vol.30 no.7 • July 2022
repertoiremag.com
The Hilton Family One family discusses a journey through med/surg sales generations in the making.
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We know it’s been a challenging year, and it matters that we made it through together. That’s what trusted partnerships are all about. Our experienced sales and service teams are always here to help ensure your success, providing diagnostic products that deliver the highest quality results. Because for you, for us, and for your customers, every result matters. POINT-OF-CARE READER
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JULY 2022 • VOLUME 30 • ISSUE 7
The Hilton Family One family discusses a journey through med/surg sales generations in the making.
28 PUBLISHER’S LETTER
IDN OPPORTUNITIES
Tools for Your Toolbox..................... 2
PHYSICIAN OFFICE LAB Cholesterol Testing and Heart Disease How reps and care givers can improve heart disease morbidity and mortality as well as improving better health outcomes....... 4
DISTRIBUTION
Supply Chain Leader Profile Angie Bruns: Making an Impact on Multiple Levels........................................ 20
IDN NEWS Breaking Ground Louisiana health system touts provider-owned PPE initiative.................... 24
REP CORNER
Together Again
A Tale of Two Industries
McKesson Med-Surg gathered to celebrate recent successes and look toward the future.................................... 8
From black angus beef to extended care, one business owner does it all.................... 26
TRENDS Home Care is Going National DeWight Titus He knew the business, he knew the people, and he loved it all
14
As home care providers keep growing, what happens to local suppliers?................ 34
An Extended Market Footprint IMCO’s Jay Butler discusses the growth and importance of the Extended Care market........................... 38
Physicians on the Move The number of physicians employed by hospitals and health systems is growing, according to a recent study.......................... 42
Heightened Cybersecurity Awareness The healthcare sector was the victim of more ransomware attacks than any other sector in 2021............................... 44
Breaking the Rules of Healthcare: Getting the Quality of Care You Pay For When patients have a choice of where to go for care, providers must also improve care.......................................... 49
HIDA Halfway through 2022, HIDA Continues to Lead.............. 52
MARKETING MINUTE Lean Marketing in Healthcare
Five strategies for small suppliers............... 54
EVENTS PWH® Celebrates Achievements, Connection and Inclusion............................................... 56
NEWS Industry News........................................... 59
Subscribe/renew @ www.repertoiremag.com : click subscribe repertoire magazine (ISSN 1520-7587) is published monthly by Share Moving Media, 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Copyright 2022 by Share Moving Media. All rights reserved. Subscriptions: $49.00 per year for individuals; issues are sent free of charge to dealer representatives. If you would like to subscribe or notify us of address changes, please contact us at the above numbers or address. POSTMASTER: Send address changes to Repertoire, 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Please note: The acceptance of advertising or products mentioned by contributing authors does not constitute endorsement by the publisher. Publisher cannot accept responsibility for the correctness of an opinion expressed by contributing authors. Periodicals Postage Paid at Lawrenceville, GA and at additional mailing offices.
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PUBLISHER’S LETTER
Tools for Your Toolbox I’m asking for your forgiveness in advance of reading this Publisher’s Letter. I want to
talk about a few of our tools created to help you stay connected, informed, and up to date on the latest industry events. Podcast. I’ve had the pleasure of doing over
20 Road Warriors podcasts these past few years, but episode 21 with the Hilton crew was an absolute blast. As you can see, we turned the podcast into this month’s cover story. I encourage you to listen to our conversation when you have some time. Simply scan the QR code below and hit play. You can also go to Repertoiremag.com and find all the past Road Warriors podcasts. There are some great conversations, stories, and pearls of wisdom in each of the episodes.
Scott Adams
new features and a fresh look. Most importantly, the manufacturers are working to update their listings, so you have the latest information. We will still have rep rosters, manufacturer listings, and 2-minute drill videos, but it will have so much more. Stayed tuned for the announcement when it is relaunched. Our goal is September. Repertoire’s Dail-eNews. This is a free subscription to industry news that we write each business day. This short 3-5 minute daily read will keep you informed on everything from distribution news and manufacturer news to primary care and health system news.
2-Minute Drills. We work in conjunction
with manufacturers to build short video modules that will teach you how to better sell their products and services. You can find a library of these in the RepConnect app. There is also a library of end-user videos for you to share with you customers.
Thank you for taking the time to learn about the above tools. We generate all of this for one reason – supporting you, the distribution salesperson. (And it helps us pay our bills.) Have a wonder Fourth of July month.
RepConnect. I’m excited to let you know that we’re working to completely overhaul the app! It will be up to date with several
Dedicated to the industry, R. Scott Adams
Repertoire is published monthly by Share Moving Media 1735 N. Brown Rd., Suite 140, Lawrenceville, GA 30043 Phone: (800) 536-5312, FAX: (770) 709-5432; e-mail: info@sharemovingmedia.com; www.sharemovingmedia.com
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Mark Thill
mthill@sharemovingmedia.com
sales executive
Subscriptions
Amy Cochran
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managing editor
2022 editorial board
ggarrison@sharemovingmedia.com
publisher
Richard Bigham: Atlantic Medical Solutions
editor-in-chief, Dail-eNews
Scott Adams
Eddie Dienes: McKesson Medical-Surgical
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founder
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circulation
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Keith Boivin: IMCO Home Care
Laura Gantert
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Ty Ford: Henry Schein Doug Harper: NDC Homecare
Brent Cashman
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Quidel has developed an innovative line of respiratory products for decades. So whatever respiratory season may bring, we’re ready.
1979
2015
Quidel founded
1999
Receives FDA clearance for world’s first rapid diagnostic flu test QuickVue Influenza Test (A/B)
2011 1996
Influenza A+B, RSV, SARS* Antigen Assays
2020
Receives FDA EUA for Sofia 2 SARS Antigen FIA, Sofia 2 Flu+ SARS FIA (ABC), QuickVue SARS Antigen Test, and Solana SARS-CoV-2
Quidel launches Sofia automated analyzer FIA
First company to receive CLIA waiver for Strep A with QuickVue In-Line Strep A Test
QuickVue®
Introduction of Solana assays
2018
Solana®
Receives FDA clearance for QuickVue Influenza A+B which meets FDA’s Class II RIDT requirements
Influenza A+B, RSV + hMPV, SARS-CoV-2*, Bordetella Complete Assays
Sofia®/Sofia 2
Influenza A+B, RSV, SARS* Antigen, Flu + SARS* Antigen Assays
To get the right RIDT for your customers, contact a Quidel Account Manager at 800.874.1517 or visit quidel.com *THESE TESTS ARE AVAILABLE FOR SALE IN THE USA UNDER EMERGENCY USE AUTHORIZATION. These SARS tests have not been FDA cleared or approved, but have been authorized by the FDA under an Emergency Use Authorization (EUA) for use by authorized laboratories for the detection of proteins (QuickVue and Sofia) or nucleic acids (Solana) from SARS-CoV-2, not for any other viruses or pathogens. These tests are only authorized for the duration that circumstances exist justifying the authorization of emergency use of in vitro diagnostics for detection and/or diagnosis of COVID-19 under Section 564(b)(1) of the Federal Food, Drug and Cosmetic Act, 21 U.S.C. § 360bbb-3(b)(1), unless terminated or revoked sooner. AD10183500EN00 (06/22)
PHYSICIAN OFFICE LAB
Cholesterol Testing and Heart Disease How reps and care givers can improve heart disease morbidity and mortality as well as improving better health outcomes. We all know that high cholesterol is a risk factor for heart disease, but do we know the details
By Jim Poggi
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important to share with our customers and prospects to galvanize them into action to test before treating? Many clinicians rely on newer statin and non-statin medications to reduce lipid levels and reduce heart disease risks. But the treatment program cannot be initiated without the data, especially lipid testing information. As consultants to our clinical customers, getting the facts in place should lead to a healthier patient base and better cardiac health outcomes. Not to mention more lab business for you.
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learn, both where we live and how we live are substantially influential in your risk of heart disease and how often the physicians you call on are likely to encounter elevated cholesterol and increased risk of heart disease. Let’s look at some facts and see where they lead us.
Cholesterol facts We now know that some forms of cholesterol are healthy (HDL in particular) and some (LDL and LP(a)) lead to increased rick of atherosclerosis and heart disease. The lower density cholesterol particles take up more space in the arteries and consequently reduce blood flow, which can lead to a heart attack, acute coronary insufficiency or ischemic heart disease. But, did you know that cholesterol is actually produced by the body as well as being available in certain foods? It’s true. Cholesterol
the impact of many of these risk factors. In 1969, 42.4% of all U.S. adults smoked tobacco products. In 2018 the rate had dropped by 13.7%. Sedentary lifestyle is another risk factor and according to the CDC it increases with age and is inversely related to socioeconomic status; poorer patients tend to be more sedentary. It is 54.8% among adults from 18 to 34, but over 61.9% for adults over 65. High blood pressure is also a risk factor and the CDC estimates that only 25% of all adults diagnosed with high blood pressure have it controlled. Thirty seven million Americans have blood pressure of 140/90 or greater. Elevated cholesterol is an acknowledged risk factor and nearly 94 million Americans have cholesterol levels over 200 (high) and 28 million have cholesterol levels above 240 (very high). Obesity is an issue. The CDC classified over 42% of
High blood pressure is a risk factor and the CDC estimates that only 25% of all adults diagnosed with high blood pressure have it controlled.
While death rates from heart disease have dropped significantly (more than 68%) from 1969 to 2014 based on the Centers for Disease Control and Prevention (CDC) data, heart disease remains on the CDC’s list of the five leading preventable causes of death. Importantly, that data was published in 2017 and predates the current COVID-19 pandemic which has resulted in a decline in physician office visits, reduced levels of treatment for chronic diseases and also the emergence of COVID cardiac co-morbidities. As a result, while we have made progress, we have a long way to go. As you will
is produced by the liver as the precursor for steroid hormones including estrogen and testosterone. As a result, cholesterol is vital for life and comes in a surprising variety of particle sizes and types. LP(a) and LDL elevations are most closely related to increased risk of heart disease, heart attack and death.
Health risk factors for heart disease Unfortunately, this list goes well beyond managing the patient’s cholesterol, LDL, HDL and triglyceride levels. On the bright side, we have made pretty good strides in reducing
all Americans as obese in 2018. The CDC reports 37 million Americans as diabetic and 96 million as pre-diabetic. Obesity and diabetes are also factors, as is increasing age.
How are statins and non-statin treatment for high cholesterol helping? With death rates from heart disease dropping as significantly as noted above, a lot of things are going well. Reductions in smoking are making a difference, but obesity, increased incidence of diabetes and a generally sedentary population are counterbalancing the positive factors and www.repertoiremag.com
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PHYSICIAN OFFICE LAB preventing death rates from heart disease from dropping more rapidly. Statins have clearly changed the ability to lower cholesterol and LDL in particular, in spite of the unhealthy lifestyle choices many Americans continue to embrace. Forty-seven million Americans currently take statins, and an estimated 87 million Americans could benefit from the use of statins or non-statin lipid lowering medications. This is a profound change since statins were introduced in the United States in 1987 and a significant contributor to better heart disease outcome statistics. In 1980, the rate of elevated LDL was reported as 59%; by 2010 it had dropped to 23%. New medications that impact reabsorption of cholesterol from the intestines are now being combined with statins to create a two-pronged approach to lowering lipid levels. I expect these decreases in LDL levels to continue somewhat irrespective of lifestyle choices. But, the fact remains today, as it did when the National Institute of Health observed in 1985 that “you need to know your numbers”. Therefore, the need to test for lipids, as well as diabetes markers continues to be critical to diagnose patients requiring treatment. It is your responsibility as consultants to our physicians and other care givers to continue to promote this message. Some recent learnings point out why this is important. This is especially true with the availability of simple, accurate waived systems to measure lipids, glucose and hemoglobin A1C. You have a range of powerful solutions for customers performing just a few patients with risk factors for heart disease daily to large practices where over 100 candidate patients are seen daily. You and your key suppliers can customize a solution to meet the needs of any sized practice. 6
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Patient facts that influence risk Not enough information yet? Well, try a couple of newer facts: the CDC describes why heart disease remains on its list of the five leading causes or preventable death. It is more problematic in rural communities and communities of 10,000 to 49,000 and it also impacts lower income communities disproportionately from wealthier ones. As a result, many Americans remain at risk for preventable heart disease. Do you know how your community stacks up? Also, we now know that a COVID infection creates an additional risk of
myocarditis and multiorgan inflammatory syndrome. This creates a new risk group. Finally, during the social distancing phase of the COVID pandemic, many patients put chronic disease management on the back burner. It’s time to discuss how we and the care givers we call on every day can improve heart disease morbidity and mortality as well as improving better health outcomes. Lipid and diabetes testing are gateways to diagnosis, and the right steps needed to initiate or modify a patient treatment program. Spread the news.
