vol.30 no.3 • March 2022
An Unwelcome Guest Inflation? Why now? What’s next?
repertoiremag.com
POINT-OF-CARE READER
IMMUNOASSAY SYSTEM
RAPID DIAGNOSTICS
MARCH 2022 • VOLUME 30 • ISSUE 3
An Unwelcome Guest Inflation? Why now? What’s next?
26 PUBLISHER’S LETTER
TRENDS
Engaged and Thankful..................... 2
Managing Pain in Long-Term Care Opioids have a place, but staff need to encourage nonpharmacological solutions..................... 32
PHYSICIAN OFFICE LAB Thinking About Value The three pillars of product and service value common to both lab and medical surgical products........................ 4
MARKETING MINUTE Getting Your Message Across Tips for effective healthcare organization content marketing.................. 45
PEOPLE In Good Hands Mark Zacur, healthcare industry executive, reflects on an unprecedented time to be in the healthcare supply chain........... 46
TRENDS
HIDA
Breaking The Rules of Healthcare: Paying Your Doctor
HIDA Launches Workforce Development Advisory Council
It’s time to transform the way doctors are incentivized, and paid, for patient care......... 8
HIDA to tackle workforce development, attract recent graduates into industry......... 50
SALES
HEALTH NEWS
Define Your Company’s Sales Culture It should mesh with the overall company culture – and then some............... 15
SUPPLY CHAIN The Healthcare Continuum Takes on Staffing Shortages Supply chain leaders examine how their health systems are handling clinical and non-clinical personnel deficits...................... 18
A Long-Term Care Crisis? Long-term care has faced staffing challenges for years, and the pandemic has only made it worse................ 38
Which States Have the Best Telehealth Practices? A new report rates every state’s telehealth policy for patient access and ease of providing virtual care............... 42
Health News and Notes................... 52
WINDSHIELD TIME Automotive-related News........... 54
NEWS Industry News........................................... 56
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PUBLISHER’S LETTER
Engaged and Thankful Things seem to be trending towards
normalcy. Not the “new norm” either, but actual life as we once knew it. At least that is my hope as we head into spring and meeting season across the industry. This month we will have the first HIDA Executive Conference in three years. In April, we will host the Hall of Fame dinner for the class of 2020. And several distributors will host their national sales meetings face to face during the following few months. I am so ready to see you all at live events, full of energy. I will leave this topic with one thought for you as you start to get back at it – don’t take one minute of these events for granted. Be engaged and thankful to each other for the time we get together and eager to learn from the manufacturers. These next few months are going to be amazing. I can’t wait! Now shifting gears on you: About twice a year I like to use this platform to remind you of the tools we have available to help in your professional development. All of which are free to you.
Scott Adams
Repertoire Magazine – Both in print and digital, Repertoire is designed 100% with the distribution salesperson in mind. The ads and content in the pages of this publication are to keep you up to date and informed about the industry and your manufacturing partners.
RepConnect – Our free app is filled with manufacturer literature, rep rosters, 2-minute educational product videos which give you conversation starters for your clients, as well as 2-minute end-user videos for you to send to your clients and podcasts. Podcast – On the Repertoire site (repertoiremag.com) there is a podcast button. Once you click that button there is a library of podcasts on products and services for you. There is also a series called Road Warriors. This is a series of interviews with industry leaders about their careers and their keys to success. I take so much from the interviews, and hope you will too. Dail-eNews – Our free subscription to our daily news feed. We pull together industry press releases each day, along some of our original content, and send it all out in one e-mail designed to be a 2-3 minute read. You can subscribe to this on the Repertoire site. We hope you enjoy the content we create for you each month, and we’re always open to ideas of things you need to further your career and sell more stuff. Thank you for allowing us into your lives for almost 30 years. 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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PHYSICIAN OFFICE LAB
Thinking About Value The three pillars of product and service value common to both lab and medical surgical products.
Every experienced, successful distributor account manager I know wakes up every morning committed to sell
value rather than price. While from time to time we need to either defend our business or increase it by pitching a price story, we usually do everything in our power to avoid participating in “the race to zero.” Moreover, I know a lot of highly qualified sales managers who coach value selling every day to their teams. Additionally, we all have our favorite sales texts and every one reminds us to sell value first.
By Jim Poggi
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The most successful distributor account managers I know establish their personal supply chain value around three elements: ʯ Personal value (how I help you) ʯ Company value (how my company invests in your success) ʯ Product value (why this product makes sense for you and why I recommend you consider it in your practice/business) www.repertoiremag.com
What are the three pillars of product and service value for lab and med/surg products? And, are we sure there are only three? Well, after a few decades of giving and listening to countless sales presentations, while others may come up with a different count, here are my three: ʯ Clinical value: impact on patient care outcomes; improvements in morbidity and mortality ʯ Economic value: positive impact on BOTH the profit and loss and balance statements ʯ Workflow value: How can the customer be more efficient? How can they use human resources more effectively? How can they positively impact job satisfaction in the workplace? Let’s take each element of value individually and see if we can agree on how they are all part of a successful presentation and, more importantly, how they contribute to the sale and a positive customer experience.
As quarterback for the sale, it’s not your job to know all the clinical detail, but it is your job to know who does, when you need them and when to bring their expertise to bear. Pillar No. 1: Clinical value
As many conversations about value that I have been in, while most of them have been good and captured the customer’s imagination, I must say they are not always as consistent as I think they can be, and sometimes they miss a high point or two. When that happens, we leave the customer’s office and have that “I wish I had said that” moment on the way out. In this column I plan to discuss the three pillars of product and service value common to both lab and medical surgical products. I intend to give you some food for thought in your pre-call planning efforts and help you to become more consistent and successful.
Especially in the lab business, positioning clinical value almost seems intuitively obvious. Since we tend to have conversations with clinicians, it seems the most obvious element of value. Fundamentally, clinical value answers the question: does this product or service improve patient healthcare outcomes? Clinical value must be anchored in credible data, often peer reviewed information. At the same time, clinical value must overcome inertia: is it too new to be consider proven, safe and effective? Can the customer be convinced the clinical value is sufficient to overcome start up, training or switchover costs? How much time will it take to implement? As quarterback for the sale, it’s not your job to know all the clinical detail, but it is your job to know who does, when you need them and when to bring their expertise to bear. That takes a lot of skill. Clinical value certainly is important to the clinical and user buyers, but the financial buyer may often argue: “Well it sounds like good medicine, www.repertoiremag.com
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PHYSICIAN OFFICE LAB
but can we afford it?” Know who has the power and leverage at your key customers and just how much focus to put on this element of value.
the new asset on line effectively. It’s not over until the customer agrees that the product has been properly installed, trained and is performing to expectations you and your key supplier set.
Pillar No. 2: Economic value Did someone say lowest price? Is that economic value? No. Make that lowest lifetime cost, best use of assets, effective leverage to the P&L and a healthy balance sheet. Know every element of economic value, with discussions of lifetime costs and the delicate balance of startup, switching and training costs versus revenue as absolutely essential for large scale lab and other capital equipment deals. Lowest initial price may look like value, but the true measure of economic value is its overall contribution to both the P&L (making a profit) and the balance sheet (effective use of assets).
