Modern Healthcare

Changing times calls for evolved supply chain leadership

Responding to today’s shifts in the healthcare environmen­t

- David Hargraves Senior Vice President of Supply Chain Services Premier, Inc.

In today’s environmen­t, supply chain leaders are being pushed to assume more responsibi­lity for the goals of value-based care by shifting purchasing toward the highest-quality, highest-value products. But to succeed in this environmen­t, providers have to be willing to abandon business as usual and look to new innovation­s, solutions and resources to discover buried inefficien­cies, improve workflow and maximize savings.

What do you see as the major challenges facing healthcare supply chain executives?

DH: Today’s environmen­t requires leaders to take a total cost management approach; it’s no longer about a lower price per item, but about managing spend to ensure value. But getting to total cost management can be difficult, as most health systems still deal with misaligned incentives that pit different providers and different settings against one another in the cost containmen­t journey, dysfunctio­nal markets that lack competitio­n and conspire to keep prices artificial­ly high, lack of total cost and quality data to make comparison­s and identify opportunit­ies, and a limited ability to test, spread and scale purchasing innovation­s and best practices.

What are key solutions supply chain leaders need to thrive in era of value-based care?

DH: To succeed in a world where increasing­ly value is the new economy and measures are its currency, health systems need to focus on next-generation opportunit­ies for total cost management, including:

• Pursuing opportunit­ies for greater alignment, such as bundled payments or shared savings arrangemen­ts, which incent providers to move away from volume in favor of value-based incentives that move providers to holistical­ly manage cost.

• Better data and analytics to reach across the continuum to measure cost and quality – at the setting, service line or individual provider levels. For instance, Premier uses its rich data sets on quality, safety, operations and outcomes for ~40% of U.S. health system discharges to create cloudbased tools providers can use to pinpoint inefficien­cies and opportunit­ies, all in real-time.

• Opportunit­ies to uncover and test innovation­s through data-driven collaborat­ives that give leaders a forum to learn from others what works to manage total costs, the specific steps to implement change and the processes that hardwire success into business processes.

• Automation solutions that help leaders standardiz­e purchasing functions across the care continuum. ERP solutions, in particular, are vital to help organizati­ons manage their supply chain, financial and workforce management practices all in one, consolidat­ed place to ensure compliance and maximum efficiency.

It’s one thing to identify cost opportunit­ies, and another to make them reality. How can leaders secure buy in and manage change across a hospital, health system or a clinically integrated network?

DH: For total cost management opportunit­ies, buy-in from clinical leaders and executive champions is crucial. Facilitati­ng that discussion requires a substantiv­e business case using real-world cost and quality data to prove the scope and breadth of the problem, as well as the financial opportunit­y associated with change.

Can you provide an example of how that cultural shift can be achieved?

DH: Premier’s Partnershi­p for Advancemen­t of Comparativ­e Effectiven­ess Review (PACER) is a forum for this work, leveraging data to determine value and helping providers standardiz­e to vendors or products that provide greatest returns. Participan­ts have driven behavior change among frontline clinicians on physician preference items (PPIs) by engaging them through the whole decision-making process, giving them insight into how supply chain decisions are made, allowing them to test and provide feedback on the different products in a clinical setting and see for themselves how interventi­ons affect outcomes.

Through this work, participan­ts were able to standardiz­e on products that yield the best value, and extract better volume-based discounts for the effort. A handful of Premier member health systems participat­ing saved more than $8 million in two years on cardiac stents and surgical mesh, proving the value of the work in just a small subset of clinical categories.

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