DON’T MISS A BEAT Test Pediatric Lipids Today
REDUCE LIFETIME CVD RISK Only 4%–5% of children between 9–11 years of age are being screened for familial hypercholesterolemia (FH).1,2 Universal lipid screenings of individuals 9–11 and 17–21 years of age enable physicians to work with patients and their caregivers to address any modified risk factors, while also screening for the presence of FH. Talk to your customers about the ease of point-ofcare lipid testing for their pediatric patients.
CHOLESTECH LDX™ SYSTEM • CLIA waived • Small, 40 mL fingerstick sample • Results in 5 minutes
CONTACT YOUR ABBOTT CARDIOMETABOLIC ACCOUNT EXECUTIVE TO LEARN MORE. CVD = cardiovascular disease 1. Knowles JW, Rader DJ, Khoury MJ. Cascade Screening for Familial Hypercholesterolemia and the Use of Genetic Testing. JAMA. 2017;318:381-382. 2. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: Summary Report. Pediatrics. 2011;129(suppl 5):S1-S44. © 2022 Abbott. All rights reserved. All trademarks referenced are trademarks of either the Abbott group of companies or their respective owners. Any photos displayed are for illustrative purposes only. Any person depicted in such photos is a model. COL-12523-01 06/22
DISTRIBUTION
Together Again McKesson Med-Surg gathered to celebrate recent successes and look toward the future. The McKesson Med-Surg National
Sales Conference was held in Las Vegas in May. This was the first time everyone was together after two years of the pandemic. More than 2,000 McKesson team members and suppliers joined the event.
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Is it COVID-19 or the Flu? Quickly detect and differentiate between Influenza and COVID-19* with a single test this flu season, with clear, trusted, digital results in 15 minutes.
See what’s new at BDVeritor.com/COVID-Flu *Emergency Use Authorization Information for the SARS-CoV-2 and SARS-CoV-2 & Flu A+B assays: • These products have not been FDA cleared or approved; but have been authorized by FDA under EUA for use by authorized laboratories • The BD Veritor™ System for Rapid Detection of SARS-CoV-2 has been authorized only for the detection of proteins from SARS-CoV-2, not for any other viruses or pathogens; the BD Veritor™ System for Rapid Detection of SARS-CoV-2 & Flu A+B has been authorized only for the detection of proteins from SARS-CoV-2, influenza A and influenza B, not for any other viruses or pathogens; and, • These products are only authorized for the duration of the declaration that circumstances exist justifying the authorization of emergency use of in vitro diagnostics for detection and/or diagnosis of COVID-19 under Section 564(b)(1) of the Federal Food, Drug and Cosmetic Act, 21 U.S.C. § 360bbb-3(b)(1), unless the declaration is terminated or authorization is revoked sooner.
BD Life Sciences, 7 Loveton Circle, Sparks, MD 21152-0999 USA 800-638-8663 BD, the BD Logo and Veritor are trademarks of Becton, Dickinson and Company or its affiliates. © 2021 BD. All rights reserved.
DISTRIBUTION The conference was a great way for McKesson team members and partners to reconnect. All told, more than 384 different companies and suppliers were represented at the Sales Conference and had the opportunity to showcase different medical devices.
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DIVERSITY EQUITY INCLUSION
NURTURING OUR DIFFERENCES MAKES US STRONGER We believe Diversity, Equity and Inclusion (DEI) is recognizing, respecting and valuing differences which foster and sustain a workplace culture of belonging and empowerment. DEI is not only the right thing to do; it‘s a critical business imperative that accelerates innovation and drives results for our customers and the patients they serve.
Learn more at bbraunusa.com/dei Rx only. ©2021 B. Braun Medical Inc., Bethlehem, PA. All Rights Reserved. 21-0806A_11/21
SPONSORED
BAXTER
Changing the View on Ear and Eye Exams Next-generation Welch Allyn exam tools provide larger viewing areas for clinicians with the same comfortable controls In developing the new Welch Allyn MacroView® Plus Otoscope and PanOptic™ Plus Ophthalmoscope, Welch Allyn product engineers and clinical researchers spoke to more than 1,000 clinicians to fully understand clinical needs in these ear and eye exam devices. There was a common theme – clinicians wanted dramatic improvements in the
viewing area.
So, the MacroView Plus Otoscope has a three times larger viewing area compared to standard or pocket otoscopes and the PanOptic Plus Ophthalmoscope has a 20 times larger viewing area in comparison to traditional ophthalmoscopes. Clinicians also wanted the new devices to be easy to use, so they were designed with familiar controls while adding new innovations. “It’s transformational in the way doctors are seeing an ear or eye when they do an exam,” said Megan Schneider, Director of Marketing, Physical Exam and Diagnostics for Baxter, which completed its acquisition of Welch Allyn owner Hillrom late last year. “The new heads and handles significantly outperform the older standard system they’re used to and [outperform] device heads in most offices.” Schneider says this a great opportunity for distribution representatives to discuss this category with customers and introduce them to our new Welch Allyn devices. “We can show them our new offerings and bring them better tools that enable faster exams,” she said. Baxter’s Welch Allyn MacroView Plus Diagnostic 3.5 V Otoscope has a familiar form and feel for clinicians. With the ability to move from 12
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optical to digital, clinicians can capture and share ear images for consultation when using the MacroView Plus Otoscope and Welch Allyn iExaminer SmartBracket paired with a smart device and the free Welch Allyn iExaminer Pro App.
“This a great opportunity for distribution representatives to discuss this category with customers and introduce them to our new Welch Allyn devices.” – Megan Schneider, Director of Marketing, Physical Exam and Diagnostics, Baxter
“Since images of the ear can be quickly captured and documented, the caregiver can have better conversations about the patient’s health,” Schneider said. “Now the physician can show the patient and caregiver what the ear looks like. That’s really powerful because many parents whose children have earaches have no idea what the ear looks like, but
now the physician has the opportunity to share that.” The Welch Allyn PanOptic Plus Diagnostic 3.5 V Ophthalmoscope has added Quick Eye Alignment technology to help direct patient gaze for better optic disc alignment. Paired with long-lasting LED lamps and DuraShock technology, the PanOptic Plus Ophthalmoscope is backwards compatible with existing Welch Allyn 3.5 V power sources, or with their new Lithium Ion Plus power handle for increased efficiency. Primary care settings and pediatrician offices, along with urgent care and emergency departments, should be the focus customers for distribution representatives. Those clinicians will most likely be very familiar and recognize the U.S. market-leading Welch Allyn physical exam devices, and many might already have the integrated wall system or desk set. “When you say the brand name Welch Allyn, it’s recognized,” Schneider said. “People say, ‘that’s what I see on my doctor’s wall.’” Distribution representatives can familiarize themselves with these products through three- to four-minute how-to videos on YouTube for the MacroView Plus Otoscope and the PanOptic Plus Ophthalmoscope.
Hillrom is a part of Baxter
DID YOU KNOW? An eye exam can be one of the diagnostic methods a clinician can use to observe and monitor signs of hypertension, also known as high blood pressure.1,2
SCAN HERE
See how a larger viewing area with a Welch Allyn PanOptic Plus device helps clinicians see more during eye exams, compared to the old standard.
20X LARGER VIEWING AREA Standard Ophthalmoscope
Lead-generating video 1
2
Cheung CY, Ikram MK, Sabanayagam C, Wong TY. Retinal microvasculature as a model to study the manifestations of hypertension. Hypertension 2012; 60: 1094-1103. DOI:10.1161/HYPERTENSIONAHA.111.189142/-/DC1 Fraser-Bell S, Symes R, Vaze A. Hypertensive eye disease: a review. Clinical and Experimental Ophthalmology 2017; 45: 45-53.DOI: 10.1111/ceo.12905
Baxter, Hillrom, PanOptic and Welch Allyn are trademarks of Baxter International, Inc. or its subsidiaries. ALL RIGHTS RESERVED. APR349202 Rev 2 09-JUN-2022 US-ENG
DISTRIBUTION
DeWight Titus He knew the business, he knew the people, and he loved it all
DeWight Titus built his family’s company in Southern California – F.D. Titus & Son – into a model for hundreds of
other local and regional distributors in the 1970s, 80s and 90s. The company set a standard for growth, profitability, sales and service excellence, and manufacturer/distributor relationships, and led the country’s suppliers in responding to a changing physician market in a managed care era. A pharmacist by training, Titus sold the company to General Medical (now McKesson Medical-Surgical) in 1994. He died at his home in the Lemon Heights area of Santa Ana, California, on May 3.
“DeWight never stopped anyone from doing whatever they wanted to do to reach their potential,” said Cindy Juhas, chief strategy officer for CME, who served as vice president of marketing for Titus from 1982 to 1993. Throughout his career, Titus freely shared his knowledge with friends and competitors alike. He served as HIDA chairman in 1983 and was two-time chairman of the HIDA Educational Foundation. He was largely responsible for rejuvenating the HIDA Educational Foundation and creating the HIDA Executive Conference. He also received HIDA’s Industry Award of Distinction and was inducted into the Repertoire/HIDA Medical Distribution Hall of Fame in 2001.
A pharmacist
DeWight Titus
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The family business was founded in 1935 by Titus’ grandfather, a professional pharmacist. After his death, his son, Frank, took over the business. It was Frank’s idea to expand beyond pharmacy into the surgical supply business. DeWight joined the company in 1958. “The lines were slow in coming, but over time, medical supplies became a major part of the company,”
DeWight Titus told Repertoire in a 1999 interview. “The focus on physicians was in part because of demand by physicians coming to us for supplies, then equipment. It was an evolution rather than a planned strategy.” At the time of its sale in 1994, F.D. Titus & Son was a $170 million firm with coverage in California, Nevada, Arizona and southern Oregon. DeWight Titus built the company on: ʯ Sophisticated operating systems. ʯ High service levels. ʯ Well-thought-out planning, with help from company CFO Jerry Neal. ʯ A generous compensation policy. ʯ Strategic acquisitions. ʯ Respect for manufacturers. ʯ An open management style.
‘ He never stopped anyone from doing whatever they wanted to do to reach their potential.’
Eye to eye with manufacturers “Years and years ago, [retired Indiana University professor and medical distribution consultant] Ron Stephenson said at one meeting that we should look at the manufacturer as a customer,” recalled Titus in 1999. “That stuck in my mind. “We treated manufacturers just like we did our customers, with respect and friendliness. We didn’t grind them for the last penny, but we set up incentives if both of us were successful.” The approach brought the company more off-invoice sales support than it would have through hard-nosed negotiating, he said. “We found that there was an enormous amount of manufacturer support that was not price-related. There’s a myriad of things that a manufacturer can do – introduce you to key customers, provide field support, all kinds of things – if you have the right relationship. I remember www.repertoiremag.com
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DISTRIBUTION one HIDA meeting where 40 or 50 of our reps attended thanks to a contest offered by one manufacturer. A lot of our growth and success came with customers whom the manufacturers helped bring us.”
The Titus culture A family culture permeated F.D. Titus & Son, Titus told Repertoire. “There are some things you don’t realize when you’re in it, but you can see in hindsight. People felt they were part of the family. I think they felt they were treated fairly, from the
standpoint of compensation and work environment.” The mood was light at the company. “We had certain objectives, and we were going to make them. But we were going to make them having a good time,” he said. Very little was kept secret at F.D. Titus & Son. “In any company that’s growing rapidly or has a lot of aggressive young people, there’s always an opportunity for misinformation to flow back and forth. So we had a policy that nothing was a secret. We told our reps what the
sales were, what the margins were, the profits. If you wanted to know what an item cost, you could go and find out. Or if there was a question of how we priced a product, we were totally upfront about it. It took away a lot of grumbling.
A good place for sales reps “We had extremely low turnover in the sales force,” he said. “Our people had the opportunity to make a lot of money. The high service levels and support they got from management, marketing and operations – in addition to their own efforts – enabled them to be very successful. “We were always clear about our expectations and what we were trying to achieve. But the people who worked for us were given broad latitude on how to get there. They knew the financial resources they had. They knew the performance targets. But they also knew we wouldn’t second-guess what they were doing on an hour-to-hour, day-to-day basis. “In addition, managers felt empowered to make decisions. Often times, there would be decisions with which I didn’t totally agree. But I felt it was important that they were supported so that they could become more confident.” Support staff were empowered as well. “We wanted everyone to get involved and support that customer,” he said. “I would tell the salespeople, ‘You are only as good as the people in the warehouse pulling orders.’ We encouraged them to go back and thank those people. I don’t think there was ever a ‘them and us’ attitude between operations and salespeople.”