With patient portals and virtual visits growing in importance and popularity rapidly, workflow value is taking on new importance. Again, this is the place where the experienced distribution professional understands the needs and probable questions of their key customers and properly and thoroughly coaches and prepares their financial/supplier partner to establish economic value. Expect to be asked about switching costs, how to effectively retire the current asset, effective life of the new asset and any expensive ancillary software and services required to bring 6
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Pillar No. 3: Workflow value There are several key considerations here. Can the solution better leverage experience and expertise of the customer’s team (using lower cost/skill labor to deliver the same or better quality result)? Can results be delivered faster, through more effective means of communication to practice staff and patients? Can new procedures be implemented based on improvements in technology (which can also drive the other two elements of value). If higher skill staff is able to be freed from the current process or procedure, what higher value tasks can they perform? Can the practice provide new, innovative services? Are there new ways to communicate to patients? With patient portals and virtual visits growing in importance and popularity rapidly, workflow value is taking on new importance. What once was a story of “we can reduce lab test turnaround time by 15 minutes” has become a far bigger story on how the practice can benefit in scheduling patient visits, providing services, communicating the results of them and managing and maintaining the information to inform future patient decisions regarding treatment programs more efficiently. If it’s true that value is in the eye of the beholder, it’s up to you to make sure you consistently tell a comprehensive value story on every customer visit knowing which element of value is most important to each buying influence. More value adds up to a larger business for you and greater customer satisfaction and loyalty.
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TRENDS
Breaking The Rules of Healthcare: Paying Your Doctor It’s time to transform the way doctors are incentivized, and paid, for patient care. By Dr. Robert Pearl
Between this century and the last, practically everything about American healthcare has changed. Patient problems
went from mostly acute and unexpected (think: broken bones and appendicitis) to predominantly chronic (heart disease, arthritis, diabetes and so on). As medical problems got more complicated, treatments became more sophisticated and wildly expensive. With the rise of for-profit insurance and “managed care” in the late 20th-century, doctors were driven to see more patients per day – spending up to half those visits on the computer for insurance and billing purposes. As a result, the relationship between patients and doctors changed, and not for the better.
Amid these ups and downs, one aspect of healthcare has remained the same: the way we pay doctors. As it was in the last century, physicians still get paid quid pro quo: They provide a service, submit a bill, receive a check, repeat. But in the 21st century, that rule no longer makes sense. 8
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Breaking the ‘rules’ of healthcare In hospitals and doctor’s offices across the country, physicians adhere to two sets of rules. There are the written rules, covering everything from human anatomy and physiology to the current laws and regulations that govern the profession.
Then there are the unwritten rules, which dictate the “right way” for doctors to act. These are the norms of the profession. Many of them persist long after scientific or societal advances render them obsolete. This article, part of a new series called Breaking “The Rules Of Healthcare,” takes a close look at an outdated and unwritten rule of healthcare payments.
The rule: The best way to pay doctors is transactionally Transactional payments are the basis for nearly all financial interactions. A seller provides a good or service in exchange for payment. This is how we hire piano teachers, rent apartments and procure Girl Scout cookies. It’s also how we pay for 95% of physician visits today. Paying transactionally for healthcare made sense in simpler times when doctors could deliver only a fraction of the “products” and “services” they provide today – and when patients trusted they’d always receive the best care available at reasonable prices. These days, researchers and policy experts point out that 25% of the $4 trillion spent on American healthcare each year is wasted (much of it on unnecessary or ineffective treatments). That’s an inevitable and well-documented consequence of quid pro quo payments in healthcare. But the harm done isn’t just limited to America’s economy. Often overlooked are the ways that transactional payments cause harm to (1) patients, (2) doctors and (3) the doctor-patient relationship.
With transactional reimbursements, doctors get paid to fix specific and identifiable problems. When someone has a heart attack, the cardiologist gets paid to perform angioplasty. When a kidney or lung fails, the surgeon gets paid to transplant an organ. These are remarkable and life-saving procedures, but doctors of the 21st century can do something even more remarkable: with preventive screenings, frequent check-ins and the right medications, they can help prevent hearts, kidneys and lungs from failing in the first place. Herein lies the transactional payment problem: How do you pay someone for something that didn’t happen (like a heart attack or a stroke)? As it stands, a primary care doctor has to file an insurance claim for each step in the process. To help just one patient effectively manage or prevent even one chronic disease, a physician has to file dozens of claims. When you consider that 133 million Americans suffer from at least one chronic illness, it’s clear that paying doctors transactionally is a costly error.
Whenever the number and complexity of services dictate the payment amount — be it in medicine or car repair or home remodeling — the recipient of the service fears the provider may be trying to “upsell” them.
No. 1: Transactional payments compromise patient health As medical science advanced in the 20th century, American longevity climbed from 46 years (in 1900) to 75 years (1999). But when American medicine hit the century mark, an odd thing happened: life expectancy plateaued. For the past two decades, the average length of a person’s life in the United States held between 76 and 77 years. Many societal factors have contributed to the relative flatlining of life expectancy in the U.S., but chronic diseases are an undeniable culprit. Ongoing ailments (e.g., diabetes, kidney disease and heart disease) account for 7 in 10 fatalities each year and cost hundreds of billions of dollars each year to treat. It is possible – with a mix of patient effort, clinical assistance and aligned incentives – to effectively manage and even avoid chronic illness. But not in a transactional payment model.
No. 2: Transactional payments harm doctors In the 21st century, insurers have sought to reduce healthcare costs by lowering payments to doctors and implementing strict prior-authorization requirements. In a transactional payment model, these are the most powerful tools a payer has to curb medical spending and dial back unnecessary services. In turn, doctors have been forced to see more patients per day to maintain their incomes, and they spend up to half of each day on insurance-related tasks – chasing down authorizations and filing paperwork. Physicians today find themselves on a care-delivery treadmill, forced to run faster and faster (seeing more and more patients each day) just to stay in place. As a result, the average patient visit is now down to just 18 minutes – not nearly enough time for doctors to adequately address all patient complaints. www.repertoiremag.com
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TRENDS Under these circumstances, it’s no wonder physicians have grown dissatisfied, frustrated and fatigued (the classic symptoms of “burnout”).
No. 3: Transactional payments erode the doctor-patient relationship In a 2019 survey, physicians said that gratitude from, and relationships with, patients were the most rewarding aspects of medical practice. And yet, 87% of doctors say patients trust them less now than a decade ago. Many factors contribute, but more than half of physicians (56%) point to healthcare costs as the primary cause of patient dissatisfaction. Increasingly, these financial frustrations spill over into the exam room, straining the doctor-patient relationship.
Rather than evaluating physicians on a litany of individual actions and clinical metrics, the transformational model rewards physicians for the positive impact they have on the lives of their patients.
Once again, healthcare’s transactional payment model fuels the problem. Whenever the number and complexity of services dictate the payment amount – be it in medicine or car repair or home remodeling – the recipient of the service fears the provider may be trying to “upsell” them. For patients and doctors alike, this fear proves unhealthy, threatening the very fabric of their relationship.
Breaking the rule: A better way to pay physicians Both the federal government and private insurance companies have tried to fix the problems of physician reimbursement with “pay for value” and “pay for performance” incentives. These programs have failed to make much difference because they simply replace one form of transactional payment with another. Instead of paying doctors per visit or per procedure, so called value-based models reward doctors for meeting dozens of preventive screening targets and other “highvalue” benchmarks. Few of these programs have moved the needle on clinical quality. Instead of a quid pro quo payment methodology, American medicine needs a relationship-based reimbursement model.
