid tons of plastic from going into the regulated medical waste stream.”
One of the most important components of taking these steps towards sustainability is to take actionable steps forward – starting small can help your team to build functional, effective processes for the facility that will get you started on the right foot. Biting off more than you can chew will likely result in burnout and avoidable mistakes along the way.
“Think about past changes in the practice and what made them successful: education, signage,
One of the most important components of taking these steps towards sustainability is to take actionable steps forward – starting small can help your team to build functional, effective processes for the facility that will get you started on the right foot.
Taking the next steps
Taking steps towards sustainability is better than not, so it’s important to find practical solutions for introducing sustainability into the flow of the daily processes. Sustainability strategies should be low cost, practical solutions for your current workflow.
“Implement sustainability strategies that minimize disruption and enhance workflows,” Moyle said. “For example, the process for disposing of a sharp (things like suture needles and scalpels) is the same regardless of whether you are placing the sharp in a disposable container or a reusable container with a point-of-care service.
morning huddles, emails, update boards, and books, and perhaps a fun competition with incentives or prizes? Don’t forget to establish a baseline, share target goals, and outcomes.”
The best way for ASCs to reach sustainability goals is to ensure that everyone is on the same page. Moyle said, “Bringing staff ideas to life will not only turn on the engine of perpetual performance improvement but also enhance staff satisfaction and engagement by being a part of the solution, participating in something greater than themselves, and fulfilling their professional oaths by doing the right thing.”
Empowering Female Physicians in Leadership
The Women Physician Leadership Council through agilon health empowers women in the primary care field.
By Jenna Hughes
 The growth in the total physician workforce, from 730,654 in 2004 to 989,320 in 2022, reflects the increasing presence of women physicians across the industry, according to the Association of American Medical Colleges (AAMC). The perspective of female physicians has become increasingly crucial to providing patients with high-quality, value-based healthcare services.
agilon health, a company transforming health care for seniors by empowering primarycare physicians (PCPs) through value-based care, has elevated women through its Women Physician Leadership Council. The Council is developing female leadership within agilon’s Physician Network and the next generation of women PCPs to deliver value-based care in their communities.
The Women Physician Leadership Council also supports female leaders within the healthcare industry in recognizing and addressing the challenges that women often face disproportionately to their male colleagues.
Repertoire Magazine spoke to several founding members of agilon’s Women Physician Leadership Council on the necessity for female leadership within healthcare, including:
Dr. Victoria DiGennaro, Family Medicine Physician of the Pioneer Physicians Network and CEO of her own private physician practice.
Dr. Liam Fry is a Board-Certified Geriatrician, and the owner/ President of Austin Geriatrics Specialists in Austin, Texas. Austin Geriatrics recently merged with a multi-state group providing multi-specialty care with a specific focus on primary care.
Dr. Kristin Oaks is a ValueBased-Care (VBC) Medical Director at Central Ohio Primary Care. Dr. Oaks provides clinical leadership for the practice’s VBC programs and serves on its executive leadership team.
Supporting female physicians
agilon’s Women Physician Leadership Council provides women physicians with leadership skills training, mentorship, support, and sponsorship. The Council also encourages female physician representation at the top levels of leadership within each of agilon’s physician partners’ respective medical practices.
“The Council was formed to help agilon health address how to promote, develop, and sponsor more women physician leaders with the goal of improving agilon’s overall Physician Network,” said Dr. Fry. “This includes representation at all levels of decision making to create a growing voice of women primary care providers within each partner organization.”
The Women Physician Leadership Council, in turn, provides a supportive space of mentorship for each of the members involved to help them achieve their respective goals personally and within their practices.
“The training the Council provides – both intensive as well as through mentoring, friendship, and general support and guidance – has helped me significantly advance my own career as well as to gain more influence in my practice,” said Dr. Fry.
“Our mission as an organization is to promote women physicians in leadership and their ongoing success in the field of medicine,” said Dr. DiGennaro. “One of our goals is to reverse female underrepresentation in
healthcare leadership through supporting and empowering each other.”
agilon health has also developed a women physician resource group (PRG) to complement the Council and facilitate conversation and empowerment of women physicians and allies throughout its network.
“We aim to guide and support women across the field of medicine to focus on their own individual leadership development through coaching and expert lectures,” said Dr. Oaks.
“Organizations such as the Women Physicians Leadership Council represent an exciting time in healthcare,” said Dr. DiGennaro. “By promoting women physicians through value-based care, the future of healthcare is very bright.”
Workplace challenges
Data suggests that female physicians deliver better patient outcomes, including lower readmission and mortality rates, according to studies from The Lancet and JAMA.
