Under One Roof: Sidebars
Edition: May 2011 - Vol 19 Number 05
Will IDNs DIY?
As hospital systems acquire physician practices, IDN supply chain executives should take the opportunity to step back and evaluate their distribution options, says Jamie Kowalski, a Milwaukee, Wis.-based supply chain consultant. And they have several. They can maintain a dual distribution system, with one primary acute-care supplier and one primary non-acute-care supplier. They can try to use one supplier for all sites. Or they can do it themselves. All options require work and thought.
For example, if the IDN decides to maintain two distributors, the supply chain executive, along with his or her distributor partners, need to rationalize the workload, says Kowalski. “The small hospital in the IDN might be consuming no more than a large clinic. Because of the volume and frequency of delivery, it might make sense for the hospital distributor to distribute to some of the clinics and ambulatory surgery centers.
“They need to ask, ‘Here’s what we have, now what makes the most sense? Who should be doing the delivery – given the distances, variety and frequency – that will get me, the customer, to lowest cost?’”
The lowest-cost option might be self-distribution, says Kowalski. “I defy anyone to convince me that the most cost-effective model” is to rely on a multiplicity of distributors, express companies, courier services, etc., to drop off products to multiple locations in the IDN. “You see there are hundreds of players, and you have to ask yourself, ‘Isn’t there a better way?’”
Self-distribution can work, says Kowalski, provided:
The ‘C’ word
Will vendor credentialing find its way into non-hospital sites?
Will vendor credentialing hit non-hospital sites? Alternate-site reps may be asking themselves that question, particularly if IDNs continue to acquire clinics and other non-hospital providers.
According to those with whom Repertoire spoke, if credentialing does sprout up in non-hospital facilities, chances are it will be in surgery centers first. In fact, the country’s largest surgery center chain, Surgical Care Affiliates, Birmingham, Ala., already has a system in place.
“It’s inevitable we’ll see it more and more,” says Bill Barr, vice president, healthcare services, Henry Schein Medical Group.
Intermountain Healthcare, the Salt Lake City, Utah-based IDN, requires credentialing for reps calling on physicians’ offices and surgery centers located in Intermountain hospitals or on hospital campuses, says Jo Ann Autenrieb, vendor access program manager, supply chain organization. Intermountain has seven surgery centers located on hospital campuses.
The IDN has 180 clinics, most of them removed from Intermountain hospital campuses. Reps calling on those clinics are not required to be credentialed, though Intermountain is in the process of reviewing its credentialing policies in an attempt to standardize procedures across all its facilities.
The Accreditation Association for Ambulatory Health Care, which accredits approximately 4,600 ambulatory care facilities, does not call for vendor credentialing per se. But its Accreditation Handbook for Ambulatory Health Care 2011 says, “The organization must have a written policy that addresses all other persons allowed in patient care areas that are not authorized staff (students, interested physicians, health care industry representatives, surveyors, etc.), including evidence of patient consent.”
“We do see our solution being implemented today, particularly in surgery centers,” says Bill Hayes, president and COO, Vendormate, Atlanta, Ga. In fact, credentialing among surgery centers “seems to be moving at a pace similar to what we saw two years ago in acute care facilities,” he says. Surgical Care Affiliates is one of the company’s clients. But Vendormate has yet to see much, if any, activity in physicians’ offices or long-term-care facilities.