From transactional to transformational Breaking a centuries-old rule of healthcare payments won’t be easy. And it can’t be accomplished overnight. However, a solid starting point would be for the Centers for Medicare and Medicaid (CMS) to shift primary care payments in the Medicare program – in a way that allows physicians and patients to form “healthier” relationships. Here’s how a transformational, relationship-based reimbursement system might work: ʯ Medicare enrollees select a primary care doctor as their accountable physician. ʯ CMS would then pay that physician a single, upfront sum to provide a year’s worth of medical care to these patients (instead of a single payment after each medical service). ʯ The doctor’s base compensation would depend on (a) the number of Medicare enrollees they care for and (b) the complexity of each patient’s current medical problems, which helps to forecast the amount of care they’ll need. ʯ Each primary care physicians would be eligible for added payments each year, depending on the patient’s experience. At the end of the year, enrollees
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would answer a series of questions about the impact their physician had over the previous 12 months: Did the doctor help you live a healthier life? Did he/she help you make good medical decisions? Do you value your relationship? Do you trust your doctor’s recommendations? The benefits of this transformational payment model: Greater satisfaction. Because doctors would no longer be paid for each service, they’d be able to spend much less time on paperwork. In place of these dissatisfying bureaucratic tasks, physicians could spend that time doing what matters: helping their patients prevent and manage their diseases. A meaningful difference. Transformational payments shift the incentives from what a doctor does to the impact a doctor has on the patient. Rather than evaluating physicians on a litany of individual actions and clinical metrics, the transformational model rewards physicians for the positive impact they have on the lives of their patients. That is, after all, the reason people choose to become doctors in the first place. Even with an incentive payment equal to 10% of a physician’s salary, the added cost of the program would be relatively low. That’s because the income of primary care doctors is a tiny fraction of total healthcare expenditures. And the potential return on the investment would be massive. By moving from transactional to transformational payments, patients could better manage their chronic diseases, live a more productive life, and reduce their risk of experiencing a heart attack, cancer or stroke. Undoubtedly, debate would center on the program’s written rules and implementation. But if we don’t break the current rule of how doctors are paid, we can expect our nation’s healthcare problems to get worse.
Dr. Robert Pearl is the former CEO of The Permanente Medical Group, the nation’s largest physician group. He’s a Forbes contributor, bestselling author, Stanford University professor, and host of two healthcare podcasts. Pearl’s newest book, “Uncaring: How the Culture of Medicine Kills Doctors & Patients,” is available now. All profits from the book go to Doctors Without Borders. For more information or to sign up for his newsletter, visit robertpearlmd.com.
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The RetinaVue care delivery model can help eradicate the leading cause of adult blindness Diabetic patients should be screened annually for diabetic retinopathy There are no early symptoms of diabetic retinopathy (DR), an eye condition that can cause vision loss and blindness in people with diabetes. It’s the most common cause of new cases of blindness in working-age U.S. adults
aged 20 to 74, leading to up to 24,000 new cases each year.1
DR affects 7.7 million Americans, and that number is projected to increase to more than 14.6 million people by 2030.2 That’s why it’s so important for diabetic patients to get a comprehensive diabetic retinal exam at least once a year because anyone with any type of diabetes is at risk of developing DR. Finding DR early can help these patients protect their vision. DR causes retinal tissue to swell, resulting in blurry vision, floating spots in vision and blindness. But symptoms like these don’t occur until DR is in an advanced state. In later stages of the disease, blood vessels in the retina start to bleed into the vitreous – the gel-like fluid that fills the eye – and it’s important to get treatment right away. “What’s scary is that up to 80% of patients living with diabetes will eventually develop some stage of diabetic retinopathy in their lifetime3,” said John Prior, Senior Marketing Manager for Vision Screening & Diagnostics and the Welch Allyn® RetinaVue® 700 Imager from Hillrom (now part of Baxter International). “Patients with diabetes should be examined for complications on an annual basis, but only 20%-to-50% of patients comply.4,5,6,7 It’s a serious problem.” But there is a silver lining. Vision loss from DR is 95% preventable with early diagnosis and treatment.8 12
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More access in primary care The RetinaVue 700 Imager offers an easy-to-use retina imaging experience, featuring auto-alignment, autofocus and auto-capture. It’s the latest addition to the RetinaVue care delivery model family and it helps make retinal exams simple and affordable in primary care. “A paradigm shift is needed to increase access to the DR exam for patients living with diabetes,” Prior said. “Our goal is to increase access to DR exams wherever patients choose to obtain their healthcare.”
The RetinaVue care delivery model is a turnkey solution that consists of three core components, including: ʯ Welch Allyn® RetinaVue® 700 Imager ʯ Welch Allyn® RetinaVue® Network Software to securely transmit patient images ʯ Interpretation by boardcertified ophthalmologists and retina specialists through RetinaVue,® P.C. The RetinaVue 700 Imager’s camera features a 60-degree wide field of
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view with 2.5 mm small pupil capability (see instructions for use) that requires little to no chemical dilation. It meets ISO 10940 optical standard for ophthalmic instruments. Its small, handheld design is perfect for performing retinal exams in clinics and mobile healthcare applications. Its RetinaVue Network award-winning, HIPAA-compliant software is hosted on the Microsoft® Azure™ cloud. “When a primary care provider purchases the RetinaVue care delivery model, we provide the services necessary for retinal image interpretation by a team of state-licensed, board-certified ophthalmologists and retinal specialists that can cover every state in the U.S.,” Prior said. Primary care providers can place retinal exam orders and automatically access diagnostic reports from their EMR. The RetinaVue care delivery model offers wireless connectivity and fully integrated, bi-directional interfaces with over 100 EMR partners including Allscripts®, athenahealth®, Cerner®, Epic®, NextGen® and others to help streamline procedures. Providers in the growing mobile healthcare space are using the RetinaVue care delivery model to
“There’s a growing demand for solutions like the RetinaVue care delivery model that can help primary care organizations improve clinical and financial outcomes,” Prior said. “Most healthcare plans provide coverage for diabetic retinal exams in primary healthcare settings,9” he said. “And as of Jan. 1, 2021, Medicare covers with CPT code 92228, which wasn’t offered before that date.10 That’s great news for providers on the reimbursement front for this important exam.”
“Also, the NCQA [National Committee for Quality Assurance], a HEDIS® quality measure for annual diabetic retinal exams, [NQF [National Quality Forum] #0055 and that’s included in Medicare Advantage Star Ratings as well as CMS Quality Payment Program measures. So, intercepting patients during routine primary care office visits can help our providers achieve up to 90% (5-Star level) documented compliance in 12 months11,12 potentially qualifying them for financial
reach patients who are homebound or receive their care in non-traditional settings. And federally qualified health centers, which can represent the first line of defense against health issues that patients face today, are another example where the RetinaVue care
incentives under those programs,” Prior concluded. Customers using the RetinaVue care delivery model are typically organizations that deliver primary care services for patients living with diabetes and have a need to close their care gaps for the diabetic retinal exam and improve patient outcomes and quality metrics like HEDIS. These organizations range from large IDNs, mobile clinics, retail clinics, nursing homes and small, internal medicine groups.
delivery model can help improve chronic care management. “Imagine tomorrow where DR is no longer the leading cause of adult blindness,” Prior said. “We have the power to eradicate diabetic retinopathy as the leading cause of blindness.”