Women, despite their contributions to the primary care
workforce, face numerous challenges to leadership and equality within the healthcare sector. Burnout, a widening workforce gender gap, taking time off work to raise children, and discrimination challenges within the workplace are significant, specifically amongst female physicians, which poses ongoing obstacles to career mobility.
“In the absence of women in positions of leadership, the industry fails to consider how women work as professionals,” said Dr. Oaks. “Without female leadership within healthcare, the voice of many physicians within the workforce is unfortunately not heard.”
The Council supports a wide network of female physician leaders, which serves to uplift its fellow colleagues to pursue positions of leadership and encourage women’s perspectives to be heard within the field of medicine.
“Women overall tend to have lower morbidity and mortality for their patients, creating very high value in medicine,” said Dr. DiGennaro. “In order to better serve patients and
Dr. Liam Fry
Dr. Kristin Oaks
Dr. Victoria DiGennaro
improve our healthcare system, it is vital that we promote women in the profession.”
“I find that value-based care helps to address workplace challenges,” said Dr. DiGennaro. “agilon health participates in full risk contracting as value-based care, meaning that we are responsible for the total quality and cost of care of our patient population. This allows clinicians to provide the ‘right care to the right patients at the right time.’”
Empowering female physicians
Women account for more than one-third of active physicians today, and, according to AAMC, women are expanding their presence in healthcare to become a significant share of active physicians in such specialties as pediatrics, obstetrics and gynecology, dermatology, pathology, and psychiatry.
More female physicians than ever are going into the field of primary care. From 2004 to 2022, the number of women in
Despite advancement for female physicians overall, within the field of primary care, there has been a trend toward women leaving the workforce five to 10 years after finishing their education.
Value-based care has transformed the healthcare landscape, with physicians taking the time to focus on patients’ entire health journey to support their care experience.
“We are in a particularly difficult time with increased utilization and increased medical expenses specifically for our senior population,” said Dr. Oaks. “Women physicians typically have shifted to fewer fee-for-service visits and seek to transform their practices aligned with value-based care guidelines.”
“Value-based care allows us as physicians to seek to improve health outcomes in our empaneled patients and are appropriately compensated for achieving that goal,” said Dr. Oaks. “When we eliminate unnecessary expenses from the patient’s care, we improve their health and our economics.”
the active physician primary care workforce increased from 28% to 43%, according to the AAMC.
“It is important that leadership within healthcare organizations is balanced,” said Dr. Fry. “We see increasing numbers of women physicians going into primary care (a larger percentage than men), and approximately half of all patients are women.”
Despite advancement for female physicians overall, within the field of primary care, there has been a trend toward women leaving the workforce five to 10 years after finishing their education. Many women within PCP healthcare leadership find themselves as one of the only women among many male leaders.
“Women leaving the healthcare field is a huge loss, both to the nation in terms of investment but also to our practices and patients,” said Dr. Fry.
A report from AAMC found that within six years of completing training, 22.6% of women physicians were not working full-time compared to 3.6% of male physicians.
“The Council is working to find ways to retain women physicians,” said Dr. Fry. “This includes working through the challenges of balancing family and work responsibilities and finding ways to effectively reintegrate women who have taken time off to raise a family and are wanting to come back to practice.”
Through the work of numerous prominent female medical leaders, the Women Physician Leadership Council develops female leadership within the agilon Physician Network and bolsters the next generation of women PCPs to stay with the career and deliver value-based care within their practices and communities.
The Women Physician Leadership Council’s top initiatives are education of more women in healthcare, promoting an increased number of female leaders, advocating for healthcare policy, reducing/ eliminating the gender wage gap, and addressing burnout within healthcare. These initiatives work toward the Council’s goal of lifting up female physicians and encouraging them to pursue positions of leadership within the healthcare industry.
“One of the most visible ways a company can demonstrate support is to ensure that their leadership, all the way up to the C-suite, has a balanced makeup that includes a significant number of qualified women,” said Dr. Fry. “If we are going to be able to both recruit and retain high quality physicians, we will need to be sure our strategy is inclusive and promotes women physicians.”
HIDA Urges Trump Administration To Protect Patients From Product Shortages
Editor’s note: HIDA was proud to work with AdvaMed to co-lead a letter – signed by 10 healthcare organizations across the continuum of care – to U.S. Trade Representative Jamieson Greer about the need to protect patients from product shortages that could be caused by recent developments in tariff policy.
April 1, 2025
U.S. Trade Representative
600 17th Street NW Washington, DC 20006
Dear Ambassador Greer,
On behalf of the undersigned health care organizations, we write in support of the administration’s focus to make America healthy again and to express our concern about the impact of tariffs on medical and dental supplies, equipment, and devices. These products are lifesaving, lifesustaining, and help deliver the timely care Americans need.
The U.S. health care system and its providers rely on having safe and cost-effective access to a broad spectrum of medical and dental devices and supplies, whether they are used in routine medical care or in emergency settings.