Seizing a growing market F.D. Titus & Son seized upon the needs of emerging IDNs and physician 16
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practice management companies in the 1980s, helping them navigate the new rules of Southern California’s growing managed care market. “We were fortunate to be where we were,” he told Repertoire. “We were in the strongest physician market in the U.S. We understood how the physician thought, how he bought, what his structure was, until the advent of managed care and integrated systems. At that time, we realized that a change was occurring.” Some were becoming part of practice management companies, others were merging, and others were becoming part of hospital-controlled IDNs. So, Titus put together a team of people who understood what was happening and developed strategies accordingly. “At one point in time, in all of California, there wasn’t a major IDN group that we didn’t have as a customer,” he said. “We were relentless in how we went about it. We almost treated them as a submarket.” The company did such things as reduce customers’ inventory days by taking product into individual clinics, then individual departments, and by offering reports that customers had never seen before. “We even had people onsite for some of the larger groups.”
Cared about people “If DeWight saw that someone had a talent, he wanted that person to fulfill it,” says Cindy Juhas, who started working for Titus in 1978 as a shared rep, with half her salary coming from Titus, the other half from the Clay Adams division of Becton Dickinson. She later ran operations and sales for the company’s branch in Phoenix. “When I wanted to come back to California, DeWight wanted me to
take over marketing for the company, because he thought I had a knack for it. I resisted at first, but he insisted. So I put together the terms and he gave me everything I needed. “He was very open to new ideas and looked to innovate all the time. He never said ‘no’ to anything. He would vet things out, but if it was a better way to do things, he would get behind it, even if it meant an investment. “He was blind to gender when it came to promotions. He was very supportive of talented people and would help them move up the ladder. In a sea of men in the industry at the time, he had several women senior managers. “When you talked to DeWight, whether by phone or in person, his attention was all on you,” she continues. “You were the most important thing to him at that moment. He really cared about the person he talked to, asking them questions
about all areas of their lives. I think that is one of the reasons people were so loyal to him. “Even as Titus grew, DeWight would walk through the warehouse or any other department in the building and knew everyone’s name and would talk to them and ask how they were. Again, adding to the loyalty people felt towards him. And he was very loyal to his people; when Titus got bought, he made sure everyone had a home. “And he had an incredible sense of humor. He made me laugh every time I spoke to him. A true visionary.”
‘He owned me’ “If I were on the front lines of battle, DeWight is the person I’d want supplying me with ammunition,” Don Kitzmiller, former vice president of Midmark (now retired) told Repertoire in 2001, when Titus was inducted into the Medical Distribution Hall www.repertoiremag.com
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DISTRIBUTION of Fame. “He keeps promises and knows how to get things done.” Kitzmiller met Titus in 1973 while working for IE Industries (now Midmark), and the two spoke weekly by phone and shared family outings until Titus’ death. “He was the pioneer in getting manufacturer reps to work on their dealers’ behalf,” he says. Kitzmiller recalls an incident when Midmark experimented with shipping its tables to the West Coast via railroad. “An entire carload got damaged, and DeWight offered to see if he could sell them at a reduced price in Mexico. From that point on, he owned me.” Titus managed rapid growth in a difficult market – the West Coast in the “boom years,” Kitzmiller says. “He did it by getting very active in the industry. He gained knowledge and expertise from others through his involvement, and so did the industry. When managed care spread to other parts of the country, he was unselfish and offered help to others.” In fact, Kitzmiller recalls saying to Titus almost 50 years ago, “DeWight, in the short period of time we’ve known each other, you’re very, very open about everything; you may want to consider not being so exposed about what you want to do and accomplish.” Titus responded, “Don, what everybody knows is not as important as what they are able to achieve and accomplish based on what they know.”
Industry contributor “DeWight was the catalyst for several of HIDA’s most important programs that are still successful today,” says HIDA Senior Vice President Elizabeth Hilla. “The Executive Conference is 35 years strong and he’s the one who suggested it to start with. We had about 50 people 18
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the first year, 400 this year!” In the mid-1980s, Titus and Bob Barnes of Durr-Fillauer identified the need for a new industry sales training program and recruited John Sasen of BD and Physician Sales and Service (now McKesson Medical-Surgical) as the volunteer to lead the effort to develop it. Initially called ADVANCE, the program is now referred to as AMS Sales Training.
someone to unload to, so whatever we talked about, it stayed with us. “I never saw DeWight lose his temper or even change his voice,” says Stover. “He had a tremendous sense of humor. You could put in any situation and he would just fit, no matter the situation. He would participate and never try to make his point over anybody. He was always out to help people. He would help anybody.”
‘ There are a few giants who helped mold what the industry is today, and DeWight is right at the top of the list. Not only did he run perhaps the finest distribution company in the country, he also gave tirelessly to the industry.’ “DeWight was an amazing role model and visionary for the industry,” Hilla says. “He promoted women leaders before it was common. He moved the industry ahead, not just his own company. He’d stand up at an event and talk about a strategy his company was trying and didn’t worry about folks stealing his ideas. His company served the physician market but saw the value in marketing directly to IDNs and managed care organizations as the markets consolidated. He understood that trend long before others did.”
Best man “DeWight and I came on at about the same time in the industry, and he and I hit it off,” says Jim Stover, secondgeneration leader of the William T. Stover Company, president of HIDA from 1987 to 1993, and former president of NDC. In fact, Titus was Stover’s best man at the latter’s wedding. The two have stayed in touch ever since. “We had a deal with each other,” he says. “Everybody needs
Class act John Moran, former vice president of sales for Welch Allyn and now retired, calls Titus a tremendous role model. “When you called on him as a sales rep or vendor, you overprepared for the meeting, not just because Titus was such a big account, but because at the end of a meeting with DeWight, you didn’t want him disappointed. He made people better, because you didn’t want him to think less of you. “I believe that today, people realize that the medical supply industry is a great one for salespeople to be in,” Moran says. “There are a few giants who helped mold what the industry is today, and DeWight is right at the top of the list. Not only did he run perhaps the finest distribution company in the country, he also gave tirelessly to the industry. There was no better ambassador than DeWight. His leadership skills were exceptional, and he was the definition of a class act.”
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IDN OPPORTUNITIES
Supply Chain Leader Profile Angie Bruns: Making an Impact on Multiple Levels By Pete Mercer
Angie Bruns joined the healthcare
industry to help people. Growing up, her aunt would always share how important her work in pathology was to the community and how it impacted her. From those conversations with her aunt, Bruns was inspired to devote her professional career to the healthcare industry. Her goal was to align her career as a professional in an industry where her contributions would impact multiple levels: external, internal, and downstream in the organization. Because healthcare has been a part of her family, stepping into the industry was an easy decision. It fits her personality as well. “I am an extrovert,” she said. “I have always enjoyed getting to know individuals and helping people. Healthcare allows me to leverage both of those traits.” Whether she is supporting a team member with mentoring, helping a clinician receive a product they need to take care of a patient or strategizing for the organization, Bruns rises to each challenge. She believes that the role of healthcare in the world is essential to everyone. “Healthcare is a global industry,” she said. “Everyone, at some point in their life, will have sought after and needed assistance from a healthcare worker. It is a conversation with which everyone can contribute and participate.” 20
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Angie Bruns
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IDN OPPORTUNITIES Starting out at TUKHS Bruns started her career in a monthlong internship at The University of Kansas Health System (TUKHS). “One of my professors was a director in Perioperative Services at the time, which gave me a peek into the supply chain realm. I was already impressed by the culture of the organization but the moment I stepped into an operating room, I was sold,” she said. Not only did she get a better picture of what the supply chain entailed, she was also able to see the impact when a supply chain operational function failed and how that can affect patients. “It’s one thing to not have toilet paper for a day, but to not have a lifesaving piece of technology hit home for me,” she said. After her internship, Bruns went from a Business Operations Analyst to the Senior Director Supply Management and Administration, her current role. Throughout her career, Bruns has maintained the perspective that she’s in this industry to help people. Even if she’s not one of the frontline workers, she understands that the role of the healthcare supply chain plays a critical part in saving lives. “Working in healthcare supply chain, I get the honor of helping someone, of contributing to saving a life, and giving back to my community.”
Navigating a pandemic During the early days of the pandemic, she stepped into a role as the System Director of Clinical Supply Optimization, where she essentially had to build an entirely new team. Despite the fact that they were building a new program at TUKHS, Bruns said she is most proud of her team’s humility and teamwork. 22
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“No one knew how to work from home. No one knew how to build a team remotely and orientate them remotely. No one knew how to build an entire program from the ground up remotely. They had to learn how to work together and trust one another without having any in-person meetings.” Her team didn’t even meet face-to-face until May 2021.
leadership. In her department, they are working on a leadership development plan for the manager leaders. It’s a year-long program for all supply chain managers with direct reports. “Each supply chain manager will undergo formal career development after they are hired into a leadership role, manager level and above.”
“ If I were to summarize my mentorship experiences throughout my lifetime, I would say they have taught me the importance of our own soft skills and how to appreciate the diversity each person carries in their own soft skills. Healthcare is one of the most diverse industries out there.” Even with these challenges, Bruns and her team have persevered and met the challenges head on. “In supply chain, understanding the end-to-end process is an art, but it is not the type everyone gets the pleasure of having up on their wall. This pandemic has enabled supply chain team members (and even those outside of supply chain) to not only understand the end-toend supply chain process but work through each facet of it.” Her team has even had the opportunity to educate end-users and suppliers on the scope of the supply chain from end-to-end. “Each of our customers knows a little more about supply chain, which has allowed us to develop bridges, build them, and walk over them together.”
Developing leaders TUKHS employs lean principles as the formal leadership model. Leaders go through lean training once they are placed into a position of
The program will focus on learning and applying key leadership traits in addition to participating in industry and career experiences on topics like emotional intelligence, mentorship, effective communication, and innovative thinking. “After completion of the program, each manager will be responsible for trickling down this knowledge and experience with their front-line team members.” Bruns understands the power of effective leadership, the capability to guide an organization, department, and workforce to better outcomes for the patients. “If I were to summarize my mentorship experiences throughout my lifetime, I would say they have taught me the importance of our own soft skills and how to appreciate the diversity each person carries in their own soft skills. Healthcare is one of the most diverse industries out there. No other industry can contribute more to people’s health and well-being than healthcare.”
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IDN NEWS
Breaking Ground Louisiana health system touts provider-owned PPE initiative. By Pete Mercer Just a little over a year ago, ground
was broken to create two new manufacturing facilities in Broussard, Louisiana, in an effort to curb the strain on the PPE supply chain in the United States. Now, SafeSource Direct is fully operational, producing PPE materials. SafeSource Direct is a joint venture between Trax Development and Ochsner Health, Louisiana’s leading integrated healthcare system, which makes it the only U.S. provider-owned PPE manufacturer with U.S. providerowned quality control, according to a release. In addition to that, these facilities have created 550 new jobs for Louisiana, with a projected 2,200 new direct and indirect jobs in the pipeline for the next two years. “We launched SafeSource Direct just 12 short months ago amid the COVID-19 pandemic as a solution to national PPE supply chain shortages, and now, we’re producing thousands of gloves, masks, and other PPE every day; and we’re continuously expanding,” said SafeSource Direct CEO Justin Hollingsworth in a press release. “We’re keeping our promise to bring jobs to the Acadiana Region while helping keep our nation’s healthcare and other essential workers safe on the job.”
Cleaning up the PPE market That guaranteed quality control is a significant step for PPE manufacturing. In the early days of the pandemic, the mad scramble for PPE materials created an environment where counterfeit and substandard items entered the marketplace. A lot of third-party 24
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organizations were looking to make a quick profit on something that frontline healthcare workers were depending on, further generating anxiety over an already complicated situation. Dr. Katherine Baumgarten, Medical Director of Infection Control and Prevention at Ochsner Health said, “Taking care of our patients and protecting our healthcare workers is our priority at Ochsner Health. At the onset of COVID, we realized that PPE was a precious commodity, and we went through great lengths to conserve it wherever possible while at the same time keeping our patients and employees safe.” By having that framework of quality control, especially with the supervision of a major healthcare system, SafeSource Direct is ensuring that the PPE going into the supply chain meets all the necessary criteria for the market. Not only is Ochsner Louisiana’s leading integrated healthcare system, but it’s also the top healthcare educator, making it an ideal partner for SafeSource’s efforts. “There is now a sense of relief to know that we will have PPE available to us in our own backyard, and it’s coming from a safe, reliable source,” Baumgarten continued. “The products have been designed to meet the high-quality standards that we require to protect those caring for our patients. I am so grateful that Ochsner Health has taken this step to ensure that healthcare workers across the country will have the protection they need, so that we can focus on giving the very best care.”