CDC: Cost-effectiveness model for Diabetic Retinopathy NIH: People With Diabetes Can Prevent Vision Loss 3 American Academy of Ophthalmology Retina/Vitreous Panel. Preferred Practice Pattern® Guidelines Diabetic Retinopathy, San Francisco, CA. American Academy of Ophthalmology, 2017. www.aao.org/ppp. Accessed Oct. 15, 2019 4 Sloan FA, Brown DS, Carlisle ES, et al. Health Serv Res. 2004; 39(5):1429–1448. 5 Lehigh Valley Health Network. http://scholarlyworks.lvhn.org/cgi/viewcontent.cgi?article=1036&context=select-program. Accessed March 1, 2016. 6 Lee DJ, Kumar N, Feuer WJ, et al. BMJ Open Diabetes Res Care. 2014;2(1):e000031. 7 Rajput Y, Fisher M, Gu T, et al. IOVS. 2015; 56(7):1440. 8 National Eye Institute. People With Diabetes Can Prevent Vision Loss. https://www.nei.nih.gov/learn-about-eye-health/resources-for-healtheducators/outreach-materials/people-diabetes-can-prevent-vision-loss. Accessed November 11, 2020. 9 Commercial Coverage Policy data on file. Welch Allyn; 2019. 10 Medicare Program; CY 2021 Payment Policies under the Physician Fee Schedule Proposed Rule [CMS-1734-P], 08/17/2020, https://s3.amazonaws.com/public-inspection.federalregister.gov/2020-17127.pdf 11 Mansberger SL, Gleitsmann K, Gardiner S, Sheppler C, Demirel S, Wooten K, Becker TM; Comparing the Effectiveness of Telemedicine and Traditional Surveillance in Providing Diabetic Retinopathy Screening Examinations: A Randomized Controlled Trial. Telemedicine and e-Health. December 2013, 19(12): 942-948. doi:10.1089/tmj.2012.0313. 12 Enabling diabetic retinal exams at the point of care: A strategy that works for patients and providers, Summit Medical Group case study, Welch Allyn, Inc., 2019 1 2
© 2022 Welch Allyn, Inc. ALL RIGHTS RESERVED. APR334301 Rev 1 15-FEB-2022 ENG-US
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SALES
Define Your Company’s Sales Culture It should mesh with the overall company culture – and then some.
Does your company have a distinct sales culture? If so,
do you believe it has an impact on your performance in the field – for better or worse? If you’re having a difficult time defining sales culture, a good place to start hunting for it is your company’s corporate culture. In any company, corporate culture and sales culture should complement each other, says CME Chief Strategy Officer Cindy Juhas. Corporate culture is the “overriding guiding light” of a firm, she says. At CME, that guiding
light is that family always comes first. The Warwick, Rhode Island-based medical equipment distributor was recently recognized as a 2021 Top Work Place in Rhode Island by Energage, a company that helps client firms recruit and retain outstanding performers. “With the utmost gratitude to our valued employees who made this happen, we are proud to have a culture that values its people and amplifies talents,” said CME President and CEO Normand Chevrette on LinkedIn at the time. www.repertoiremag.com
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SALES Says Juhas, “We also have a strong overall strategy and mission which everyone in the company – sales and operations – recognizes, and we establish specific strategic goals to support it. Our mission is to help healthcare facilities nationwide reduce the total cost of the equipment they purchase and make their equipment specification, purchase, installation and maintenance processes more efficient. “Our sales culture includes all the elements of the corporate culture plus some.” Brian Vierra, senior director of sales for Midmark, believes that corporate culture, vision and direction set the tone for the entire enterprise. Sales is an important part of it, because “today the sales function is more intertwined with other departments working together to deliver exceptional customer experiences.”
‘Elements of competitiveness, teamwork, learning, creativity, resourcefulness and grit are taken to the next level to fuel a professional sales team.’ Sales consultant (and former medical distribution salesperson) Nigel Green believes corporate culture needs to be closely tied to the voice and the face of the customer. “You can have nuances of values that you look for in people you want to invite onto your sales team, and you can have certain tenets and behavioral requirements that every person must maintain in order to remain on that team. But the undeniable element is that companies that get it right are those whose corporate culture embraces a sales culture.” So, what exactly is a sales culture?
Fundamentals “The most important aspect of our sales culture that distinguishes us from others is the fact that our account managers are encouraged to run their territories as their own business,” says Juhas. “We give them guidelines and direction, but they have autonomy to do what needs to be done to run their business successfully. Our other big differentiator is an easy-to-understand, straightforward commission structure.” In addition to those three characteristics, a strong sales culture has the right metrics in place to help the salesforce perform optimally, she says. “Measuring the right things and sharing that information across the company 16
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encourages healthy competition.” Each week CME shares entered sales and profit leaders, YTD to budget, and manufacturer leads by account manager. “Our budgets are done from the ground up. Each account manager sets specific annual budgets by customer, which I think is unique. It enhances that cultural aspect of running their territories as their own business.” According to Vierra, “sales teams are driven, measured and directly incentivized on performance. Elements of competitiveness, teamwork, learning, creativity, resourcefulness and grit are taken to the next level to fuel a professional sales team.” But the most fundamental component of a successful sales culture is the character of its people, he says. Healthy competition, collaboration, continual learning, goal alignment, trust and communication are outputs of a high-character team. Elite dynastic teams that succeed over and over again exemplify an unwavering commitment to values, especially in the face of adversity; a high level of personal accountability; and a consistent focus on effort instead of results. Accountability is essential to a healthy sales culture, says Green. “Accountability means autonomy and a sense of contributing to something bigger than oneself,” he says. That spirit can be challenging to maintain, given the fact that many sales reps seldom gather regularly with teammates in an office. “You miss some camaraderie, despite email or Slack. So the sales leader has to trust that reps in the field care about the company’s mission as much as their own success.” In a strong sales culture, it is each rep’s belief in the nobility of that mission that drives them forward day after day. A strong sales culture encourages inquisitiveness among team members, he adds. “The whole purpose of any business is to create a customer. But you can’t do that if you’re not spending time with your customers and helping them anticipate problems. In the past, people believed the good reps would ask their customer, ‘What keeps you up at night?’ Today, that’s not good enough. Today, they need to say, ‘Doctor, this is what should be keeping you up at night,’ and then help that customer address that problem. “A lot of customers are having a hard time making sense of what tomorrow might be like for them.”
The sales leader Cindy Juhas believes that any sales leader who wants to build a strong sales culture must “collaborate with their salespeople to help them achieve their goals, resolve issues that may impede their success, and support, educate and encourage
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them 100%. A leader’s job is to develop their associates to be as successful as they can be, always keeping the company’s overall strategy in mind,” she says. Brian Vierra believes that a healthy sales culture is cultivated by a leader’s ability to drive results through others. “The best sales leaders are consistently connected with their teams at the right cadence and in the right moments. They work to improve process while providing tailored coaching to each teammate to help them achieve their individual goals and the goals of the salesforce.”
‘The sales leader has to trust that reps in the field care about the company’s mission as much as their own.’ Sales leaders can promote character in three ways, he says: 1) Prioritizing integrity above all else when bringing talent into the organization, 2) publicly celebrating examples of the effort that leads to results, and 3) most important, leading from in front by modeling the behavior that is expected. Nigel Green says that effective sales leaders must make a conscious effort to stay in touch with the current sales culture of the organization. “Time dilutes awareness,” he says. “The longer you’ve been in an organization, the less likely you are to be aware of its current realities. And the longer you’ve been the sales leader, the more likely you are to characterize the sales culture as it was when you started, not how it is today.” So, the leader may tell prospective reps, “This company is built for the salesperson.” But if it takes two weeks for the new hire to get a laptop, and Salesforce doesn’t work, that doesn’t ring true. “The leader has to have vulnerable conversations with the team to stay in touch with the culture as it is today.” The average tenure of a sales leader across industries is about 18 months, often because they didn’t understand the day in the life of their reps, he adds. “The way to beat that statistic is to remember your job isn’t to be a dashboard, firing off sales reports and inventory management reports from your office. If you’re asking your reps to be in the marketplace, you have to be there too.”