Given the important role of our work in making America healthy, we are concerned that tariffs placed on medical and dental equipment threaten to disrupt the supply chain and raise costs for these critical items. This ultimately places
further financial pressure on providers, hospitals, and health systems, particularly those located in rural and medically underserved areas. According to the American Hospital Association, 136 rural hospitals closed between 2010 and 2021, and a recent study by the Center for Healthcare Quality & Payment Reform found that 700 more hospitals are at risk of closure.
We are also concerned that increased costs on medical and dental supplies could impede our ability to improve treatment outcomes, foster innovation, and meet the growing needs of pediatric and adult populations. This could result in longer wait times, reduced access to necessary treatments, and greater financial strain on health care systems that are already under pressure.
Since the tariffs were announced, other health care stakeholders have weighed in expressing concerns on consumer access, drug and product shortages, and medication price increases. A recent study from Black Book Market Research found that of the 200 industry professionals surveyed, 80 percent expected costs
for hospitals and health systems to increase by at least 15 percent in the next six months due to increased import costs.
We look forward to working with the Trump administration and other agencies to advance policies that improve the health outcomes of Americans. We respectfully request that medical and dental supplies, equipment, and devices are made exempt from tariffs to prevent further escalation of health care costs and ensure patient accessibility to these products.
Thank you for your attention to this matter. We are available for further discussion and look forward to working together to address these critical concerns.
Sincerely,
AdvaMed
Health Industry Distributors Association
American Association for Homecare
American Dental Association
America's Essential Hospitals
Association of American Medical Colleges (AAMC)
Conquering CHD
Preeclampsia Foundation
Prevent Cancer
Sepsis Alliance
Infection Prevention
Boyle’s Law and the Infection Prevention Supply Chain.
By Paul Girouard
 Do you remember playing with a balloon as a kid? You’d squeeze or poke one end, and it would bulge in another. That’s Boyle’s Law in action – when temperature stays constant, the pressure and volume of a gas are inversely related. In other words, pressure in one area causes expansion in another.
That same principle applies to today’s infection prevention supply chain. Every day we’re managing pressure from multiple directions: tariffs, clinical compliance, shifting public policy, unpredictable demand spikes, and the global complexity of sourcing. When pressure builds in one part of the system, it creates disruption somewhere else.
Over the years (especially the last five) our industry has learned a lot. But now, more than ever, we need to plan proactively to avoid service interruptions and support our customers in delivering safe care. Here are a few areas to focus on, along with practical solutions we should all be thinking about:
1 Supply chain resilience and readiness
Stockpiling isn’t financially realistic for most distributors or manufacturers. But keeping inventory too lean doesn’t work either. The sweet spot is somewhere in the middle.
Diversify your supply base. Both geographically and by vendor. Avoid putting all your eggs in one basket.
Review and build cross-reference lists. Include primary, direct alternatives, and even tertiary options. They might not be perfect substitutes, but in tight supply situations, flexibility is key.
Strengthen your supplier network. Relationships matter in this industry. In moments of crisis, the strength of your network often determines your ability to deliver.
2 Aligning with infection control best practices
You bring more value to your customers when you understand the guidelines they have to follow.
Spend time on trusted sources like CDC.gov, FDA.gov, and WHO.int. These sites provide clear, updated recommendations on hand hygiene, surface disinfection, sterilization, PPE, and more.
While the FDA provides product-specific guidance, comprehensive infection prevention protocols – especially around bloodborne pathogens – are set by OSHA (29 CFR 1910.1030). These standards guide PPE use, decontamination, and worker protection.
Use tools like ChatGPT to summarize these documents and stay informed. The more you know, the more you can help your customers stay compliant – and compliance drives demand.
3 Infection prevention as a value-add
This category is more than just
gloves and wipes. Infection prevention is complex, dynamic, and full of opportunities to demonstrate value.
Public policy is shifting.
Healthcare facilities are often understaffed and overwhelmed.
Clinical teams need support, and your product knowledge can make a real difference.
Partner with your suppliers to build product formularies that support compliance programs. Help your customers create consistent protocols that protect staff, patients, and bottom lines.
The bottom line
Going back to Boyle’s Law: we know where the pressure is coming from. Our job is to help absorb and redirect that pressure – so our customers don’t feel it. In 2025, infection prevention isn’t just about PPE. It’s about ensuring healthcare facilities are ready for the next outbreak, meeting ever-changing regulatory expectations, and using technology to drive efficiency.
Distributors who show up as true infection prevention partners – not just product providers – will stand out.
And don’t forget… Wash your hands.
SCAN ME
Dialogue That Drives Outcomes
Kaiser Permanente’s Nestor Jarquin says collaboration with clinicians is the secret sauce for the organization’s supply chain.