Innovation leading the way SafeSource Direct is using innovation and automation to provide highquality PPE at a competitive price in a location that is primed to distribute the PPE materials to the rest of the nation. In the nitrile glove plant, two lines produce around 27,000 gloves an hour. Early 2023 there will be an additional 14 lines become operational, according to a release, making SafeSource Direct one of the largest manufacturers of nitrile gloves in America. The other plant is focused on nonwoven material, producing level 1 and 3 surgical ear loop and surgical tie masks, standard three-ply procedure masks, shoe covers. Eventually, this plant will also be producing N95 respirators, hair bouffants, and isolation gowns. Vizient, one of the world’s largest group purchasing organizations, has partnered with SafeSource Direct to supply nitrile gloves to its thousands of member providers. With partnerships like this, SafeSource Direct will be able to create a PPE supply chain that improves resilience, reduces risk, and guarantees access with 130% flex capacity of normal volume. Warner Thomas, President and CEO of Ochsner Health said, “Challenging times spark innovation. Throughout the COVID-19 pandemic, we have pushed boundaries and thought creatively about how best to deliver on our commitment to our patients and our communities. Manufacturing PPE that we depend on is a prime example. We are proud to play a leading role in ensuring a high-quality and reliable PPE supply made in America. We owe it to Ochsner’s healthcare heroes and others across the country to ensure they have everything they need to keep themselves and their patients safe – now and in the future.”
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REP CORNER
A Tale of Two Industries From black angus beef to extended care, one business owner does it all. Like many business owners, Dennis Loflin typically begins his day on a call with one of his employees, often fielding
questions about client onboarding. Unlike most, however, the owner of NH Med Services, an extended care distributorship in Denton, North Carolina, doesn’t typically take these early morning calls at his desk – not when his cows need to be fed.
Before Loflin began NH Med Services in 2001, he was a full-time farmer. His family’s farm was founded in 1916 and has passed from one generation to the next ever since. Each generation has added on to the original farm, he explains. “I farmed with my dad, Clarence Loflin, for 35 years, until he passed away in 2011. We raise corn, wheat, soybeans and black angus beef cattle.” Today, he continues to oversee the day-to-day farming operations and decision making, carefully balancing the various agricultural demands with those of running a distributorship. It turns out, however, that healthcare and farming have more in common than one might suppose. Both industries require 24/7 attention, he points out. “Neither of these operations stop for holidays or inclement weather. Having a foot in both worlds keeps me quite busy, but the experience has taught me innumerable lessons, which ultimately have impacted me as a husband, father, brother and friend.”
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A new beginning Loflin’s decision to start an extended care distributorship took root in his concern over the direction in which he saw the industry moving. “In extended care, companies have often grown to be so large that business becomes purely transactional; they lose their personal touch,” he says. NH Med was established as “a personable solution” in an industry that had become increasingly more sterile, he adds. “NH Med began as a part B billing/furnishing company for skilled nursing and assisted living facilities,” he continues. “Our goal was to source locally-made products. We’ve always maintained a strong commitment to providing top-tier, American-made products to the people we serve.” Watching as his competitors expanded their scope, Loflin recognized the importance of positioning NH Med as a versatile company that could initially service the medical supply and furnishing demands of the industry, and eventually take on additional ventures. “NH Med’s growth has largely been driven by our marketing strategy, which is directed towards long-term care communities, assisted living communities, hospice and the general public,” he explains. “We have tried to expand and diversify our service area and inventory over time to become a one-stop solution, making it easy for facilities to have access to everything they need.” What began as a three-person operation eventually grew to a staff of 35 in a 37,000-square-foot office/ warehouse. “In the beginning, we focused on furnishings within facilities,” Loflin explains. “In recent years, we’ve added more design services and a full line of locally made furniture, which we now offer to other long-term care communities outside of our company network. We also service other markets in extended care, such as home care, hospice and other emerging fields where quality supplies are needed. As we’ve gained flexibility, we’ve grown more attentive to our market’s needs.” That’s not to imply the past 20 years have been without their share of challenges, he continues. But Loflin and
his team were clearly up to the task. For instance, when it became too difficult to directly source products, the company wasted no time in joining Daytona Beach, Floridabased Independent Medical Co-Op, Inc. (IMCO). “Doing so has greatly improved our ability to source products as an independent distributor and stay competitive,” he points out. “IMCO has made it possible for us to find higher quality, American made products, as well as to network with companies nationwide that are similar to NH Med.” Then came the COVID-19 crisis. As for many companies, the pandemic led to supply-and-demand challenges, making it extremely difficult to move products to longterm care settings. As a high-risk population, older adults were especially vulnerable before a vaccine was approved, he notes. “It proved very challenging to deliver medical supplies to facilities that needed product in a timely manner. We worked tirelessly to ensure this population and their staff were well-equipped with what they needed.” Indeed, the pandemic has sparked much discussion regarding how best to serve long-term care customers. Not only has the recent move to remote work and meetings impacted how NH Med interacts with clients, increased industry consolidation has made it difficult to access decision-makers, he says. “Whereas many distributors are sticking to their traditional formulas, NH Med is taking a multi-modal approach to communication. We are working on ways to better engage our clients, from email blasts and mailers to more in-person meetings, as safety permits. Our goal is to understand our clients’ needs, even when they do not necessarily relate to the products and services we offer. “We try to use our resources to provide answers or to create unique solutions,” he continues. “For instance, when our clients express their concerns over staffing challenges, which have become common in long-term care facilities, we keep an eye on potential recommendations for hire. We also try to provide them with education credits and other benefits that could help their staff and address their pain points. And, we offer same-day service – something most companies aren’t able to do. We ask ourselves how we can help out clients rather than determine that we cannot do so. “My grandfather used to say that life is all about perspective, something I’ve found truer with each passing day. I think having experience in both medical distribution and agriculture have definitely helped me broaden my overall perspective, as well as made me more adaptable.” As busy as it gets, he wouldn’t have it any other way. www.repertoiremag.com
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The Hilton Family One family discusses a journey through med/surg sales generations in the making.
Brad Hilton was at a crossroads early in his career and
he wanted his father Herb’s advice. He had a consulting opportunity on the table that would make more money. “This was a big deal, and he gave me some incredible advice and feedback,” Brad said. They jumped in Herb’s truck and drove around town, ending up in a Walmart parking lot. Brad asked him if he thought it was possible to make that kind of money in his current role. Herb told Brad yes, if Brad worked hard and did the right things. “If you don’t focus on the money, the money will follow,” Herb told Brad. They laugh about that family story four or five times a year now. “Every single time we talk about business, he says, ‘Do you remember?’ and I say, ‘you’re going to talk about the Walmart parking lot, aren’t you,’” Brad recalled. That’s one of many fond memories for Brad, now senior vice president of primary care sales at McKesson Medical-Surgical. Herb Hilton, who retired in 2012, and his three sons – Dan, Doug (both McKesson reps) and Brad – recently sat down with Repertoire for a deep dive into the lessons Herb’s sons learned from working with him for so many years, including career pivots, industry changes and even the family’s love of racing. 28
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The Hilton Family
‘A real blessing’ In the winter of 1959, Herb was between school semesters and didn’t have a job when his future father-in-law, Bud Bischoff, wondered why he was hanging around his house during the middle of the day. “He said they were moving their retail store [Bischoff ’s] into a warehouse and could use some help. So, I started at Bischoff ’s and was going to college full time and working full time. By the time I got out of college, it seemed to me like the logical thing would be to start selling cotton balls and catheters,” Herb said. Thus began his career in medical sales with his fatherin-law as one of his early mentors. Later on, Ted James, president of Intermedco, a distributor of medical and surgical supplies, was instrumental in helping guide Herb from Orlando to Houston [at Intermedco] and eventually starting to form his own company, Hilton Surgical Supply, which serviced physicians in the Greater Houston area. All three of his sons – Brad, Dan and Doug – worked there at one time or another. In 1995, Hilton sold the company to Taylor Medical, which soon thereafter became part of PSS (now McKesson Medical-Surgical). “[Ted] helped me with finances and encouragement,” Herb said. “I’ve always considered it a real blessing to have had him and others in my life.”
Vacation’s over Herb passed on those lessons to his sons as they grew in the family business. Before college, Herb’s sons worked in the warehouse doing pickups, packing and pulling, and preparing orders for the next day’s deliveries.
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Doug remembers when he and his brother Dan convinced Herb into letting them run the warehouse one summer. “We talked him into allowing us to go water skiing in the morning, then come home around lunchtime [to start working],” Doug said. “Somehow, we convinced him that was a good idea. But since there were two of us, he was probably paying us half-wages because we got double the work done in half the amount of time.” Doug and Dan would wake up at 5 a.m., go to the lake and ski until 12 p.m. “We probably did it four days a week,” Doug said. “We’d take the boat back to the warehouse and put it in the sun to dry. Then, we’d pick, pack and pull until it was all done at about 6 p.m. We’d wake up the next morning and do it all over again.” Those were some of Doug’s earliest and fondest memories before college graduation. But as Doug and Dan walked across the graduation stage on a Saturday afternoon, Herb was waiting with his hand extended to congratulate them – or so they thought. “I want my gas card back,” Herb told them. Doug and Dan were going to work for Herb at 7 a.m. Monday morning, but not before Dan asked if they could have two or three more days to unwind after graduation. “You guys have been on vacation for five years,” Herb told them. “You don’t need any more vacation. I’ll see you Monday morning.”
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The Hilton Family
Do things right Herb had a perfecting work style, his sons said. One of the first lessons ingrained in Brad was if you’re going to do something, do it right. “That was an absolute,” Brad said. The Hiltons used to handwrite orders and Brad admits to having bad handwriting. But when he’d scratch something out, Herb would tell him to rewrite it. “Our customers deserve better, and they deserve right,” Herb would say. “Rewrite it.” When Herb’s sons would staple papers, staples were never allowed on top of each other. All the staples had to be removed and the new staples needed to be punched through the existing staple holes. “There’s only one way to do staples,” he’d say. “You have to do it right.” There were even hygiene lessons thrown in with stapling and sales. “I showed up to work unshaven one day,” Brad said. “[My dad] told me to go to the bathroom and shave. But there were only soap and prep razors in the bathroom. He said, ‘sounds like your problem, not mine. If you don’t shave, you’re not working today.’” Brad admitted it was a bad experience. “Don’t shave with a prep razor and hand soap,” he said. “But dad’s big focus was on doing things right.”
Show your value After making sure things are done right, you must bring value to the customer and believe in it. According to Brad, that was an important philosophy to his dad. 32
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“Margins were king,” Brad said. “At one point, he wouldn’t pay a rep on any transaction below 40% margin. That’s how adamant he was.” Herb believed if you can’t substantiate your value, then shame on you. But if you can substantiate it, don’t be scared of having a conversation about it with a customer and charging for it. “If you bring value to the customer, then you have something to stand behind, but you have to believe it,” Brad said. “Those lessons are almost impossible to forget about today as we go about our daily work.”
A love of racing The Hiltons work hard and play hard. The sons’ love of water skiing doesn’t stray too far from its source. Herb jokes that he said he sold surgical supplies so he could water ski and race cars. He’s been racing since 2000. “We race about once a month,” Herb said. “We race on tracks all around the country. We’ve developed some fun relationships with competitors from different states and clubs.” Some of Herb’s proudest memories are winning the championship in his group each year until last year. “And that’s only because I blew up my car three times,” he said. Doug and Dan currently race in a different group, and Herb gets to watch them. “I have two grandsons racing as well,” Herb said. “So, what began as a solo adventure racing cars has become a family event.” To listen to the complete interview, visit Repertoire’s Road Warriors Podcast Episode #21 – The Hilton Family.
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TRENDS
Home Care is Going National As home care providers keep growing, what happens to local suppliers? The demand for home care is growing, sparking a wave of consolidation by private equity firms, payers and big
health systems. It’s a busy and challenging environment for local providers of home-based medical services as well as their suppliers.
“The pressure being applied by higher costs, difficulty finding qualified people, and stagnant reimbursement has resulted in many [providers of home-based medical care] looking for a way to survive or get out with minimal losses,” says Jay Butler, vice president of extended care, IMCO. “Integrated health systems can navigate the difficult market and realize savings that standalone providers simply can’t. 34
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“I believe venture capitalists are looking to capitalize on the market disruption by acquiring providers at desperation prices with intention to spin them off for a quick profit. They’re very good at what they do. However, I question if this is in any way good for the patients or business overall. Many times, the focus on the bottomline forces decisions to lower product quality, and the patient pays the price.”
“I understand why [consolidation] happens,” says Kevin Davis, corporate account manager, Concordance Healthcare Solutions. “If you look at it from the [perspective of] larger organizations doing the purchasing, it’s a streamlined process for patient care. They can follow the patient from the hospital into the home or vice versa. It helps with many facets of the continuum of care. “Have I seen a drop in patient care? I can’t personally speak to that, but I do hear the corporate culture works its way into the communities and workforce. Is this a good or bad thing? That’s according to who you ask. I really try to look at it from both sides.”
