Synergies of supply chain management for healthcare

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Advancements over the last 50 years have transformed the manufacturing supply chain. Parallel advancements have entered the world of healthcare. Microsegmentation and servitization are creating new value for companies and patients.

Industries are taking notice of the parallels between advancements in manufacturing and advancements in healthcare. The similarities are staggering.

Organizations utilizing supply chain management (SCM) are taking a serious look at digital for process improvement and enabling collaboration across suppliers. New synergies, full engaged customers, the ability to scale with new offerings have become sources of renewed value. Does this sound familiar? Healthcare also needs new synergies between providers, a complete picture of patients’ health, and the ability to adapt to new payment and reimbursement models.

Virtually all supply chain optimization initiatives observe the same key lesson.The lesson is that collaboration between suppliers is essential for efficient and lean supply chain management. 

There are twelve areas where the synergies of supply chain management and healthcare management align. Today we’ll be covering the first six areas of alignment. In my following article will expand on the remaining areas.

  1. Microsegmentation: Consumerization
  2. Point-of-Sale: Point-of-Care
  3. Servitization: Person-Centered Primary Care
  4. Value-Based Supply Chains: Value-based reimbursements
  5. Reverse Logistics: Patient Readmissions
  6. Manufacturer List Price: “Chargemaster” or Provider List Price
  7. Product Volume Discounts: Patient Volume Discounts
  8. Design of Products: Design of Care
  9. Cost-to-Build: Cost-To-Serve
  10. Product Commoditization: Population Health
  11. Removing intermediaries: Cost-Out Initiatives
  12. Direct-To-Consumer: Direct-to-Patient

1.        Microsegmentation: Consumerization

Microsegmentation uses technology to understand the needs of customers better. The objective is to divide a company’s customers into groups to better serve those customers. The organization can then target specific customers according to microsegments to maximize the needs for each group of customers.

In healthcare, we call this consumerization, which involves a new product, service, or interaction design. It’s a reorientation of the patient experience using technology to focus on the patient and the spaces around a patient (life, the world, home, work).

2.        Point-of-Sale: Point-of-Care

Cashiers and checkout lines all come to mind. Point-of-sale is usually where the final manufacturing transactions occur. Point-of-Sale signals the tail end of the supply chain from buy, make, store, move, and sell.

Point-of-care, is the time to which clinician’s delivered healthcare products, services, or offer interactions to patients at the time of care. Paper documentation and electronic medical records can be utilized or updated during this period. This is the most recent interaction of an episode of the care (“Episode”) where services are provided for the treatment of conditions.

3.        Servitization: Person-Centered Primary Care

Servitization gives manufacturers the capability to bundle services and present new solutions to customers to supplement existing product offerings. Rolls-Royce today doesn’t only sell aircraft engines. They offer complete service solutions including core operations and engine maintenance functions.

Bundled payments, of course, sound familiar with episode-based payment where payment is delivered for services from two or more providers. However, what about Person-Centered Primary Care? Person-Centered Primary Care is about grouping services to be more flexible for patients considering their desires, family situations, values, social circumstances, and lifestyles. Person-Centered Primary Care groups services to meet the needs of patients. Doing things with patients, not to them.

4.        Value-Based Supply Chains: Value-based reimbursements

Value-Based Supply Chains (VBSC) are about partnerships with producers, processors, distributors, and retailers. These separate players in the supply chain together share an environment, economic, or social values. They all have common goals.

Ask anyone is healthcare, and they are there for a reason. They care. They want to make a difference and want to help. They provide care for our loved ones when all hope has been lost. They speak to us when we need that friendly voice. They care.

When you enter a provider office and consider the multiple treatments and procedures and could result from a diagnosis, it’s hard to find value alignment from each player in the healthcare supply chain. That’s about to change. Value-based reimbursement is a paradigm shift and will change the landscape of healthcare for payers, providers, and yes change the experience for the patient too. The population health approach moves away from fee-for-services (charge per procedure, more procedures equals income for the provider) and steps into a world of fee-for-value. In this model, reimbursement is conditional based on the value the patient receives not the number of procedures they endure.

5.        Reverse Logistics: Patient Readmissions

A forward supply chain has five main phases: (1) Buy, (2) Make, (3) Store, (4) Move, and (5) Sell. Reverse logistics, aftermarket, logistics, and retrologistics all refer to the reverse supply chain. However, a reverse supply chain changes the direction of the supply chain: (1) Sell, (2) Move, (3) Store, (4) Make), and (5) Buy. A reverse supply is used for repairs or defects, field service, warehousing, and recycling. Product returns or defects are the most common use.