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SUPPLY CHAIN
The Healthcare Continuum Takes on Staffing Shortages Supply chain leaders examine how their health systems are handling clinical and non-clinical personnel deficits. By Daniel Beaird
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Recently in California, the state’s department of public health temporarily
changed its coronavirus guidelines to allow asymptomatic, COVID-19 positive healthcare workers back to work without isolating or testing. The guidelines were in effect from Jan. 8 to Feb. 1 to curb the critical staffing shortages experienced across the healthcare continuum, the state health department stated. The California Nurses Association criticized the decision.
Many healthcare workers burned out by the pandemic have quit. Many that remain have tested positive for the coronavirus and are isolating. Healthcare facilities are busier than last year due to more demand for non-COVID related care. Where does this leave the nation’s health systems with staffing issues? How are they being mitigated? The Journal of Healthcare Contracting (JHC ) surveyed supply chain leaders from health systems about the medical staff shortages. JHC: There are staffing shortages amongst hospitals in general. Clinician burnout along with the resurgence of COVID-19 in high infection regions has pushed workforce management to the front of the line. How are staffing shortages affecting how you take care of your patients? George Godfrey, Corporate VP and Chief Supply Chain Officer of Baptist Health (South Florida): We take incremental steps to make certain that patient care is never impacted. This takes additional time and resources to properly manage staff scheduling and deployment.
Erik Walerius
George Godfrey
Erik Walerius, Chief Supply Chain Officer of UW Medicine (Seattle, WA): Increased use of overtime and temporary labor to fill in staffing challenges to avoid clinical impacts. JHC: Have noncritical services been cut back due to staffing shortages?
Steve Faup
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SUPPLY CHAIN Steve Faup, Divisional Director, Supply Chain of Capital Health (Trenton, NJ): In some cases, there has been a scale back of available hours. An example would be Food and Nutrition Services. Their resources are focused on patient care. The pre-pandemic hours of operations and offerings for walkup service have been modified. Godfrey, Baptist Health: At this time, only minimal cutbacks have been made to non-clinical services. Walerius, UW Medicine: Earlier in the pandemic, supply chain services not directly related to clinical services were reprioritized to support pandemic-related efforts. JHC: Have vaccine mandates contributed to staffing shortages? Faup, Capital Health: There are many issues feeding the labor shortages. Mandates are contributing but probably not a significant factor.
“ The return back to a fully staffed team is slow, at best. We are nearly 24 months into a remarkable and relentless pace due to the pandemic, with a constant push and pull on all fronts of our industry, and people are fatigued. Additionally, the added lifestyle impacts of being remote and remaining socially distant for so long have added to the stress, strain and exhaustion of our troops.” Godfrey, Baptist Health: As an organization, we moved toward vaccine mandates for all employees during fall 2021. We created a vaccine campaign across the organization to provide not only the shots across our many hospitals and urgent cares, but also to provide information, research and clinical support for those employees who expressed reservations about the vaccine process. As a supply chain department, we reinforced the organization’s approach to get everyone vaccinated with strong, weekly communication to our teams to provide
any necessary resources needed to get our team 100% vaccinated. Walerius, UW Medicine: Yes, but minimal. EDITOR’S NOTE: Healthcare workers covered by the Biden administration’s vaccine mandate will have until March 15 to be fully vaccinated in the 24 states where the requirement was reinstated by the Supreme Court. Twenty-five states and Washington, D.C., continue to face a Feb. 28 deadline for covered healthcare workers to be fully vaccinated, as the mandate had not been blocked
UPMC launches in-house travel staffing agency to address nursing shortage UPMC has created UPMC Travel Staffing, a new in-house travel staffing agency as a solution to the nationwide nursing shortage and to attract and retain highly skilled nurses and surgical technologists to its workforce. UPMC is believed to be the first health system in the country to launch its own staffing agency – initially for registered nurses and surgical technologists, with the potential to evolve to include additional job roles. UPMC has brought in external travel nurses and surgical technologists to help at the bedside and in operating rooms throughout the past year. The goal of UPMC Travel Staffing is to rely less on outside agency staff and empower UPMC employees who would like to travel to UPMC hospitals across Pennsylvania, Maryland and New York – wherever and whenever the need is greatest. This
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new program will provide needed support for our frontline caregivers and career growth opportunities for UPMC nurses and surgical technologists interested in travel. Not only will the program be a retention tool for our current staff, it also will fuel a new pipeline to recruit nurses to UPMC and to bring people back who left UPMC, according to a release. The advantages of this innovative program include competitive wages and excellent benefits that are unmatched by outside travel agencies, such as tuition assistance. The program also offers vast career growth opportunities and diverse clinical experience working and living temporarily in communities across UPMC’s footprint. UPMC Travel Staffing will rotate nurses and surgical technologists to different facilities for six-week assignments.
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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.
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SUPPLY CHAIN
In December 2021, as healthcare staffing shortages began to mount due to the transmissibility of the COVID-19 omicron variant wreaking havoc across the country the CDC issued guidance designed to enhance protection for healthcare personnel, patients and visitors, and address concerns about potential impacts on the healthcare system. Maintaining appropriate staffing in healthcare facilities is essential to providing a safe work environment for healthcare personnel and for safe patient care. The CDC said when staffing shortages are anticipated, healthcare facilities and employers should use contingency capacity strategies to plan and prepare for mitigating this problem. They included: ʯ Adjusting staff schedules, hiring additional healthʯ Allowing personnel with infections who are well care personnel and rotating personnel to positions enough and willing to work to return. Those with mild to that support patient care activities. moderate illness who are not moderately to severely immunocompromised and at least five days have passed ʯ Developing regional plans to identify designated since symptoms first appeared and at least 24 hours healthcare facilities or alternate care sites with have passed since last fever without the use of feveradequate staffing to care for patients with infection. reducing medications, and symptoms have improved. ʯ Allowing asymptomatic personnel who had a higher risk exposure to COVID-19 and are not ʯ If shortages continue despite other mitigation strateknown to be infected with COVID-19 and have gies, as a last resort consider allowing personnel not received all vaccine doses to continue to to work even if they have suspected or confirmed work onsite throughout their 14-day infection, if they are well enough and willing to work, post-exposure period. even if they have not met all return to work criteria.
in those states before the Supreme Court order that came down in January. The mandate, issued by the U.S. Department of Health Services’ Centers for Medicare and Medicaid – remains blocked in Texas (at time of publication). JHC: How has pandemic burnout contributed to staffing shortages? Faup, Capital Health: Absolutely, and it has become increasingly documented within a variety of industries and specific jobs. For example, nurses and truck drivers. Godfrey, Baptist Health: We have seen this within both clinical and non-clinical positions during the duration of this pandemic. The return back to a fully staffed team is slow, at best. We are nearly 24 months into a remarkable and relentless pace due to the pandemic, with a constant push and pull on all fronts of our industry, and people are fatigued. Additionally, the added lifestyle impacts of being remote and remaining socially distant for so long have added to the stress, 22
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“ In some cases, there has been a scale back of available hours. An example would be Food and Nutrition Services. Their resources are focused on patient care. The pre-pandemic hours of operations and offerings for walkup service have been modified.” strain and exhaustion of our troops. If you take all of those factors and add them to the historic amount of workforce that has left the employment pool, our ability to maintain a fully staffed supply chain team in some areas has been difficult. Walerius, UW Medicine: An increase has been seen in early retirements and moves to other hospital departments and transfers have increased. JHC: What are you doing to attract staff and stave off shortages? Godfrey, Baptist Health: We have been very communicative as an organization regarding our needs for staffing across the network. The
organization has increased the referral bonus for employees in an effort to get our current workforce to refer qualified candidates for internal opportunities throughout our network. Additionally, our internal HR, training and development teams have been very forthcoming with information about our own internal training and internship opportunities for clinical and pharmaceutical careers to promote, teach and train our own team members who may want to pursue those areas. Walerius, UW Medicine: Strategies include hybrid and remote working for applicable jobs and extensive HR recruitment tactics.