 Nestor Jarquin may look at physician engagement with the supply chain a bit differently than most. A healthy sign of collaboration to him isn’t when everybody is on the same page at the start of the process. He believes it’s when clinicians and supply chain leaders can actually sit down and debate during their meetings – from the clinician’s product preferences to the business ramifications those choices will create for the organization.
“Those kind of collaborations – where they are open to dialogue – give you a good feeling about how connected you are to the clinical group,” said Jarquin, strategic sourcing sr. category manager, surgical, Kaiser Permanente.
Indeed, Jarquin doesn’t take for granted that Kaiser Permanente clinicians are open to having a business dialogue about the products and instruments they use. “Those dialogues are hard,” he said. “But in our culture, it’s not argumentative, it’s collaborative. The clinicians understand that on the supply chain side, we’ll always honor and respect their clinical expertise and opinions. Conversely, they understand and respect the business paradigm. It’s a unique blend between the two perspectives.”
Kaiser Permanente’s seasoned physicians know the market and the organization’s business practices and can put that mindset to use when making clinical decisions. That cohesion helps the organization come to a solution that’s ultimately meaningful for the patient and the business.
Nestor Jarquin
More than just moving boxes
Jarquin describes his career in supply chain as a “winding path.” While in college, he worked at a major medical center as an orderly. In that role, he became interested in the science of caring for patients, beyond just ordering and stocking supplies. He would eventually secure a managerial role at that medical center and become involved in the supplies for the entire organization. From there, he worked as a director in materials management at several different institutions.
Those roles involved traditional supply chain responsibilities for the ordering, stocking, and delivery of supplies throughout the entire medical center or hospital. He gained experience in supply management, contract management, and in some of the institutions, stakeholder management. He worked beyond the purchase order, collaborating with clinicians to better understand their needs and requirements, and how the products were being used, an aspect of the work that appealed to him.
In October 2006, Jarquin joined Kaiser Permanente’s supply chain department. He admits he didn’t totally know what to expect working for the organization and how its supply chain operated. “When you’re outside of Kaiser Permanente, you always wonder how they do what they do,” he said.
Jarquin marveled at the connectivity of the supply chain to its end users. Supply chain wasn’t just about moving boxes; it touched the entire procurement cycle. Although there are different departments, they’re still part of one family and fully engaged in
the entire buy-to-pay process. “From strategic sourcing to receiving, payment, inventorying, and picking – all that falls within supply chain,” he said. “We see the whole continuum.”
Kaiser Permanente’s supply chain team relies on one another to ensure they have a successful strategy to deploy – in whatever category they’re talking about. “I’m directly linked to the storeroom clerk and the clinical end user,” Jarquin said. “I don’t see that happening throughout healthcare in general. We’re a
qualitative outcomes, and cost. There are some categories that, qualitatively, have similar device options, but one company has a business model that portrays it as being unique in the market, when in fact it’s not. And, if it’s a physician preference item, supply chain has to weigh that consideration heavily into its purchasing decision.
Recently, there was one category where Kaiser Permanente ended up with a favorable proposal that made sense both clinically and financially. What
“ We’re trying to keep our costs down so that the cost of membership for Kaiser Permanente is kept to a competitive space. It was only because of a mutual understanding with our clinicians that we were able to do something like that.”
single supply chain. We’re all connected and we benefit from that. All the way from that storeroom clerk who needs to order a particular item, to me and strategic sourcing who are trying to ensure we’re making the right decision based upon clinical evidence and outcomes. The fact that we’re a part of that cycle from buy to pay gives us a different perspective from most organizations.”
Kaiser Permanente’s “secret sauce”
He also noticed early on how aligned the organization’s supply chain team was with clinicians. “It’s our secret sauce,” Jarquin said. Indeed, supply chain leaders often have a delicate balance to make between clinical necessity,
encouraged Jarquin was how in sync the clinicians were about the decision-making process they had built together. “I knew our clinicians wanted these products, but all things being equal, they were not willing for the company to pay X amount more. They told us that they had to help reduce the cost of care here. That was our constant message.”
Eventually, the company agreed to a proposal with Kaiser Permanente. Jarquin was able to give the clinicians something they wanted and hadn’t had in quite some time. “It happened because our clinicians understand our model,” he said. “They understand the cost. It goes back to our culture, which is all about tying the business, outcomes,
and cost together. We’re trying to keep our costs down so that the cost of membership for Kaiser Permanente is kept to a competitive space. It was only because of a mutual understanding with our clinicians that we were able to do something like that.”