Patient readmissions refer to the circumstance when a patient is admitted to a hospital within a certain period from an initial admission. For reference, Medicare defines readmissions as patient hospitalization within 30-days of the initial hospital visit.

Medicare recently ratcheted up their readmission penalties. A total of 2,597 hospitals or half the nation’s hospitals will be punished for poor readmission rates in a government attempt to curb the trend.

6.        Manufacturer List Price: “Chargemaster” or Provider List Price

The Manufacturer List Price is also known as the manufacturer’s suggested retail price (MSRP). This list price is commonly 2.5 to 3 times the wholesale price. Essentially it’s a manufacturer attempt to standardize prices by suggesting prices for goods, services, or interactions. Often this is not followed by resellers. The solution has been the minimum advertised price (MAP). The MAP requires sellers not to sell lower than an agreed upon price. MAPs help to establish price consistency.

There is some transparency in the fact that if you went to CVS and bought a candy bar Monday and it was USD $0.99, and Friday it was USD $12.00 it would be obvious something was going on. While consumers don’t get a direct benefit from the transparency, anomalies are easy to identify. In summary, retailers get a discount from distributors – customers do not.

Most people had had a period in their lives when they had no insurance. It may have even been a 1-day period between jobs during your youth. The price of candy bars does not vary that much. However, the “sticker” price of a medical procedure is harder to notice. What if Telnet Healthcare in Dallas increased the cost for a procedure from $1,000 to $5,000 when would you notice? Seriously, take a minute to think about that. Would you ever notice? Insurers never pay “chargemaster” prices referred to as “charges” because of bilateral agreements between insurers and providers to pay the “negotiated price.” Payers get a discount from providers – patients do not.

Better health from supply-chain management

Sliding revenues and creeping expenses have pushed payers and providers to lean out their organizations. In many organizations, staff reductions, and budget reductions have impacted operations and clinical performance.

Individually, the silos of the healthcare delivery system have been “leaned for maximum benefit.” Reevaluating your organization from a healthcare supply chain perspective and collaborating with supply chain partners may offer the last available reduction in the cost-to-serve.

 

Read all 3 parts of this supply chain for healthcare series below

Part 1: The healthcare intelligence revolution: supply-chain management for healthcare

Part 2: Synergies of supply chain management for healthcare

Part 3: Reinforcing healthcare delivery with a supply-chain management perspective

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Peter is a healthcare business and technology executive, recognized for Digital Innovation by CIO 100, MIT Sloan, Computerworld, and the Project Management Institute. As Managing Director at OROCA Innovations, Peter leads the CXO advisory services practice driving digital strategies.

Peter was honored as an MIT Sloan CIO Leadership Award Finalist in 2015 and is a regular contributor to CIO.com on innovation. As Head of Information Technology, Peter was responsible for Connecticut’s Health Insurance Exchange’s (HIX) industry-leading digital platform transforming consumerism and retail oriented services for the health insurance industry. Peter championed the Connecticut marketplace digital implementation with a transformational cloud-based SaaS platform and mobile application recognized as a 2014 PMI Project of the Year Award finalist, CIO 100, and awards for best digital services, API, and platform. He also received a lifetime achievement award for leadership and digital transformation, honored as a 2016 Computerworld Premier 100 IT Leader.

Peter is the author of Learning Intelligence: Expand Thinking. Absorb Alternative. Unlock Possibilities (2017), which Marshall Goldsmith, author of the New York Times No. 1 bestseller Triggers, calls "a must-read for any leader wanting to compete in the innovation-powered landscape of today."

Peter also authored The Power of Blockchain for Healthcare: How Blockchain Will Ignite The Future of Healthcare (2017), the first book to explore the vast opportunities for blockchain to transform the patient experience.

Peter has a B.S. in C.I.S from Bentley University and an MBA from Quinnipiac University, where he graduated Summa Cum Laude. He earned his PMP® in 2001 and is a certified Six Sigma Master Black Belt, Masters in Business Relationship Management (MBRM) and Certified Scrum Master. As a Commercial Rated Aviation Pilot and Master Scuba Diver, Peter understands first hand, how to anticipate change and lead boldly.