Cloud Based Requisitioning & Big Data Joe Volpe, Vice President Supply Chain Terri Kendrick, Director Procurement Services Wheaton Franciscan Healthcare
Speaker Profile Joe Volpe, MBA-HA Vice President, Supply Chain 40 years in healthcare Terri Kendrick, MS (Medical Informatics), MBA Director, Procurement Services 20 years in healthcare, 10 years in manufacturing 2
Agenda Healthcare System Profile Health Care Reform Impact Advanced Strategic Sourcing Formulary Based Requisitioning Performance Dashboard Summary Questions 3
Wheaton Franciscan Healthcare Glendale, WI Integrated regional health care system serving Iowa, Illinois and Wisconsin 100 Sites 11 hospitals 70 + clinics Three long-term care facilities Over 3,500 physicians Operating Statistics $500 Million Annual Spend $ 1.7 Billion Revenue 1.5% Operating Margin 7.8% Cash Flow Margin 65% Government Payors 4
Startling Pressure on Margins The supply chain is a primary area of savings opportunity Hospital Expected Revenue Decline 10% 70% 20% Up to 10% 10-20% 21-30% Hospitals are expecting to reduce 20%-30% of their operating costs in response to declining reimbursements, which has led to a renewed emphasis on reducing non-labor expenses. Supply Side Economics Modern Healthcare Source: McKinsey & Company/HIDA Thought Leaders Interviews 5
Supplies Will Soon Be The Largest Expense Supply expenditures account for 40% of expenses Med/Surg Spend by Category PPI Clinical Med/Surg & Lab Commodity Med/Surg 20% 9% 71% Around 2020, medical supplies will surpass labor as the biggest expense for hospitals and health systems. Strategic Supply Chain Management, Hospitals & Health Networks 6
Operational Objectives Achievement of 10% cash flow operating margin Expect to cut $20M per year from operations Operational excellence measures Paid FTE s 17% work force reduction in past 6 years More in process driven by multiple lean projects Supply Expense per CMI Weighted Adjusted Discharge 7
$1,200 $1,100 $1,000 $1,104 WFSI Annual Supply Cost (Med/Surg + Drugs) per CMI Adj Discharge All Acute Sites $1,127 $1,065 $1,087 $1,052 $1,032 $984 $1,004 $1,058 $1,050 $1,061 $1,112 Target $900 $847 $800 $700 $830 $786 $823 $806 $781 $734 $760 $754 $716 $696 $757 $600 $500 $400 $300 $257 $297 $279 $264 $247 $250 $250 $245 $304 $333 $366 $355 $200 FY05 FY06 FY07 FY08 FY09 FY10 FY11 FY12 FY13 FY14 FY15 YTD FY15 Target Med/Surg + Drugs Med/Surg Drugs 8
Achieving Our Goals Supply chain is critical area of focus Labor Management Increase Efficiencies Clinical Excellence Expand VA program Expand New Products Committee Physician Partnership Partner with physicians on all high cost Physician Preference Items (PPI) Reduced ortho implants by $3.8M per year Reduced spine implants by $1.37M per year Financial viability Reduce CMI Cost per adjusted discharge 174K CMI Adj. Discharges in FY2014 Reduce overall product spend (formulary based purchasing) $4.8M cost reduction FY2014 9
Current Supply Chain Challenges Lack of visibility within supply spend Value Analysis Opportunities Contract Opportunities Non-Catalog Purchase Reductions Inability to enforce product formularies Tools and processes ineffective to achieve significant cost savings 10
Digging Deeper Into The Issues Simply put Clinicians cannot find needed items Typical Item Master 50,000+ items Items change daily <4 words per description Nonsensical naming No photographs Clinician cannot find Item Clinician contacts manufacturer or sales rep Rep orders noncontracted items or pulls from trunk-stock On average, nonfile items cost 15%+ more than contracted or stock items McKesson Strategic Supply Sourcing Non-file items are on a PO, making it difficult to reconcile 11
Savings to Date Category Current Score Realized Savings* $4,827,744 Missed Opportunities* $2,856,904 Contract Compliance > 90% % of Formulary Level 1 Requisition 88.7% % of Formulary Level 2 Requisition 2.2% % of Formulary Level 3 Requisition 0.1% % of Formulary Level 4 Requisition ** 9.1% Contract Overspend ** --------- 12
Findings Formulary Levels Corporation Name Formulary Level # of Reqs per Formulary Level Formulary Level Percentage WFH-WISC HEART HOSP 1 9,186 86.36 WFH-WISC HEART HOSP 2 220 2.07 WFH-WISC HEART HOSP 3 10 0.09 WFH-WISC HEART HOSP 4 1,221 11.48 MIDWEST ORTHO SPECIALTY HOSPITAL 1 25,091 89.95 MIDWEST ORTHO SPECIALTY HOSPITAL 2 156 0.56 MIDWEST ORTHO SPECIALTY HOSPITAL 4 2,647 9.49 WFH-ST. JOSEPH 1 26,887 88.44 WFH-ST. JOSEPH 2 1,035 3.40 WFH-ST. JOSEPH 3 4 0.01 WFH-ST. JOSEPH 4 2,477 8.15 WFH-ELMBROOK MEMORIAL 1 1,6576 86.18 WFH-ELMBROOK MEMORIAL 2 633 3.29 WFH-ELMBROOK MEMORIAL 3 4 0.02 WFH-ELMBROOK MEMORIAL 4 2,022 10.51 WFH-ST. FRANCIS 1 23,240 82.57 WFH-ST. FRANCIS 2 1,312 4.66 WFH-ST. FRANCIS 3 4 0.01 WFH-ST. FRANCIS 4 3,591 12.76 13
Analytics Reporting Summary for Wheaton 14
Summary Paradigm shift to transparency Purchasing Spend visibility Product formulary Universal view Comprehensive, empowering data Improve decision making Enable supply chain to improve operating margins 15
Cloud Based Requisitioning & Big Data Questions?