Sustainability and lifecycle management
Because of its alignment with clinicians, Kaiser Permanente can tackle big initiatives. For instance, the organization has lofty sustainability goals. “We have tremendous goals in reducing waste, eliminating the use of plastics, being stewards of our resources, etc.,” said Jarquin. “All of our category managers are driven by those metrics and have individual goals to go out and affect the environment positively.”
In 2020, Kaiser Permanente became the first U.S. health care organization certified as carbon neutral, and they have continued to maintain the certification annually. In 2022, they publicly stated their goal of reaching net-zero emissions by 2050. Sustainability is a key part of Kaiser Permanente’s procurement collaboration, and new suppliers are selected based in part on their environmental commitments. Kaiser Permanente also works with existing suppliers on their greenhouse gas reduction goals, innovation, and process improvement to drive action and accountability.
According to its 2022 “Sustainability & Responsibility” report, just over half – 51% – of Kaiser Permanente’s nonhazardous waste was collected for recycling, reuse, and composting in 2022, including:
More than 39,000 tons of waste collected for recycling.
More than 2,700 tons of organic waste collected for composting, a 55% increase over 2021.
More than 3,200 tons of cardboard waste collected for recycling.
More than 1,375 tons of electronic waste collected for reuse or recycling.
In addition, over 1,290 tons of plastic waste was avoided by the use of reusable sharps containers. Over the years, through programs to recycle single-use devices, Kaiser Permanente has diverted 1.2 million devices to be re-manufactured instead of thrown away, Jarquin said.
job to work on sourcing material and supplies in the market at large, both domestic and international. “We had to prepare ourselves for the unknown.”
Jarquin and his team learned how the international supply chain market operated, how products came across the water, and how they were validated. He was surprised by the delicate nature of the international raw material market and how one disruption could lead to issues throughout the supply chain. For example, during this time, Jarquin observed one overseas manufacturing plant that started hoarding a particular commodity. This resulted in a domino effect throughout multiple product categories. Jarquin’s
“ Now we’re including language in our contracts that sort of changes the definition of force majeure. What we’re saying is that a pandemic is not a force majeure event. It’s an event that you need to plan for. So, what are you doing to plan for that event?”
Kaiser Permanente’s clinical groups are also heavily involved in sustainability efforts. “As we go through our reviews and discussions with clinicians, they’re saying, ‘Hey, that’s made out of plastic. Can we do something with it? That’s a single-use device scope with precious metals in it. Do we have to throw it away?’
Sustainability is a part of our requirements, even with the clinical groups,” Jarquin said.
Eyes wide open
For almost two years following COVID, Jarquin gave up his day
team discovered that there weren’t enough protections in that international market, both from a supply chain resiliency side and a qualitative side.
“We didn’t know that until we dove into the international market,” he said. “It was a realization that you have to go into this with your eyes wide open and work with the diligence that any other Fortune 500 company would when looking at its supply chain. Get into those details. Bring people onto your team who know what questions to ask. That’s what we’ve built over the years.”
As a result, Kaiser Permanente is now staffed and equipped to take a deeper look at manufacturers’ supply chains, especially with certain product lines like PPE and surgical instruments. Not only are they asking suppliers if they can ship the product, but they want to know things like where the product is manufactured, what the raw material source is and where the supplier gets it, and how the supplier is making its own supply chain resilient so that when (not if) the next pandemic hits, they be will able to continue to produce.
testing. They have developed a policy that tells the manufacturers their obligations around quality specific to Kaiser Permanente in addition to the FDA.”
The pandemic opened everybody’s eyes to the need to do things differently in supply chain. There’s now more of an appetite for increased transparency across the board. On the hospital or healthcare side, transparency has meant being clear about what their needs and requirements are for a category beyond just an RFP. It can no longer be “three bids and a whirl of dust” to determine which
Kaiser Permanente has three-year contract cycles. So, in essence, 18 months after signing a contract, Jarquin and his team have to revisit it. They’re already thinking about and preparing for 2026.
“Now we’re including language in our contracts that sort of changes the definition of force majeure,” said Jarquin. “What we’re saying is that a pandemic is not a force majeure event. It’s an event that you need to plan for. So, what are you doing to plan for that event?”
Kaiser Permanente has also developed its own product quality department within its sourcing structure that includes a director of medical device quality who gets into the details of quality processes in design and manufacturing. “Not clinical quality, but medical device quality,” said Jarquin. “How do you validate? How do you test? This person is well versed in ISO certifications and
supplier to go with, Jarquin said. “It’s more, ‘This is my situation, these are my requirements, and here are my asks. Can you provide those?’”
In turn, suppliers are being asked about their inventory levels, manufacturing locations, product testing, and certifications. “In the past, health systems just sort of accepted those things without really asking,” Jarquin said. “Now we’re validating some of the requirements that we always assumed were there.”