Growing demand For home health and hospice providers, the aging population provides significant tailwinds for patient volume and continuing growth, according to Precedence Research, which recently published a report on home care. “By 2030, all baby boomers will have reached the age of 65, causing one out of every five Americans to be categorized as retirees. The home health business is primed for expansion, thanks to the high frequency of disease, the need for assistance among the elderly, and the desire to receive care in the comfort of one’s own home.” Based on a survey of physicians who serve predominantly Medicare fee-for-service (FFS) and Medicare Advantage (MA) patients, consulting firm McKinsey estimates that up to $265 billion worth of care services (representing up to 25% of the total cost of care) for Medicare FFS and MA beneficiaries could shift from traditional facilities to the home by 2025 without a reduction in quality or access. “That number represents a three- to fourfold increase in the cost of care being delivered at home today for this population, although how the shift will affect reimbursement rates is not yet clear,” says the firm. A variety of pandemic-related factors have contributed to the growth of what McKinsey refers to as Care at Home, including: ʯ Growth in virtual care: In February 2021, the use of telehealth was 38 times higher than prepandemic levels. The share of Medicare visits conducted through telehealth rose to 52.7 million in 2020, from approximately 840,000 in 2019, according to a December 2021 report from the U.S. Department of Health & Human Services. ʯ New technologies and capabilities: Remote patient-monitoring devices allow providers to monitor patient progress remotely and receive alerts if there is an issue.
ʯ
Growing investment in digital health: Venture funding for digital health companies was a record-breaking $29.1 billion in 2021. Comparatively, there was $14.9 billion invested in 2020 and $8.2 billion invested in 2019.
While the post-acute home-health segment remains the largest care-at-home segment, McKinsey reports that emerging subsegments – such as home infusion, home-based dialysis, primary home care, and hospital home care – are growing rapidly. Chronic-care patients make up about 75% of the healthcare spending in the United States, according to the firm. Healthcare consulting firm Avalere reports that between 2012 and 2017, higher spending on in-home care led to significant decreases in overall spending on 10 chronic conditions: ʯ Quadriplegia. ʯ Traumatic amputations and complications. ʯ Multiple sclerosis. ʯ Atherosclerosis of the extremities with ulceration or gangrene. ʯ Lung and other severe cancers. ʯ Reactive and unspecified psychosis. ʯ Artificial openings for feeding or elimination. ʯ Bone, joint or muscle infections or necrosis. ʯ Seizure disorders and convulsions. ʯ Intestinal obstruction or perforation.
Private equity Private equity firms and payers have their fingerprints all over home-based medical care today. In June 2021, Humana signed a definitive agreement to acquire One Homecare Solutions (“onehome”) from WayPoint Capital Partners, the private equity affiliate of a New York-based family investment office. onehome manages a range of post-acute needs including infusion care, nursing, occupational therapy, physical therapy and durable medical equipment (DME) services at patients’ homes, as well as appropriate site of care placement through its skilled nursing facility (SNF) at home programs. Two months later, in August 2021, Humana completed its $8 billion acquisition of Kindred at Home, a home health and hospice provider, from TPG Capital, the private equity platform of TPG, and Welsh, Carson, Anderson & Stowe. At the time, Kindred at Home employed 43,000 caregivers providing home health, hospice and community care services to over 550,000 patients annually. With locations in 40 states, the company had geographic coverage with approximately www.repertoiremag.com
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TRENDS 65 percent overlap with Humana’s individual Medicare Advantage membership. In March 2022, Optum – which is part of UnitedHealth Group and which works with more than 100 health plans – agreed to acquire LHC Group, a national provider of in-home health care services. LHC Group’s 30,000 employees, including frontline care providers and administrative and support personnel, provide more than 12 million annual in-home interventions.
Supply chain consolidation Consolidation has a direct impact on distributors and dealers, says Davis, who lost two large home health agency accounts to buyouts in the last three years. “I can tell you not only did this affect my own territory, but it has affected home health agencies. I still get calls to this day because they can’t purchase a specific type of wound care product, urology product, etc., because their corporate agreements do not allow this on a formulary purchase. In the end, the effect is felt by the patient because the HHA has had to delay the care required to obtain a particular product.” In March 2022, Owens & Minor strengthened its presence in the market by acquiring for $1.6 billion home healthcare equipment company Apria Inc. Apria offers products and services for in-home care and delivery across three core service lines: home respiratory therapy (including home oxygen and non-invasive ventilation services); obstructive sleep apnea treatment, including CPAP and bi-level positive airway pressure devices, and patient support services; and negative pressure wound therapy. The Apria acquisition follows by five years Owens & Minor’s 2017 acquisition of White Plains, New Yorkbased Byram Healthcare, a distributor of medical supplies to home patients and home health agencies, with principal product lines of ostomy, wound care, urology, diabetes, and incontinence supplies. At the time of the Apria acquisition, Owens & Minor announced that Apria and Byram Healthcare would be combined to form the new Patient Direct segment. “The company will leverage its existing market reach and expertise in the hospital setting to create a more efficient, single-source home healthcare delivery and distribution model to support patients as their care transitions from the hospital into the home,” according to the company. The home healthcare industry has traditionally been highly fragmented and decentralized, which has historically complicated the access, coordination, distribution and billing of durable medical equipment (DME) products and related services that support the work of home 36
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health agencies who directly provide care to patients in the home setting, Daniel Starck, executive vice president of Patient Direct, told Repertoire. “In general, the industry is currently being driven by a desire for home healthcare services to be more integrated and accessible to rapidly growing patient populations, many of whom are living with one or more chronic health conditions requiring long-term care beyond the hospital and into the home. The combined strength and geographic reach of Owens & Minor’s existing Byram Healthcare business with Apria is able to more effectively meet the demands of larger national home health agencies that provide care for these patients. “From an administrative perspective, our home healthcare delivery and distribution model will streamline supply management. From a patient care perspective, supply continuity and management help to improve adherence to care, which can in turn improve patient satisfaction and outcomes.”
Outlook for local suppliers Given consolidation among home care providers and their suppliers, local home care/DME suppliers have some challenges ahead. But IMCO’s Jay Butler believes they can successfully meet them. Most of the nationals have services to meet the pharmacy and medical supply needs, he says. “Consolidation has had a negative impact on the locals’ ability to service some of these patients. When an acquisition occurs, the supply source generally switches over to the purchaser’s system and distribution arrangement. With the cost of supplies, freight, and staffing on the rise, it makes it much more difficult for DME dealers to continue servicing patients after consolidation and/or acquisition. “Having said this, many IMCO independent distributor members have been quite successful in maintaining and growing this business. Providers have learned bigger does not necessarily mean better when it comes to getting product to patients when needed. Independents tend to be more nimble and able to adjust quickly, allowing them to meet the ever-changing needs of the patients and providers. They have learned you can’t ‘boil the ocean,’ and have narrowed their coverage focus accordingly to the areas they can serve efficiently.” Butler believes the era of consolidation will pass. “As prices come down, the labor market improves, and supplies return to normal availability, I believe we will see the resurgence of independent, local homecare providers, and IMCO members will be there to assist in the process.”
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TRENDS
An Extended Market Footprint IMCO’s Jay Butler discusses the growth and importance of the Extended Care market. By Graham Garrison
It seems like everyone in the med/surg industry has a different definition for Extended Care, said IMCO’s
Jay Butler. “From an IMCO perspective we define it as everything from ‘post acute’ – including HomeCare, DME, Hospice, LTC – to everything in between,” said Butler, who was recently named IMCO’s new Vice President of Extended Care. In essence, Butler’s role is to bring members and vendors, serving the EC markets, together to help drive incremental growth by working to pair them up based on the product, target audience, and competitive landscape.
Butlers comes to IMCO with 27 years’ experience at Nestle Health Science, most recently holding the position of Director of Distribution and Extended Care. In his previous role, Butler was very familiar with many of the IMCO members and 38
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their business. During his tenure he also gained a lot of experience with distribution, how companies within the space work, and how best to integrate into their organization. “This combination made my transition into IMCO a bit smoother,” he
said. “Of course, with my knowledge being mostly with nutritional products, I had a lot to learn about other product categories and vendors. The vendors and members have been great, and very patient, in helping me get up to speed.”
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TRENDS In an interview with Repertoire, Butler shared several insights into the Extended Care market and the industry at large. The following were some takeaways:
An “explosion of demand” has created more concern with reimbursement In Butler’s opinion, the area of most concern within Extended Care from a reimbursement perspective is homecare. This segment has seen an explosion of demand. At the same time, homecare has been impacted equally with rising costs in labor, freight, products, etc., with very little change in reimbursement. “This has created a perfect storm of issues for this segment that needs to be addressed,” he said. “Much work has gone into lobbying for relief that will hopefully result in increased reimbursement to ease the pressure. At this point, the sustainability of the category is difficult at best.”
Continued consolidation Consolidation continues in the Extended Care channel, yet the challenges of lower LTC census and reimbursement in homecare continue. “This trend started well before the pandemic,” Butler said, “and I suspect it will continue as long as providers look for ways to escape the challenges all face with staffing costs and limitations, steadily rising product and freight costs, and reimbursement issues.”
Definitions are blurring The pandemic definitely resulted in accelerating the blurring of lines between different care settings, Butler said. As patients were unable to enter LTC facilities and chose to stay home, the homecare setting exploded. At the same time, the 40
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acuity level of patients in the home and LTC setting was on the rise, resulting in services being provided in those settings that traditionally had been delivered in acute care and LTACs. “This presented an opportunity for our IMCO members to offer services and products outside the traditional core.”
otherwise may not have had the opportunity. “This has resulted in expanding their market footprint in many instances.” From a vendor perspective, the pandemic opened doors that may otherwise have not been open to them. “As vendors struggled to get product, those with supply were able
Butler said since the pandemic began, IMCO Members have been able to expand into accounts and business segments in which they otherwise may not have had the opportunity. “This has resulted in expanding their market footprint in many instances.” Opportunity is out there Along with all the challenges from the pandemic, opportunities arose for independent distributors. “As the national distributors suffered the same limits on product availability, and pulled back from many accounts and certain channels of the market to protect their base, IMCO Members were able to capitalize on the opportunity to fill the gaps for accounts frantically searching for needed products,” Butler said. “This opened the door for business in new accounts in all care settings.” The strength and nimbleness of the independent distributors was showcased as they worked feverishly to meet customer needs and clearly showed size does not necessarily mean better, he added.
Change hasn’t been all bad Butler said since the pandemic began, IMCO Members have been able to expand into accounts and business segments in which they
to fill the needs and establish themselves in more IMCO Members,” he said. “At the same time, many were able to strengthen their positions as they worked to address Member needs and concerns. I would say the pressure of the pandemic allowed the cream to rise to the top.” The pandemic brought IMCO new members, vendors, and product opportunities and innovations. The shortage of product in the market resulted in IMCO searching out new sources. “As you know, the number of pop-up companies offering PPE exploded, so we served our IMCO Members by screening out those who were questionable and providing guidance on the legitimate vendors who could meet the immediate demand while offering value in the post-pandemic environment as well,” Butler said. “As a result, our Members and vendors looked to IMCO as a valued resource partner. The stronger bonds resulting will carry forward for us all.”
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Physicians on the Move The number of physicians employed by hospitals and health systems is growing, according to a recent study. By Pete Mercer
With all the challenges healthcare has faced in the last couple of years, it’s
no surprise that the industry as whole is constantly shifting and changing. The latest trend signifies a greater shift towards consolidation in the healthcare marketplace, which completely changes the practice landscape for physicians.
A recent study by Avalere Health and the Physicians Advocacy Institute shows that, as of January 2022, 74% of physicians in the United States are employed by hospitals or corporate entities, growing from 62% in January 2019.
Results of the study In the study, Avalere looked at two consolidation trends occurring on the national and regional levels of healthcare: 1. A cquisitions of physician practices by hospitals/ health systems and corporate entities like insurers and private equity firms. 2. P hysicians leaving independent medical practices for employment with hospitals/health systems and corporate entities. Researchers cited the pandemic as a contributing factor to this shift, finding that 108,700 additional physicians became employees of hospitals or corporations 42
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since January 2019, with 83,000 of them making the change after the onset of the pandemic. “COVID-19 drove physicians to leave private practice for employment at an even more rapid pace than we’ve seen in recent years, and these trends continued to accelerate in 2021,” Physicians Advocacy Institute CEO Kelly Kenney said in a news release. “This study underscores the fact that physicians across the nation are facing severe burnout and strain. The pressures of the pandemic forced many independent physicians to make difficult decisions to sell their practices to hospitals, health insurers or other corporate entities.” In addition to the pandemic, researchers found that acquisitions by hospitals and other corporate entities, like health insurers and private equity firms, are other contributing factors. According to the study, Avalere found that hospitals and other corporate entities acquired 36,200 additional physician practices from 2019 to 2022.