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4 Critical Factors to Know When Choosing a Healthcare Surface Disinfecting Wipe Healthcare-associated infections (HAI) are an unfortunately common complication of hospital care, and while there are varying factors associated with HAI, contaminated surfaces and equipment can contribute to the problem. Although hand hygiene is an important disruptor of the cross-transmission of microorganisms, improved
cleaning and disinfection of medical equipment and environmental surfaces is fundamental to reducing their potential contribution to HAI.1,2 Increased focus on the need for improved surface disinfection in healthcare settings – kill more germs!, take less time!, don’t damage my equipment! – has only added to the confusion many healthcare workers experience as they are trying to select the best possible product for their environment of care.
Long a mantra of GOJO®, inventors of PURELL® hand sanitizer, formulation counts. As with many infection prevention products sold into healthcare, from hand hygiene to surface disinfection and beyond, not all products are created equally. Because of this, it is important for healthcare facilities to critically evaluate both the products that they have as well as those they are considering. For surface disinfecting wipes, there are 4 simple but important areas to consider when evaluating your options: efficacy against relevant pathogens, a good safety profile (non-toxic), high material/device compatibility, and ease of use.
and Enterobacter species. Using a patent-pending, ethyl alcohol-only formulation, the new PURELL® Healthcare Surface Disinfecting Wipes kill the problematic ESKAPE bacteria and seven of the most common drugresistant bacteria and viruses significant to the healthcare environment (including bloodborne pathogens, SARS-CoV-2, influenza A, respiratory syncytial virus, and norovirus) in 2 minutes or less. This broadspectrum efficacy with rapid kill time against these highly relevant
healthcare pathogens is critical to help support busy clinical workflows. Highest Safety Profile. As an EPA Category IV product (see Figure 1), the PURELL wipes achieve the EPA’s lowest toxicity rating (and highest safety profile) – meaning no personal protective equipment (PPE) is required for use – while also being FDA Food Code Compliant. Meeting the Food Code requirement means that the EPA has evaluated the formulation of the product and
Figure 1:
Environmental Protection Agency (EPA) Toxicity Categories
Real-world Efficacy. The pathogens responsible for the majority of HAI, that also have the highest risk of mortality and resultant increased healthcare costs, are caused by a group of bacteria commonly referred to as ESKAPE pathogens. This group of bacteria is so named for their ability to “escape” the biocidal action of antimicrobial drugs. The ESKAPE acronym, or mnemonic, stands for Enterococcus faecium/ faecalis, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa www.repertoiremag.com
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has indicated that it is safe for use on food-contact surfaces without a postapplication water rinse. Reading the Instructions for Use (IFU) on many other healthcare-grade surface disinfectants will reveal language advising against the use on surfaces that food may come into contact with. This is a unique attribute as it is incredibly rare for hospital grade surface disinfectants to also meet the EPA requirements for use as no-rinse food contact surface sanitizers. Further, it is even more rare for a hospital-grade surface disinfectant meeting the EPA requirements for a no-rinse food-contact surface sanitizer to have such an extensive range of efficacy, including ESKAPE pathogens, drug-resistant bacteria, viruses, and bloodborne pathogens as previously discussed. This allows healthcare workers and hospitals the freedom to use surface disinfecting wipes anywhere from over-bed tables to NICU rooms. Versatile Compatibility. Costs associated with damaged equipment are major concerns for healthcare facilities, and damaged surfaces (even if clean) can negatively affect patient perceptions of the aesthetics and cleanliness of the hospital and environment. Leveraging our history, experience and understanding of formulating with ethyl alcohol, the new PURELL wipes also offer hospitals a wide range of proven surface material compatibility, including electronic devices. While it is true that many materials in healthcare are chosen specifically for their resistance to chemical degradation (e.g., plastics – a lightweight and costeffective alternative to stainless steel),
Healthcare Terms There are several terms used within healthcare that are often incorrectly used interchangeably. It is helpful to clarify them to avoid confusion: Contact time (wet time, kill time, or dwell time)
The amount of time the disinfectant product must be “wet” and “in contact” with the surface to effectively kill all of the organism(s) that were tested.
Dry time
Time from application until the surface is fully dry. This time should be at least as long as the contact time to ensure efficacy.
Undisturbed contact time
Time the surface remains untouched after product application. This term implies the surface does not need to remain wet for the contact time but just untouched. This term is sometimes used by industry or in the field, but it is an oversimplification and does not match regulations and guidance. Per the EPA and CDC, the surface must remain wet, and not just undisturbed, for the time specified on the label.
there are a group of materials used in healthcare despite known sensitivity to chemical degradation because of the important role they play. Some examples of these materials are aluminum (think walkers), acrylics (think incubators or sneeze guards) and polyurethane (think tubing or protective covers). The PURELL Healthcare Surface Disinfecting Wipes have been shown to be compatible with each of these sensitive materials, unlike products that contain actives such as bleach, hydrogen peroxide or quaternary ammonium compounds (quats). Coverage You Can Count On. According to the EPA, if a surface dries more quickly than the required time for efficacy, known as the product’s “contact time”, another wipe should be used – and so on – until the desired surface area has been covered for the entire kill time required. Contact time is an important part of how much surface area one wipe can effectively keep “wet” for
the required time (see “Healthcare Terms” for additional definitions) as visible wetness is a critical measure of product efficacy. In healthcare settings, surface wipes are chosen specifically because they offer the potential for on-demand disinfection that is both efficient and effective. Therefore, when facilities are considering surface disinfecting wipes, understanding how much surface area one wipe can effectively cover for the listed contact time is integral to how many wipes should be used to clean the needed surfaces, devices or equipment. In a head-to-head comparison, the new PURELL wipes were proven to cover 3X to 5X the average surface area covered by two of the leading healthcare surface disinfecting wipes on the market – allowing hospitals to do more with less.3 Only PURELL, the most trusted brand in hospitals, offers the efficacy you require with the compatibility you need and efficiency you want – all in just one wipe.