“It’s not just about bids,” Jarquin continued. “What are we trying to do? What are we trying to achieve? If we can make that shift on both sides, providers and
suppliers, I think we can meet in the middle. Just remember why we’re in this. We’re here to provide care.”
Driving value
Jarquin believes the U.S. healthcare system would benefit from moving away from episodic care to more holistic principles around the value of care. “It’s more about managing the lives of the patient from both sides of the equation, clinical and business.” Instead of focusing on volume, valuebased care would free up clinicians to focus more on improved outcomes. Instead of revenue, manufacturers could focus on evidence that their product line is going to provide a different state, whether it’s a better outcome, shortened length of stay, or even a better cost.
Why should supply chain care about that? “Because of the fact that the products, equipment, and services we source and distribute are all part of the patient journey in some form or fashion. So, if you’re more about episodic versus the holistic view of managing the overall care of the patient, you’re not seeing the forest for the trees,” Jarquin said. “You’re not seeing that end state for the patient.”
In the last several years, many companies that supply products to Kaiser Permanente have had to adjust their supply chains, which has resulted in disruptions. Kaiser Permanente’s supply chain team and clinicians have come together as a group to determine whether certain alternate products meet clinical practices while the supply chain recovers for its regular product orders. Some disruptions
continue even through today. “The challenging part is, some of these supply chain constraints were sole-source devices in the sense that they’re the only thing in the market out there for particular procedures. So, this forces us to look at options and workflow differences, collaborating with our clinicians.”
Kaiser Permanente has three-year contract cycles. So, in essence, 18 months after signing a contract, Jarquin and his team have to revisit it. They’re already thinking about and preparing for 2026. “I have to study,” he said. “I have to become an expert in new
technology every year and be able to understand our requirements and project those requirements to the supplier base.”
Fortunately, Jarquin doesn’t have far to look when seeing the impact he and his team have on the health of patients. It’s one of the most rewarding parts of his job, and something that keeps him going two decades plus into his career.
“The fact that I’m so closely aligned with clinicians means I can see the impact,” he said. “Every year, it’s a new challenge, and I can say there’s never a dull moment in this particular category.”
Kaiser Permanente’s Footprint
Kaiser Permanente is one of the nation’s leading notfor-profit health plans, serving nearly 12.5 million members. Kaiser Permanente has 40 hospitals, 614 medical offices, 24,605 physicians, 73,618 nurses, and 223,883 employees, according to the latest figures.
The Silent Epidemic
Despite the importance of bone health, the U.S. is currently seeing epidemic levels of osteoporosis.
 The bones in the body are dynamic, living tissues that support an individual throughout their entire life. Yet, the U.S. is currently experiencing epidemic levels of osteoporosis, according to Dr. Rita Roy, Chief Executive Officer of the National Spine Health Foundation.
Osteoporosis is a condition that leads to a decrease in bone strength, making them fragile and prone to fractures, according to the National Institutes of Health (NIH). Osteoporosis is the major cause of fractures in postmenopausal women and in older men. Fractures can occur in any bone but occur most often in bones of the hip, vertebrae in the spine, and wrist.
“There is consensus among physicians that osteoporosis is a silent disease and epidemic in our country. And although there were many, many efforts to combat this epidemic, the rates have only continued to increase,” according to Dr. Roy.
Rates of osteoporosis are higher among women than men, with one in two women and one in four men 50 years and older breaking a bone at some point in their lifetime due to osteoporosis, according to the Bone Health Policy Institute. As of recent, rates are not just increasing in post-menopausal women, the largest population of osteoporosis, but also in much younger age groups, says Dr. Roy.
“We often hear about falling and breaking your hip following a fracture, but what a lot of people don’t know is that osteoporotic
fractures in your body occur more commonly in the spine than anywhere else,” said Dr. Roy. “Advocacy organizations and physicians are aiming to increase healthcare industry knowledge of vertebral compression fractures (VCFs), especially those caused by osteoporosis, as they increase the risk of subsequent (secondary) fractures and are very harmful to patients.”
“Osteoporosis is thought of largely as a women’s health issue, because it affects women more proportionately than men,” said Dr. Roy. “Women are often the caretakers of their children and families, so it is important both for men and women to recognize that in order to care for all the people you love, you must put your health needs first to avoid broken bones.”
A healthy skeletal system
Nearly 10 million Americans have osteoporosis, and another 44 million have low bone density, which puts them at increased risk of suffering from a bone break due to osteoporosis, according to the Bone Health and Osteoporosis Foundation. Throughout one’s life, your bones are in a constant state of building and repair. This ongoing process can be supported by healthy lifestyle choices and dietary intake of specific nutrients, according to The National Spine Health Foundation.