Effects of consolidation As healthcare continues to shift towards consolidation, many have argued for the benefits that consolidation can bring to the industry, citing things like reduced costs, improved care coordination, increased efficiency and enhanced patient access. Others have argued that consolidation will in turn increase patient care costs. John McCracken, PhD and Clinical Professor of Healthcare Management at the Jindal School of Management at the University of Texas at Dallas, wrote an article in 2019 about the effects of consolidation in healthcare. In the piece he said, “There are many studies of the effect of hospital mergers, and they generally find resultant price increases on the order of 20% – 30% to be common. Overall, these studies show that the primary effect of consolidation between market competitors is to increase prices, and by substantial amounts as market concentration rises.” As the study indicated, the shift towards healthcare consolidation is already happening and will continue to happen. There is likely no preventing consolidation, so it comes down to working with markets that are already consolidated. McCracken wrote, “An approach that is likely to come to the fore in the run-up to next the election is some form of Medicare buy-in or public insurance plan option, for which provider reimbursement would be based on Medicare rates and total spending controlled by global budgets.” While this isn’t likely the end of independent physician practices, it does raise alarming questions about the future costs of healthcare. There will always be a need for physicians, especially in rural areas where consolidation is less likely. It’s just a matter of ensuring that the physicians who are looking for communities to serve have those options. www.repertoiremag.com
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Heightened Cybersecurity Awareness The healthcare sector was the victim of more ransomware attacks than any other sector in 2021. By Daniel Beaird
Russia’s invasion of Ukraine has marked Europe’s larg-
est refugee crisis since World War II with more than 6 million Ukrainians fleeing the country.1 Meanwhile, the war in Ukraine has U.S. health systems and supply chains on high alert for cybersecurity breaches. Rapid integration of new technologies during the pandemic like telemedicine and remote monitoring technology are heavily relied on now. But the sector is susceptible to cyberattacks due to poor cybersecurity infrastructure. Therefore, the bipartisan Healthcare Cybersecurity Act of 2022 (S. 3904)2 was introduced in March by Sens. Bill Cassidy (R-LA) and Jacky Rosen (D-NV) to buttress healthcare defenses against potential Russian cyberattacks amidst the war in Ukraine. The Healthcare Cybersecurity Act calls on the U.S. Cybersecurity and Infrastructure Security Agency (CISA) to collaborate with HHS to improve cybersecurity in the healthcare sector. Shortly after the war in Ukraine began, HHS claimed there were three potential primary threat groups to the U.S. healthcare and public health sector: 1) organizations that are part of the Russian government, 2) cybercriminal groups based out of Russia and neighboring states, and 3) organizations that are part of the Belarussian government. Healthcare entities have been promoted as critical infrastructure providers (CIPs) for years and the COVID-19 pandemic highlighted this fact as the healthcare sector faced the most ransomware attacks in 2021 compared to other CIPs.3 However, according to a cyber readiness report by cybersecurity company Trellix that surveyed 900 cybersecurity professionals from across critical infrastructure sectors in April, the healthcare industry is woefully underprepared to defend against cyberattacks.4 Nearly three-quarters (74%) of healthcare providers in the report admitted that they had not fully implemented www.repertoiremag.com
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TRENDS sufficient software supply chain risk management policies and processes. The healthcare sector particularly noted underinvestment as a contributing factor. While 83% of healthcare services respondents claimed to have implemented some degree of software supply chain risk management policies and processes, the sector significantly trails other CIPs in fully implementing these measures. Difficult implementation (92%), little oversight on cybersecurity products themselves (68%) and a lack of U.S. federal government demands on cybersecurity (83%) were all cited as reasons for a lack of full implementation. But almost nine in 10 healthcare respondents reported the need to secure remote access to their enterprise resources became more important in maintaining their cybersecurity posture during the COVID-19 pandemic. “It all starts with understanding and outlining the risks involved with leveraging telemedicine and virtual operations,” said Ben Schwering, vice president, chief information security officer for Premier Inc., representing an alliance of approximately 4,400 U.S. hospitals and health systems and more than 225,000 other providers and organizations. “Performing regular risk assessments, documenting standard architecture and data flows, and undergoing formal threat modeling are essential to understand potential risks and weak points and ultimately addressing them,” he said. “One of the biggest lessons from COVID-19 is identity management. Health systems need to focus on securing all identities, including patient, provider and staff, as well as machine identities, including medical devices and telemedicine. Many times, these won’t be within the four walls of a hospital.” Schwering explained that Zero Trust architecture has become a standard approach to securing health systems in a post COVID-19 world, where identities are secured first before physical networks. “The concepts and best practices associated with Zero Trust principles apply anywhere – within the hospital and remotely,” he said. Zero Trust is a strategic approach to cybersecurity that secures an organization by eliminating implicit trust and continuously validating every stage of a digital interaction. The Healthcare Cybersecurity Act would partner CISA with HHS in an agreement, as defined by CISA, to improve cybersecurity in the healthcare and public health sector. It supports training efforts for private sector healthcare professionals. CISA would be responsible for teaching healthcare providers, suppliers and manufacturers on cybersecurity risks. CISA would also explore strategies on securing medical devices and EHRs. 46
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HSCA and its Committee for Healthcare eStandards issued its own guidance for healthcare providers on key cybersecurity considerations,8 including: ʯ Designating an IT security officer and maintaining anti-virus software. ʯ Providing cyber training and assessment for staff. ʯ Purchasing insurance policies that cover cybersecurity risks. ʯ Testing manufacturer claims. ʯ Encrypting personal authentication data. ʯ Certifying that suppliers of network-accessible medical devices, software and services are compliant with FDA guidance documents. ʯ Adopting, implementing and actively using industry-wide data standards for improving efficiencies and safety throughout the healthcare supply chain. Participating in at least one Information Sharing and Analysis Organization (ISAO) like the Health Information Sharing and Analysis Center (H-ISAO). Adopting an IT security risk assessment methodology like the NIST Cybersecurity Framework (CSF).
“There are several great resources available to help health systems and hospitals shore up their security capabilities such as the resources made available by CISA,” Schwering said. “Focusing on basic cyber hygiene and sticking to the fundamentals are the best approach to prepare for a potential cyberattack.” Schwering said this includes fundamentals such as security awareness training and up-to-date BC/DR (business continuity and disaster recovery) and incident response plans that are regularly tested. It also includes technical fundamentals such as multifactor authentication, system patching, secure remote access gateways, and modern endpoint detection and response.
Vendor and supplier risk Healthcare providers also face risks from many different types of supply chain vendors. This dramatically increases the consequences of a cyberattack. “Current approaches to assessing and managing vendor risks are failing,” said Dr. James Angle, co-chair of the Cloud Security Alliance’s Health Information Management Working Group, which drafted a whitepaper called Healthcare Supply Chain Cybersecurity Risk Management in May. “Given the importance of the supply chain, it’s critical that healthcare delivery organizations identify, assess and mitigate supply chain cyber risks to ensure their business resilience.”
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TRENDS Healthcare providers and suppliers are high-value targets. When addressing cyber risk and security within the supply chain, the Cloud Security Alliance (CSA) recommends healthcare delivery organizations: ʯ Inventory all suppliers, then prioritize and identify those they consider to be strategic suppliers. ʯ Tier suppliers based on risk, using a third-party risk rating service if possible. ʯ Contractually require suppliers to maintain security standards. ʯ Develop a schedule for reevaluating suppliers. CSA is dedicated to defining and raising awareness of best practices to help ensure a secure cloud computing environment. It offers cloud security-specific research, education, training, certification, events and products. “Supply chain exploitation is a reality,” said Michael Roza, a risk, audit, control and compliance professional, CSA Fellow and a contributor to the whitepaper. “It’s incumbent on healthcare delivery organizations to ensure that their supply chain partners comply with data management policies in order to keep their organizations and their users safe.”
Cyberattacks are costly – the average financial impact of a supply chain attack reached $1.4 million this year, making it the most expensive type of cyber incident5 – and additional economic burdens on healthcare providers are being experienced with increasing fines and investigations from HHS and the Office of Civil Rights (OCR) due to current supply chain risk management approaches. Order processing, inventory management, transportation and payment rely on electronic communications. Medical devices are now connected to the cloud so that vendors can manage them. This complexity and interdependency heightens the potential risk. Healthcare organizations are targeted given they have more assets to potentially exploit,6 and the supply chain is the most fundamental component to uninterrupted daily business operations. “Supply chain security, especially with medical devices, has become one of the top cybersecurity priorities for health systems,” Schwering said. “Performing risk
assessments and threat models for each use case involving online devices and services can help identify potential weak points and safety risks. Infusing cybersecurity controls throughout the lifecycle of a device, from procurement to disposal, is critical in enabling safe use of online devices.” This starts with a strong partnership with the manufacturers and suppliers to ensure cybersecurity expectations are clearly outlined and agreed upon, Schwering emphasized. The supply chain is an interdependent system that affects everything in healthcare. An insecure supply chain can impact a healthcare provider’s risk profile and security. Assessing and mitigating risk in the supply chain should be applied with the same energy as it is internally. “Fundamentals such as developing standard operating procedures (SOPs) for updating devices, implementing strong authentication, removing hard coded passwords and disabling unused components are critical steps in securing your online footprint,” Schwering said. When the supply chain is compromised, a healthcare provider’s networks and systems are at risk. “The cybersecurity risks in delivering healthcare services have beyond just the four walls of the hospital,” Schwering said. “Health systems are much more aware of the need for strong supply chain security, especially involving medical devices and managed services.”
1. Operational Data Portal: Ukraine Refugee Situation 2. S. 3904 – Healthcare Cybersecurity Act of 2022 3. Federal Bureau of Investigation: Internet Crime Report 2021 4. Trellix Cyber Readiness Research: Path to Cyber Readiness – Preparation, Perception and Partnership
5. ITProPortal: Supply chain attacks are now more costly than ever 6. Palo Alto Networks: Ransomware Threat Report 2021 7. Ponemon Institute: The Economic Impact of Third-Party Risk Management in Healthcare 8. HSCA: Medical Device and Service Cybersecurity
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According to the CSA’s Healthcare Supply Chain Cybersecurity Risk Management and the Ponemon Institute, which runs IT infrastructure studies, there are several reasons why supply chain and risk management programs fail in healthcare, 7 including: ʯ The lack of automation and reliance upon manual risk management processes makes it challenging to keep pace with cyber threats and the proliferation of digital applications and medical devices used in healthcare. ʯ Vendor risk assessments are time-consuming and costly, so few organizations conduct risk assessments of their vendors. ʯ Critical vendor management controls and processes are often only partially deployed or not deployed at all.
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Breaking the Rules of Healthcare: Getting the Quality of Care You Pay For When patients have a choice of where to go for care, providers must also improve care By Dr. Robert Pearl
As consumers, we typically assume
there’s a positive correlation between price and quality. We expect the $40 toaster to have distinct advantages over the $20 model and the luxury sedan to have superior engineering compared to the midrange option. But when it comes to inpatient care, this assumption proves dead wrong. High-priced hospitals don’t necessarily deliver higher-quality care. That’s because of an unwritten rule that hospital administrators and their boards have dutifully followed for decades. This article, the sixth in a series called “Breaking The Rules of Healthcare,” introduces the rule and explains why breaking it will lead to better medical care. Rule No. 6: Hospitals maximize profits by monopolizing markets It used to be that hospitals based their prices on the cost of providing care. When prices went up, the added revenue went to hiring more support staff, recruiting top physicians and buying new technologies. Last century’s patients (and their insurance companies) didn’t mind paying more for better quality. Back then, they got what they paid for. Toward the turn of the century, however, for-profit health insurers began exerting greater influence www.repertoiremag.com
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TRENDS over the industry with a goal of earning outsized profits for shareholders. They did this, in part, by cutting hospital costs and imposing restrictions on care delivery. Hospital leaders countered, buying up competing hospitals to gain greater leverage and market control. Once communities were left with only one hospital or health system, insurers were left with no choice but to pay the asking rate.