tter JA, Yezli S, Salkeld JA, French GL. Evidence that contaminated surfaces contribute to the transmission of hospital pathogens and an overview of O strategies to address contaminated surfaces in hospital settings. Am J Infect Control. 2013 May;41(5 Suppl):S6-11. doi: 10.1016/j.ajic.2012.12.004. PMID: 23622751. 2 Donskey CJ. Does improving surface cleaning and disinfection reduce health care–associated infections? Am J Infect Control. 2013;41(suppl 5):S12–S19. 3 *Based on 5 PURELL Surface Wipes vs 5 of each of the leading competitive wipes and two minute dry time. GOJO Development Lab, 2945R1R1; LIMS #: P21-0084-001 1
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An Unwelcome Guest Inflation? Why now? What’s next? Inflation – no matter when it strikes – is an unwelcome
guest. Still, providers are asking why now, when the American Medical Association reports that Medicare physician pay has increased 11% over the last two decades but the cost of running a medical practice increased 39% during that same time? Why now, just a few months after healthcare consulting firm Kaufman Hall projected that hospitals nationwide would lose $54 billion in 2021 and more than a third of U.S. hospitals would maintain negative operating margins through the year’s end? And why now, just as nursing homes were reported to have lost 220,000 jobs between March 2020 and October 2021 and were projected to lose $94 billion in 2020 and 2021? Manufacturers and distributors are asking themselves similar questions, as the cost of raw materials and transportation keep going up. How long will it last? How bad will it be? Well, in December, the Federal Reserve Board said it was committed to achieving “maximum employment and inflation at the rate of 2% over the longer run.” Other sources aren’t so optimistic. In the same month, mortgage financing firm Fannie Mae projected inflation would hit 7% in the Q1 2022 before decelerating to 3.8% by the end of 2022. In the medical products and equipment industry, three factors will contribute the most to inflation in 2022, says Margaret Steele, senior vice president of med/surg for Vizient: rising labor costs, transportation costs and raw materials. “However, labor costs will likely have the most long-term impact as this metric doesn’t typically decline unless new technology is introduced to create more efficiencies in the manual labor aspect of production.” www.repertoiremag.com
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An Unwelcome Guest
Labor costs
Supply chain costs
“COVID-19 had a dramatic impact on the world’s workforce and production that we’re still feeling today,” says Kim Anders, group vice president, strategic supplier engagement for Premier Inc. “Healthcare has also felt the pinch as workers in high-demand groups, from nurses to pharmacists to ICU physicians, have been in short supply and subject to a more competitive recruiting landscape. Early retirement and employee burnout have also contributed to the healthcare worker shortage.” U.S. healthcare was experiencing a workforce shortage prior to the pandemic, but it has been exacerbated by the mental and physical strain of COVID-19, says Anders. She points out that healthcare had the secondhighest quit rate (6.4%) in November of all industries. Among nursing homes, employment remains far below pre-pandemic levels, and hospitals and health systems remain nearly 100,000 jobs below their pre-pandemic peak in February 2020.
As of mid-January, global logistics remained “an overloaded and stressed combination of port congestion, vessel shortages, equipment and container shortages,” says Anders. Not surprisingly, the cost of land, air and water transportation increased to record or near-record levels. Lead times for the manufacturing of additional cargo ships, shipping containers and freight trucks were also significant. Although shipping container availability has improved slightly, costs remain at record levels, she says. Compared to prices in March 2019, freight rates from China to the U.S. increased 500 percent with spot rates up to about $10,000 per container, compared with the more typical price of $1,200. In addition, the pandemic and other restrictions have limited the availability of dockworkers and truck drivers, causing delays in cargo handling after it arrives at ports, she says. “There’s no clear consensus on how long this situation will last, with some experts assuming that these logistical challenges will remain for the foreseeable future.”
‘ If I were still a supply chain executive in a hospital or health system, I would be more concerned about having goods available at a price that is reasonable and stop worrying about whether I’m getting the lowest price on everything.’
Raw materials
In healthcare, workforce shortages mean higher costs, not lower ones. An October 2021 Premier analysis revealed that U.S. hospitals were paying $24 billion more per year for qualified clinical labor than they did pre-pandemic, says Anders. For the average 500-bed facility, this translates to $17 million in additional annual labor expenses. “Many hospitals and health systems were forced to turn to staffing agencies to supply urgently needed health workers to care for the increasing number of patients,” she says. “However, the pandemic’s longevity has pushed hospitals to rely on these temporary workers more than ever – ballooning the typical costs for travel staff.” 28
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All that notwithstanding, a key driver for inflation in medical products lies at their very source – that is, the raw materials needed to make those products, says E.V. Clarke, CEO of Health Products Xchange, whose HPXConnect is an electronic marketplace connecting manufacturers, distributors, providers and others. In most industries, too much money in the market leads to inflation but doesn’t necessarily lead to a greater demand for medical products, he says. Instead, it increases the cost of the raw goods, such as minerals and resins and other natural resources. “If metals are diverted from the medical side to making higher-margin goods, like washing machines, that will have an impact on the medical market,” says Clarke, who co-founded Health Products Xchange in 2018. “It’s especially true for commodities, like crutches – though it also applies to things like suction canisters, OR towels and tubing,” he says. “In the case of crutches, there’s no sudden surge in demand, but the price of aluminum and logistics has increased 40% since the pandemic began. So you have a low-cost, bulky item – crutches – and the manufacturer can’t pass along all those costs, at least not immediately, given the nature of the U.S. healthcare system and the contracts between distributors, manufacturers and providers.” Consequently, manufacturers may lower their inventory of crutches and shift production to higher-margin goods.
THIS ISN'T OUR FIRST RODEO. The result is a shortage of crutches, which can push up prices of that commodity. Clarke expects logistics and raw materials pricing to remain inflated for the next 12 to 24 months, and that’s not accounting for anomalies, such as rolling blackouts in China or domestic regulations about the sourcing of finished goods and even the raw materials used to make them. In economic storms such as the current one, alternative suppliers and brokers come out of the woodwork, he says. And that’s a market opportunity for digital marketplaces such as HPXConnect. Todd Nelson, director of professional practice and partner relationships, and chief partnership executive for the Healthcare Financial Management Association, says that partnering with national, regional and local organizations will continue to be a key to addressing inflationary pressures. “For many it will take the form of looking at non-traditional partners to assist them in having access to products and equipment they depend on, which will require a level of creativity, building trust and relying on additional clinical and financial evidence to build that credibility with new partners.”
The healthcare environment changes at a rapid pace; MTMC continues to grow. If you don't have the right relationships, you're bound to fail.
NO BULL.
Think it through What should providers and their suppliers do about inflation? For starters, avoid panicking. Vizient believes inflation will continue through much of 2022, though at a lower rate than its most recent 7% pace, says Jeff King, research and intelligence director for Vizient. “Production costs will continue to put pricing pressures on product and service producers,” he says. “Vizient anticipates that raw material costs will decline, as resins already started their descent late last year. Unfortunately, the climbing labor costs won’t return to previous levels, and the issues impacting transportation appear to be long-term and will strain the ability of producers to maintain current price levels.” “Everyone is facing increased costs,” says Steele. “However, it’s important that we look at these drivers individually. For instance, we may see some relief as it relates to ports and raw materials in the next few months, therefore those price increases should be temporary. However, labor shortages and increased labor costs are likely here to stay. “Often, we look at all these factors collectively and accept the increased costs for the longer term,” she says. “We need to stay diligent and have transparent
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An Unwelcome Guest
conversations with suppliers. This should allow for appropriate, temporary adjustments to ensure supply and business continuity rather than allowing the water line to rise across the board.”
Pricing strategies For suppliers, contracting and pricing strategies only work when the economy for a category of goods or services is balanced, says John Strong, chief consulting officer for Access Strategy Partners, a national accounts consulting firm. “If I were still a supply chain executive in a hospital or health system, I would be more concerned about having goods available at a price that is reasonable and stop worrying about whether I’m getting the lowest price on everything.” Lowest price isn’t the only measurable factor that goes into a supply chain executive’s annual goals and objectives, he says. Supply chain professionals are more likely to get fired due to declining order fill rates and services to the people on the front line. “A balanced scorecard requires looking at service levels, real value analysis and other factors – not just price.
‘ Unfortunately, the climbing labor costs won’t return to previous levels, and the issues impacting transportation appear to be long-term.’ “I’m a big fan of bringing products back to the U.S. to manufacture and sell,” he continues. “It provides meaningful work for our own country and has the added benefits of a shorter supply chain (and less carbon footprint) as well as the possibility of rebuilding industrial deserts in our largest cities. Yes, it is going to cost more in terms of a direct price. But I must ask, What have been the indirect costs to this country of offshoring much of our manufacturing base – inside and outside healthcare?” Nor can supply chain executives “source” or “procure” their way out of the difficulties in today’s med/surg marketplace, says Strong. “You cannot get manufacturers to make things if they can’t make a reasonable profit. Consolidation has brought us to a total of three national GPOs, and many products that can be aggregated by them in a reasonable fashion already have been. Having scale, size 30
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and influence is important, but you can still reach a point in the economics of any goods or services where they cannot be provided any longer at a contracted price, [especially] in a period of short supply, inflation, supply chain/logistics issues or other factors along the supply chain. “It is similar to the so-called ‘hog cycle’ in economics,” he says. “More farmers start to raise hogs when prices are high. This leads to an overall lowering of prices because of the increase in supply. So farmers get out of hogs and into something else because the price has become too low, driving prices up again. The cycle repeats itself.”