There are many factors that contribute to osteoporosis, such as getting older, hormonal changes, past fractures, family history, glucocorticoid steroid use, and being a female. Though many factors contributing to osteoporosis are uncontrollable,
there are modifiable risk factors that individuals can take to maintain their bone health, such as decreasing alcohol consumption, reducing or quitting smoking, participating in physical activity, getting adequate supply of key nutrients that support bone health such as vitamin D and calcium, and increasing sunlight exposure.
calcium in your diet, the body will pull calcium from the bones to support the many other physiologic processes in our bodies that require calcium,” said Dr. Roy. “If too much calcium is removed for other functions, the bones become weak and fragile.”
Dairy products such as yogurt, milk, and cheese are the most well-known sources
“ The bones in our body are dynamic, changing every day, expanding and contracting. Many people think of bone as rigid and hard, but it is breathing and living tissue. People achieve peak bone mass by age 30 years which is when someone has the maximum amount of bone which we then withdraw from our “bone bank” as we get older.”
“There are risk factors that you cannot control, and there are risk factors that we can control, so we tend to focus our public education messaging around the risk factors that you can control,” said Dr. Roy. “The number one contributing factor to developing osteoporosis is your genetics. The rest of the population may have low bone mineral density for a variety of factors. For those with risk factors, there are many things we can do to enhance our bone health.”
As CEO, Dr. Rita Roy oversees The National Spine Health Foundation’s strategic initiatives around public health messaging, research operations, and advocacy initiatives related to spine and bone health.
“Your bones serve as a repository for calcium in the body. When you don’t get enough
of calcium, and calcium is also found in other foods such as leafy green vegetables, fish, beans, and nuts and seeds. Vitamin D is also essential to the body’s ability to absorb calcium and can be increased through sunlight exposure and consuming foods like egg yolks, cheese, and fish.
“The bones in our body are dynamic, changing every day, expanding and contracting. Many people think of bone as rigid and hard, but it is breathing and living tissue,” said Dr. Roy. “People achieve peak bone mass by age 30 years which is when someone has the maximum amount of bone which we then withdraw from our “bone bank” as we get older.”
Advocating for bone health
Healthcare professionals have acknowledged the importance of
bone health to a patient’s overall health for a long time. However, for patients themselves, there can be very long waits to see a bone health specialist such as a rheumatologist or endocrinologist. Primary care doctors, who are the front lines of healthcare, are so busy and overloaded with treating other conditions, says Dr. Roy, that osteoporosis diagnosis and treatment often do not occur or is delayed.
“Osteoporosis is a silent disease, and it is all about preventing the first fracture. The bone density scan known as DXA is the de-facto standard for measuring bone density, but we have learned that in most major cities and in small towns across the country, it is sometimes hard for patients to get a DXA scan,” said Dr. Roy. “Osteoporosis doesn’t always appear to be the most imminent health threat, so it can be put in the back seat to allow physicians to treat other more pressing diseases. Unfortunately, as a result, there has been a lack of urgency across the nation for getting osteoporosis diagnosed and treated.”
The mission of the National Spine Health Foundation is to increase patient education, patient advocacy and patient-reported outcomes research on spine and bone health. Bone health is spine health, says Dr. Roy, and what matters to the health of your bones also matters to the health of the spine. Maintaining a healthy lifestyle and diet can reduce the risk of both spinal degeneration and osteoporosis.
“Advocacy groups, including The National Spine Health Foundation, are pushing for DXA scans to be a part of routine health
screening in anyone 50 years and older,” said Dr. Roy. “DXA scans are low risk, and should be part of routine testing along with mammograms, colonoscopies, etc.” Dr. Roy also noted that all patients are able to obtain a baseline DXA scan as part of their Welcome to Medicare preventive care benefits, but many patients and physicians are unaware of this opportunity.
The National Spine Health Foundation features the ‘Bone Hub’ resource for patients and healthcare providers on its website, offering easy-to-understand information on risk factors, prevention strategies, and treatment options to support bone health.
“One of the greatest points of opportunity for patient education is in the clinical encounter. This May, for National Osteoporosis Awareness and Prevention Month, the National Spine Health Foundation is doing a very large digital media campaign around vertebral compression fractures and secondary fractures,” said Dr. Roy. “Across the organization, we’ll spread bone health messaging we’ve created in the form of support videos, educational tools, patient webinars, infographics, and more to support doctors and inform the patient community on the importance of lifelong bone health.”
Industry News
Owens & Minor announces major innovations to Products & Healthcare Services Network
Owens & Minor, Inc. announced important milestones in advancing the medical distribution capabilities of its Products & Healthcare Services (P&HS) business segment, which provides essential products and services to thousands of healthcare customers. These milestones are the result of recent company investments in new technology, automation and analytics capabilities geared specifically toward driving greater efficiencies for the P&HS segment and improving the customer experience. Initial roll out will focus on two new Owens & Minor distribution centers in West Virginia and South Dakota.