Hospital consolidation shows no signs of slowing down Between 2000 and 2012, nearly 900 hospital mergers and acquisitions were announced. Over the next three years, from 2012 to 2015, another 1,600 hospital mergers and takeovers took place. These numbers continue to grow. The 40 largest health systems now own 2,073 hospitals, roughly one-third of all emergency and acute-care facilities in the United States. The top 10 health systems own one-sixth of all hospitals and combine for $226.7 billion in net patient revenues. Today, inpatient care is the single largest contributor to healthcare costs in the United States, accounting for 31% of the total. Monopolistic hospital pricing helps explain why healthcare spending has increased 35-fold over the past 40 years, from $353 per person in 1970 to more than $12,531 in 2020. Yet, despite soaring costs, few Americans today get what they pay for. In fact, the U.S. ranks last among wealthy nations in practically every measure of quality and performance. Two recent studies shed light on how hospitals – and the doctors who work there – use their size and numbers to maximize profits without improving patient care. 50
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Quality suffers without competition Last month, a Yale-Harvard research collaboration for the National Bureau of Economic Research found that expensive hospitals (priced 52% higher than average) reduced patient mortality by a mere 1%. But researchers identified a huge difference in the death rate when they compared high-priced hospitals in competitive vs. non-competitive markets. In places where hospitals vie for patients, higher prices correlated with a 47% lower mortality for time-sensitive medical problems like heart attacks. In concentrated markets (with only one hospital system), higher prices had “no detectable effect on mortality.” This finding makes sense. When patients have a choice to go elsewhere,
hospitals that raise prices must also improve care. To attract patients, competing hospitals use higher revenues to hire more nurses and support staff – or launch diseasemanagement programs and other quality-improvement efforts. By contrast, for-profit hospitals in monopolistic markets use higher revenues to cushion their bottom lines. Nonprofit monopolies in noncompetitive areas are more likely to use the added dollars to construct ornate buildings with beautiful lobbies that resemble luxury hotels.
Physicians also use market control to increase prices Radiologists, ER doctors and others who work fulltime for hospitals have, themselves, figured out how
merge with the intent to raise prices, the DOJ must step up enforcement and start reversing the status quo.
to benefit from the unwritten rule of market control. A study published in JAMA Internal Medicine examined the difference in hospital pricing when anesthesiologists join physician management companies that are backed by private equity (a growing trend in hospitals). Researchers found that when private equity is involved, prices paid to anesthesia practitioners increased by a whopping 26%. You can’t run a hospital without anesthesiologists or ER physicians. And when these specialists band together, hospitals have no other choice but to meet their financial demands. The added costs get passed on to purchasers and patients the following year.
How to get what we pay for To break this harmful rule – and help patients get better care at more affordable prices – here are two practical steps governmental agencies could take. No. 1. Expand DOJ regulation of hospitals. When a single health system buys up all the hospitals in town, the U.S. Department of Justice (DOJ) has the authority to enforce anti-competition laws. The Justice Department did so in 2020 when it sued Sutter Health for price gouging, leading to a $575 million antitrust settlement with the State of California (later overturned by a jury). Still, most hospital mergers get approved with little pushback and no mandate to improve quality or make care more affordable. When hospitals
No. 2. Create a hospital quality scorecard. For years, the Centers for Medicare & Medicaid Services (CMS) have collected some hospital data (called Quality Measures) for the sake of determining hospital payments. In simplest terms, financial penalties are imposed when patients suffer a medical error or are discharged prematurely. But this information is far from comprehensive. A better CMS solution would require hospitals and electronic health record companies to open their application programming interfaces (APIs) so that artificial intelligence software could conduct a much deeper analysis of patient health records. CMS could then publish a definitive hospital “quality scorecard” that would allow patients and commercial insurers to compare hospital prices with quality outcomes and patient safety records. Of course, hospitals have tremendous clout with elected officials, and they will vigorously oppose these measures. But, as a voter, you can play your part to tilt scales of justice. First, check out this spreadsheet from the Yale University Tobin Center for Economic Policy, https://tinyurl.com/3kfah7tm. Its author, a Yale economist named Zach Cooper, explains how to know if you’re in a consolidated hospital market: “You should be concerned about hospitals with a Herfindahl Hirschman Index (HHI) of greater than 4,000.” Second, if you want higher quality medical care, ask your state representative and senator whether they support the two actions steps outlined above. Remember their answers when you head to the voting booth this fall. www.repertoiremag.com
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HIDA
Halfway through 2022, HIDA Continues to Lead As HIDA began 2022, our Board of Directors committed to four key areas of focus: pandemic
preparedness, diversity & inclusion, environmental stewardship and membership growth. As we approach mid-year, HIDA is pleased to report substantial progress on all of these issues.
Matt Rowan, President & CEO, Health Industry Distributors Association
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Preparing for future pandemics HIDA’s Pandemic Preparedness Summit will bring together healthcare supply chain stakeholders and federal partners to build on the public-private partnership. Throughout the pandemic, the collaborative efforts of government and the supply chain were instrumental in the response. Envisioned as an annual event, the Summit will be a working session to exchange information, develop best practices, protocols and information on supply chain readiness. This focus on preparedness is part of our “whole of government” approach to
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advocacy, as HIDA has deepened its ties with both the legislative and executive branches. At the U.S. Department of Health and Human Services, HIDA has entered into a cooperative agreement with the Office of the Assistant Secretary for Preparedness and Response (ASPR) to work with subject matter experts on issues of mutual concern. In Congress, HIDA has engaged with Senators from both parties on comprehensive legislation such as the PREVENT Pandemics Act that would strengthen medical supply chains and public health preparedness.
Competing for talent, building diversity As an industry, we compete for talent against other industries. The healthcare supply chain provides meaningful jobs and rewarding careers that stack up well when compared to other industries. Also we want to continue to benefit from a workforce of diverse perspectives and experiences. This summer, HIDA will launch a website where prospective applicants can browse entry-level listings, apply for their first jobs and launch their careers. This effort will include digital and direct recruitment efforts focused on graduates of Historically Black Colleges & Universities (HBCUs) and Hispanic-Serving Institutions. To guide this effort, HIDA launched the Workforce Development Advisory Council composed of business leaders in our industry with wide experience in talent acquisition as well as human resource professionals from member companies.
Sustainability and the supply chain Among our members, being good stewards of the environment is a high priority. HIDA has launched a Sustainability Council to take a leadership role in setting standards for our industry around sustainability. This council will advance sustainability practices in the healthcare supply chain, focusing on standardizing reporting structures and information exchange between trading partners. The vision is to then promote peer to peer information sharing on sustainability best practices, goal setting and metrics.
Membership expansion As always, the strength of HIDA is in our membership. In 2021, HIDA’s membership increased by 21%. So far this year, we have added 14 new members of HIDA and 13 new associates of the HIDA Educational Foundation – a membership increase of more than 10%. HIDA’s first priority is to continue this membership growth is among medical distributors, manufacturers and stakeholders. To continue to broaden and deepen our engagement with members companies across the healthcare supply chain, HIDA launched a new Councils in Direct to Patient and Environmental Services to provide focused networking and learning opportunities in these areas. HIDA’s goal is to continually grow influence and relevance by engaging member companies that share the common goal of improving our supply chain and responsiveness. We invite everyone to learn about the value of distribution and access the resources available on our website at HIDA.org.
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MARKETING MINUTE
Lean Marketing in Healthcare Five strategies for small suppliers. The healthcare industry is a highly competitive market. In the United States alone, 784,626 healthcare companies
are vying for consumers. Small healthcare suppliers have a big challenge ahead of them when competing with big brands. They don’t typically have the marketing budget that large companies do, so they don’t have the same brand recognition and visibility. But that doesn’t mean that small suppliers can’t compete in the industry.
Through lean marketing in healthcare, smaller companies can maximize their budgets to earn more success with potentially smaller funds. Lean marketing creates room for adaptability, allowing small suppliers to adjust their efforts along the way for more impactful results and a higher ROI. While big brands have several advantages when it comes to marketing, they’re not unbeatable. To compete with big brands, small healthcare suppliers must develop lean marketing strategies that yield big results.
What is Lean Marketing in Healthcare? The lean philosophy began in the automobile industry with Toyota Manufacturing Systems (TMS). They believed that, through a framework of efficiency, repetition, testing, and quantifying metrics, they could outperform their competitors. Although the lean philosophy was initially used in terms of manufacturing, businesses in other industries began adopting it into their marketing plans. It’s especially helpful in the healthcare industry, where multiple departments often must work together on complex projects with a shared budget. Lean marketing allows for departments to work seamlessly together, helps to simplify complicated projects, and provides flexibility for a smooth project workflow of continuous improvement. With lean marketing, small businesses in the healthcare industry can: ʯ Improve delivery time: Larger tasks are broken up into smaller pieces that are easier to manage. This lets you test and launch campaigns more quickly, seeing results sooner. Additionally, by performing a task repeatedly, you can make improvements each time for a more efficient and effective marketing plan. ʯ Better connect with members of their team: To become lean, staff must meet daily to give status updates on the projects they’re working on. Such transparency not only keeps everyone on the same page. It helps identify potential pitfalls and provides an arena for peer-to-peer problem solving, continual learning, and growth. ʯ Narrow their focus on single tasks: Multitasking takes focus away from several projects at once. In
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lean marketing, people are encouraged to focus on one thing at a time. This helps people work more efficiently and yields a higher rate of productivity. Pivot their strategy mid-stride: By constantly measuring your efforts, you can see what parts of your plan are working and what needs improvement. Workers are encouraged to make datadriven adjustments to ensure they’re working as proficiently and effectively as possible. Pivoting a strategy mid-stride helps to reduce waste of time and resources on a plan that simply isn’t working.
leads to wasted money, time, and effort, and that’s not what the lean philosophy is all about. When developing your marketing strategy, think about the things your business does well. Focus on those aspects and use them to create your marketing plan. With lean marketing, quality is more important than quantity. Invest your resources into whatever will make the most impact. Avoid tactics that aren’t performing and focus on what yields results. It’s better to focus on a few things and be exceptional than several things and be mediocre.
5 Lean Marketing Strategies for Small Healthcare Suppliers
No. 3: Leave Room in Your Marketing Plan for Adjustments
Through careful strategy, small companies in the healthcare supply chain can gain a foothold in the industry’s marketplace. Whether you’re a hospital distributor, a member of a group purchasing network, or in charge of purchasing physician office supplies, here are five lean marketing strategies that can help you beat big brands.
From acquisitions and medical research to government policies and technological advancements, the healthcare industry is constantly changing. That’s why flexibility is so important to a marketing campaign. Through constant evaluation, you’ll know which of your marketing tactics is underperforming. With lean marketing, small suppliers can adjust as necessary. When you set your marketing plan, remember it isn’t chiseled in stone. Allow opportunities for creative solutions and new directions so you can pivot freely without hesitation.
No. 1: Set SMART Goals To function more efficiently, it’s important to know what you’re aiming for and how well that plan is working. By setting measurable goals at the onset of a project, you can stay on track while adhering to your budget. SMART goals help define your intentions and keep you driven toward success. SMART goals are: ʯ Specific: A narrowed scope yields higher rates of efficiency. ʯ Measurable: Metrics and their reassessment will reveal areas of accomplishment. ʯ Attainable: A series of smaller goals gain more success and propel you forward to more rewards. ʯ Relevant: Objectives should be in line with your long-term plans. ʯ Timely: A realistic deadline helps prioritize your course of action. Setting manageable and achievable targets will launch you and your team toward success while maximizing your work efficiency.
No. 2: Amplify Your Strengths It’s common for companies to invest marketing dollars into a campaign that just doesn’t work. They try to capitalize on too many products, services, and promises. This
No. 4: Constantly Review Your Budget Lean marketing encourages constant assessment of what is and isn’t working in your marketing plan. This should also apply to your marketing budget. Set longterm goals for the year, but make frequent assessments as you determine the effectiveness of your marketing strategy. Find areas in your budget that need to be adjusted, eliminated, or reconfigured to meet the needs of your flexible marketing goals.
No. 5: Outsource Projects to Save Resources It’s not always most efficient to do your own marketing. If you don’t have a dedicated promotional team, balancing those responsibilities can take time and focus away from other projects that need your attention. This goes against the lean philosophy. Consider outsourcing some of your projects to a medical manufacturer marketing agency. Hiring an outside expert can sometimes be more efficient and cost effective than trying to manage it all yourself. Share Moving Media is a full-service media and content company that specifically helps businesses in the healthcare industry meet their marketing goals. For more information, visit http://sharemovingmedia.com/contact-us. www.repertoiremag.com
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EVENTS
PWH® Celebrates Achievements, Connection and Inclusion By Rachel Bailey, Editor, PWH® Connect Journal
The PWH® Leadership Summit in Denver, Colorado was packed with professional development and networking opportunities. Thank you to all attendees, our PWH® member volunteers, Summit sponsors and all our excellent speakers and break-out session presenters. Shown here, attendees gather for the annual Summit group photo that has become a tradition since 2018.