These new capabilities will be operational at two new Owens & Minor sites starting in 2025:
A new state-of-the-art distribution center with advanced automation and robotics technology to help streamline and expedite inventory management and order fulfilment in West Virginia (now open)
A second state of the art distribution center in South Dakota that will integrate the latest augmented reality (AR) system for supporting the order picking process (opening spring 2025)
“Over the past two years, our P&HS teammates have worked creatively and diligently to identify areas where technology investments, operational upgrades and new approaches to how we
do business could have a meaningful impact for our customers,” said Andy Long, EVP and CEO, Products & Healthcare Services, Owens & Minor. “We’re excited for these advancements to go live in West Virginia and South Dakota and look forward to the benefits they will provide for other Owens & Minor customers in years to come.”
Midmark celebrates 110 years of innovation and leadership in healthcare solutions Midmark Corp. celebrates 110 years of innovation this year. Founded in 1915 in Minster, Ohio, with a patent for a concrete mixer, Midmark has continually reinvented itself. Today, the company provides holistic care solutions that transform clinical care environments for the betterment of patients and caregivers alike. Today, headquartered in Versailles, Ohio, Midmark designs and manufactures integrated ecosystems of products and solutions that harmonize space, technology and clinical workflow to create highly efficient and effective care environments.
As a longstanding leader in Ohio’s Dayton region, Midmark continues to expand its operations, investing in both business growth and community support. The company employs more than 1,900 teammates globally, including 1,200 in the Dayton area. Midmark’s commitment to innovation is evidenced by the company’s recent investments in state-of-the-art facilities. In 2021,
Midmark unveiled its Experience and Technology Centers in Versailles, Ohio, fostering collaboration and innovation to meet the evolving challenges in healthcare.
Midmark’s continued investment in the region includes a 114,000-square-foot expansion in 2021 and a $19 million manufacturing expansion in Versailles in 2024. These efforts demonstrate the company’s ongoing dedication to its teammates, customers and the local community, ensuring shared prosperity for future generations.
Henry Schein donates health care products to support Special Olympics Healthy Athletes® screenings
Henry Schein, Inc. is supporting the Special Olympics Healthy Athletes® screenings at the Special Olympics World Winter Games Turin 2025, which take place from March 8 to 15, 2025, in Turin, Italy. The organization is donating a range of medical products essential to overall health and wellness. During the Healthy Athletes Ribbon Cutting Ceremony, on March 8, 2025, Henry Schein was recognized for these contributions. Healthy Athletes offers free health screenings and education to participating Special Olympics athletes.
The goal of the program is to identify and address unmet health needs for people with intellectual and developmental disabilities (IDD) and provide referrals for follow-up care while also promoting healthy lifestyle choices.
50 organizations join Premier in urging congressional leaders to pass the Medical Supply Chain Resiliency Act
A strong and sustainable healthcare supply chain is essential for quality patient care and requires a multifaceted strategy that incentivizes domestic manufacturing while cultivating trusted trade partnerships. Premier joined 50 other organizations in sending a letter of support for the bipartisan, bicameral Medical Supply Chain Resiliency Act (S. 998/H.R. 2213). The Premier-endorsed bill would enable the President to enter into trade agreements with trusted trade partner countries to diversify sourcing for critical medical devices and pharmaceuticals, protect public health and bolster national security.
Nearly 3 million Americans live where even telehealth can’t reach
Nearly 3 million Americans live in mostly rural counties that lack both healthcare and reliable high-speed internet, leaving them with worse outcomes and fewer options, according to data collected by KFF Health News.
Measles cases exceed 600 nationally with majority in Texas
There are 607 confirmed cases of measles across the U.S., according to the latest data released April 4 by the Centers for Disease Control and Prevention. The majority of cases are in Texas, as an outbreak in the state has grown to 481 cases, according to the Texas Department of State Health Services. Cases have been reported by 21 states, with 93% being outbreak-associated, according to the CDC. The vaccination status of 97% of cases is classified as “unvaccinated or unknown.”
Midmark is the first and only manufacturer in the market to have both a procedure chair and an examination chair that comply with the US Access Board Standard.
Getting to know the standard
01 Seat Height: <17" low and >25" high
02 Transfer Surface: 21" wide and 17" deep
03 Base Clearance: <26" wide
04 Transfer Supports: Compliant to the US Access Board Standard
05 Leg Supports: Compliant to the US Access Board Standard
Learn more at: midmark.com/compliant
Source: US Access Board. (2024, July 25). Standards for accessible medical diagnostic equipment. Federal Register, 89(143), 47823-47839. https://www.federalregister.gov/documents/2024/07/25/2024-16266/standards-for-accessible-medical-diagnostic-equipment
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