The Professional Women in Healthcare® (PWH®) organization celebrated the achievement of being together
in-person at its fourth annual PWH® Leadership Summit in Westminster, Colorado, May 16-18, 2022. The PWH® Leadership Summit is our industry’s only conference dedicated to diverse and inclusive leadership development. Driving the PWH® mission of creating a more diverse and inclusive healthcare industry equally led by women, a variety of mentoring, education and networking sessions inspired over 180 attendees to step out of our comfort zones, embrace inclusion and connect!
“It was so wonderful to celebrate all our personal and professional achievements together at this year’s Summit,” said PWH® Chair and Vice President of Industry Associations at Owens & Minor Vicky Lyle. “Thank you to all our attendees, our Summit Sponsors, amazing speakers and dedicated member volunteers who 56
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helped make the event so impactful and inspiring. I’d especially like to thank the PWH® Summit Committee, led by April Shomper, who also serves as Vizient’s Event Director.” Vizient sponsored our opening keynote speaker, Mike Rayburn, who demonstrated how asking what if can turn challenges into opportunities.
Indeed, throughout the Summit, speakers and attendees appealed to the what if approach. Vicky Lyle asked, “What if we had a culturally inclusive healthcare industry equally led by women?” According to the latest research from McKinsey & Company, we would all be in a position for greater profitability.
Joe Walsh of Supply Chain Sherpas asked, “What if the [healthcare] system perfectly delivered, even in a crisis?” Joe Machicote, Chief Diversity and Inclusion Officer of Premier, challenged us to be more accountable by asking “What if we are the teammate who isn’t showing up for our company’s culture?” Attendees bemused these questions during meals, receptions, mentoring circles and interactive breakout sessions. Some highlighted sessions included opportunities to learn best practices for professional development from professional trainers and executive coaches, as well as industry veterans like Cathy Denning, Janis Dezso, Sue Hulsmeyer and Anne Eiting Klamar. Sessions featured topics such as motivating in virtual environments, presenting with executive presence, advocating for a seat at the table and managing up. A favorite of past Summits, this year’s series of 15-minute Leadership Insights was sponsored by Midmark and did not disappoint: ʯ Joe Walsh, Executive Coach and Founder of Supply Chain Sherpas, encouraged us to unlock our potential by focusing more on skills development and storytelling. Know which limiting stories might be getting in your way. Then embrace leadership preparedness by developing new skills (and stories) on our way to new summits. ʯ Stephanie Muir, Chief Technology Officer of Midmark, provided clear steps for creating our life’s roadmap to success and reminded us it is never too late to plan our legacy. Naming our goals makes them clearer and adjusting to
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rocky terrain along the way helps realize goals faster. Joe Machicote, Chief Diversity and Inclusion Officer of Premier, inspired us to build an environment that sustains diversity and inclusion by recognizing and sharing our privileges. A commitment to showing up, being accountable and superior to
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our former selves helps everyone thrive. Natalie Martin, Director, Creative Services for NDC, explained how to influence from different angles and levels of our organization’s hierarchy. Knowing when to put which foot forward in time with the beat can get a dance floor grooving, even in virtual environments.
Monica Davy, Senior Vice President, Chief Culture, Diversity and Inclusion Officer at Vizient led a Fireside Chat with Jeff Jochims, EVP, Chief Operating Officer & President at Owens & Minor, and Brianna Dillard-Dula, Supervisor, Customer Service at Owens & Minor.
PWH® Chair Elect Allison Therwhanger (left) and PWH® Chair Vicky Lyle (right) presented the Anne Eiting Klamar Leadership Award of Distinction to Janis Dezso, Vice President, Global Distribution for Symmetry Surgical (center). The 2022 Jana Quinn Inspirational Award was awarded to Rebecca Benga, Sr. Manager, Clinical Education-Medical, Midmark (not pictured).
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The PWH® Leadership Summit is our industry’s only conference dedicated to diverse and inclusive leadership development. The 2022 Summit attracted over 180 attendees.
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Aster Angagaw, Vice President, Head of Commercial and Public Sectors at Amazon Business and former Board Member at Owens & Minor, taught us how to integrate career, growth, play, community, money, self-care and purpose to grow in our leadership roles without burning out.
Tuesday’s sessions ended with the powerful gender partnership Fireside Chat, “Better Together: Creating an Inclusive Environment”, moderated by Vizient’s Monica Davy, featuring an open and honest conversation with Owens & Minor’s Jeff Jochims and Brianna Dillard-Dula. This critical discussion reminds us that if we don’t intentionally include, we unintentionally exclude. Attendees were challenged to create an inclusive environment where all voices can be heard and to use our privilege and positions to open windows of opportunity for diversity. During the final leadership panel entitled “Leading with Impact through 58
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Historical Change,” moderator Elizabeth Hilla, Senior Vice President of HIDA, picked back up on the what if theme. She asked industry leader panelists: “What if the pandemic never happened, what leadership lesson would you have missed and what have you gained because it did?” ʯ Amanda Chawla, Chief Supply Chain Officer, Vice President for Stanford Health Care, said, “Without the pandemic I don’t think I’d be as brave as I am today.” ʯ David Gillan, Chief of Client Retention & Strategy for Sodexo, said, “The pandemic made us live our values in ways we hadn’t before.” ʯ Tina Murphy, Division President, Value Based Care for GHX, said, “I learned I can be an exceptional leader because I’m a woman and not despite the fact.” ʯ Joe Grispo, Senior Vice President, Chief Sales Officer for B. Braun, said, “If it wasn’t for the pandemic, we
wouldn’t have the most common phrase in business today – ‘You’re on mute!’” Last, but definitely not least, closing keynote speaker Colette Carlson had the room rolling with laughter as she shared five strategies to connect: 1. Awaken your awareness 2. Express your success 3. Cultivate connections that count 4. Act in authentic alignment 5. Get your ask together! We hope you do “get your asks together” and join us next year for more networking and high-quality education as we learn together and strive to cultivate inclusive leadership. “After coming off the heels of such an inspirational and impactful re-connection in Denver, I hope all of you will save the date for the 2023 Summit and don’t forget to invite a colleague to join you!” said April Shomper, chair of the PWH® Summit Committee. Make sure to mark your calendar for the 2023 PWH® Leadership Summit at the St. Anthony in San Antonio, Texas, May 1–3, 2023.
NEWS Industry News IMCO names Adam Deets as director of primary care IMCO recently named Adam Deets as director of primary care. In his new role, Deets will be responsible for managing IMCO’s primary care business including membership support, vendor relations, and program effectiveness in this segment of healthcare. Deets brings with him nearly 20 years of sales experience in healthcare in a variety of markets including medical device sales, sterile procedure trays and supplies, vascular access devices, and reprocessed medical device programs. In Deets’ past roles, he has hired, trained, and developed sales talent as a mentor for 11 years. Deets holds a B.A. in History from Ripon College in Wisconsin. Bill McLaughlin, CEO of IMCO, said Deets “not only has a wide variety of experience in many aspects of healthcare, but he also brings a unique set of skills that will benefit all of our Member Distributors in the primary care space.” Deets will report directly to McLaughlin.
Medline opens state-of-the-art distribution center in Southaven, Mississippi Medline’s new 1.2 million-square-foot, medical-grade distribution center opened its doors at the end of 2021 and is now fully operational. The $45 million cutting-edge facility serves healthcare systems and facilities across the continuum of care, adding 450 jobs to support customers in the Southeastern region.
As Medline’s business continues to grow, serving major hospitals, nursing homes and military facilities in the region, the company has invested in expanding its storage and distribution capacity in Mississippi to meet the product needs of its healthcare customers.
“We are excited about our new home in Southaven, which is an ideal location to serve our customers in the region,” said Steve Miller, Medline’s executive vice president of supply chain. “We have the benefit of expanding our team and gaining access to a strong local labor market.” The new Southaven facility handles the distribution of thousands of individual products and devices which are shipped to healthcare providers across the continuum of care. Over $350 million in annual orders are expected to be handled from the Southaven facility.
Maureen Knott named president of the Henry Schein Cares Foundation The Henry Schein Cares Foundation announced that Maureen Knott will assume the role of President, helping to drive forward the Foundation’s mission and vision of accelerating change to build a healthier world. Knott, who is Vice President, Maureen Knott Product Advertising, for Henry Schein’s U.S. Dental business, will succeed Steve W. Kess, Founding President of the Henry Schein Cares Foundation, who will continue to offer leadership and guidance in his new role as President Emeritus. The Henry Schein Cares Foundation is a philanthropic vehicle that aims to build a healthier world by bringing together key stakeholders to support innovation, strengthen health care system resilience, expand access to care for underserved communities, and invest in the next generation of health care professionals. The Foundation’s key focus areas include wellness and preventive health care as critical components of better health outcomes, including oral health as an important part of overall health; access to care for vulnerable populations; disaster response and relief efforts for communities in need; and support for diverse, innovative health and public leaders to advance the capacities of health care professionals worldwide. Knott has been a Team Schein Member for more than 35 years and is a key driver of several initiatives led by Henry Schein Cares, the Company’s global corporate social responsibility program. She created and implemented the Henry Schein Cares Calendar of Caring marketing initiative, which has raised more than $2 million to support environmental www.repertoiremag.com
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sustainability, overall health, and the fight against cancer. She also launched Henry Schein’s Practice Pink Program, through which Henry Schein has contributed $500,000 to the American Cancer Society Hope Lodge Program, as well as $500,000 to the Memorial Sloan Kettering Women’s Health Center in Commack, NY. Knott is also a founder and Executive Sponsor of Henry Schein’s Women’s Leadership Network, an employee-led network that fosters a diverse, inclusive workplace aligned with the Company’s corporate charter, Team Schein values, and business goals.
BD names Simon Campion as Medical Segment President BD announced it has appointed Simon Campion as executive vice president (EVP) and president of the Medical segment for BD, effective July 1, 2022. Campion, 51, will replace Alberto Mas who previously announced his intent to retire from BD. In this role, Simon Campion Campion will be responsible for the global strategic, operational and commercial performance of the Medical segment portfolio and will be accountable for delivering the segment’s innovation agenda aligned to the BD 2025 strategy. Campion will also continue to lead the Interventional segment in the interim until a successor is named. He will report to Tom Polen, chairman, CEO and president of BD. “Simon is a proven business leader with excellent strategic and operational skills and deep global experience,” said Polen. “Since joining BD from the Bard acquisition, Simon has been integral in the integration and growth of the legacy Bard businesses across the Interventional segment and is well positioned to lead BD’s largest segment.” Campion has served as EVP and president of the Interventional segment for BD since September 2018. Prior to that he was president of the BD Surgery business unit, where he integrated legacy Bard and BD product platforms into an integrated Surgery offering. Campion joined Bard in 2008 and held leadership roles in numerous Bard businesses in the U.S. and Europe. Prior to Bard, he held marketing and R&D roles at Cook Medical and Boston Scientific. Campion holds a Ph.D. in Mechanical Engineering from the University of Limerick in Ireland and a Master of Business Administration from The Open University in the United Kingdom. 60
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Cardinal Health continues at-Home Solutions growth with new distribution center in Ohio Cardinal Health announced the addition of a new distribution center in the Columbus, Ohio, area as part of a multi-year warehouse modernization and growth plan. The new distribution center will support the company’s at-Home Solutions business, a market-leading medical supplies provider and specialized business focused on providing comfortable care in the home for people with chronic and serious health conditions. “We have been committed to helping patients take care of their health at home for decades,” said Rob Schlissberg, President, Cardinal Health at-Home Solutions. “As a result of the pandemic, the health care industry is experiencing accelerated consumer demand for personalized experiences when it comes to health care at home. Expanding our warehouse footprint optimizes our distribution network and enhances our customer service levels, while positioning us for sustained growth in an area of patient care that continues to evolve.” The 208,144 square-foot building will be the tenth U.S. distribution center for Cardinal Health at-Home Solutions. The new facility will integrate state-of-the art logistics technology, including robotic storage capabilities, conveyance and the Kinaxis® RapidResponse® platform to optimize digital supply chain planning. All technology and automation will work alongside Cardinal Health employees to deliver operational efficiencies as well as enhanced employee and customer experiences, while supporting fluctuations in volume and labor. Located in Grove City, the distribution center will create approximately 100 new job opportunities for the Ohio Valley market and is estimated to be fully operational in November 2022. The new location joins another recently announced 574,670 square-foot Cardinal Health distribution center, also expected to open later this year in Columbus. “The Ohio Valley is one of the most densely populated areas of the country and a centrally located region with access to a major interstate highway system – critical to our fast transit needs,” said Steve Mason, CEO of the Cardinal Health Medical Segment. “These investments are part of Cardinal Health’s commitment to growing our already significant and strategic distribution footprint in Central Ohio and delivering end-to-end products and solutions that advance healthcare and improve lives every day.”
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