Provider strategies “While it may be difficult to identify what major U.S. or global events will impact the world’s economies and supply chain, Premier aims to arm our members with the information, tools and support needed to tackle cost imperatives,” says Anders. The company is accelerating the development of its MedSurg and ASCEND Inflationary Calculators so members can stay abreast of the most recent inflation estimates, she says. In addition, through collaborations with Prestige Ameritech, DeRoyal Industries, Honeywell, Exela Pharma Sciences and VGYAAN Pharmaceuticals, Premier is producing “millions of domestically made PPE and pharmaceutical products ... thus helping to eliminate overreliance on overseas manufacturing and port congestion,” she says. Meanwhile, the company continues to help hospitals and health systems deal with clinical and nonclinical labor shortages and rising labor costs. Its PINC AI analytics technology can provide health systems with productivity benchmarks to pinpoint areas in need of adjusted staffing levels, says Anders. Premier also has contracts to help health systems control the costs of FTE and/or contingent staff for both clinical and non-clinical assignments.
Buckle up “Buckle up,” says Strong. “Many people working today don’t remember the Jimmy Carter years, when we witnessed a period of runaway inflation. I still remember being relieved to be able to get a three-year variable mortgage note on a condo at 14.5%. The average rate at the time for a fixed 30-year mortgage was somewhere around 18%.” The demand for medical products and services won’t go away, he adds. “The question for [providers] is, What price am I going to have to pay in 2022 to see those goods arrive on my receiving dock?”
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TRENDS
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Managing Pain in Long-Term Care Opioids have a place, but staff need to encourage nonpharmacological solutions.
Pain is universal, but its prevalence increases with
advancing age, disability and morbidity. Anywhere from 45% to 80% of residents of long-term-care facilities are estimated to have pain associated with injuries, postoperative status, arthritis, cancer and other chronic conditions. Helping residents manage pain is challenging, especially today, given the demands of the pandemic and slimmed down work forces. But by incorporating guidelines for assessment, treatment and monitoring of pain into routine care, long-term-care staff can alleviate or at least ameliorate much unnecessary pain among residents. In November 2021, AMDA—The Society for PostAcute and Long-Term Care Medicine published an updated set of pain management guidelines, as it has several times since publishing its first guidelines on the subject in 1999. Post-acute and long-term-care facilities should have written policies and procedures in place for pain assessment and management, according to the organization. Although staff and practitioners may change over time and treatment options may vary, the process should be universal and enduring. www.repertoiremag.com
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TRENDS AMDA represents more than 50,000 medical directors, physicians, nurse practitioners, physician assistants and other practitioners working in post-acute and long-term-care settings. “Our biggest push with the clinical practice guidelines is to improve the assessment of pain and identification of the underlying cause and type of pain we are treating,” says Barbara Resnick, Ph.D, CRNP, a professor in the Department of Organizational Systems and Adult Health at the University of Maryland School of Nursing and part of the core group that revised the AMDA pain management guidelines. With its revised guidelines, AMDA is challenging staff and residents to search for and treat the underlying cause of pain, and to try nonpharmacological treatments, such as physical activity for those with musculoskeletal pain, rather than relying on kneejerk prescriptions for pharmaceuticals, she says.
have limited ability to report and describe pain. Meanwhile, staff can bring with them their own biases, such as “excessive reliance on pre-existing information and failure to reconsider previous conclusions or interventions when evidence suggests that current working assumptions might be wrong,” the guidelines state. Staff can also be swayed by the conclusions of others, even if those conclusions are against their better judgment. Both undertreatment of pain and overtreatment with and excessive dosing and duration of opioids can affect mental status and behavior, according to AMDA. “In addition, the clinical, legal, and political landscape has shifted between pressure to treat pain aggressively and stricter prescribing guidelines related to heightened concern about the adverse impacts of pain medications. Ultimately, treatment is a balancing
‘ I believe we will continue to develop more nonpharmacological approaches to pain and hopefully continue to develop and use motivational interventions to get individuals to do them.’ The challenge Identifying and describing pain and accurately diagnosing its causes present ongoing challenges, says AMDA in the guidelines. Residents’ perceptions of, responses to, and descriptions of pain vary widely. They differ in how they perceive and respond to pain and how much pain they tolerate. What’s more, many residents in post-acute or long-term-care settings 34
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act that requires careful assessment of the patient and the clinical knowledge to find the path that provides enough of the right interventions and limits marginal, problematic, or ineffective treatment.”
Team effort Effective pain management in longterm care calls for coordination and communication among medical
directors, attending physicians, nursing staff, consultant pharmacists, social workers, pharmacists and others – as well as residents and their families and friends. “A variety of health care professionals working in the [post-acute and long-term-care] setting ... make and document observations (e.g., that a patient does not sleep at night, has become more withdrawn, or has a change in usual eating patterns),” according to the guidelines. “However, only some may be qualified to determine the significance of those observations (e.g., the cause of sleeplessness or of a change in eating patterns). In contrast, practitioners may not be present to observe patients in detail or deliver treatments but are responsible for analyzing the significance and causes of symptoms.” What’s
needed among the entire interprofessional team is an understanding of the specific functions and tasks of each. The guideline provides information to help all levels of staff provide appropriate pain-related information to practitioners for the final diagnosis and to provide input – along with other members of the healthcare team – for the pain management plan, says Resnick.
Assessing pain Among many residents in long-termcare facilities, pain is one symptom among many, e.g., anorexia, confusion, dysphagia, falls, impaired behavior, indigestion, nausea, weight loss, according to AMDA. “Pain should be considered and managed in the context of the whole patient, not in isolation (a ‘silo’)”.
While periodic screening for pain is important, it is no longer recommended to consider pain as the “fifth vital sign” or to record pain level when other vital signs are measured. Even so, residents without diagnoses of chronic pain or active pain problems should be screened for pain on admission, on a change of condition, quarterly, and annually, according to the guidelines. Assessment may be both direct and indirect. Direct assessment involves gathering information directly from the patient, either through conversation, observation (e.g., pain while dressing) or physical exam. Indirect assessment involves reviewing other sources of information, such as current and previous medical records, diagnostic tests and the observations of those in direct contact with the patient.
“Verbal description is only one of several ways to express pain,” as noted in the guidelines. Further, “limited ability to communicate does not preclude the existence of pain.”
Analgesics and opioids Several stepwise approaches to analgesic prescribing have been developed. The World Health Organization Pain Ladder for managing cancer-related pain, for example, identifies the following approach: ʯ Step 1: Non-opioid analgesics for mild pain. ʯ Step 2: Low-potency opioids (e.g., hydrocodone, morphine) for moderate pain. ʯ Step 3: High-potency opioids (e.g., hydromorphone, oxycodone) for severe pain. www.repertoiremag.com
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TRENDS ʯ
Adjunctive medications as indicated at any step
Any discussion of opioids for pain management is bound to be a lively one, given the medical and media attention to the topic. As noted in the guidelines, opioids have an important place in pain management, particularly for cancer-related pain, end-of-life pain and cases of severe chronic pain in residents with co-existing illnesses. However, even when opioids are indicated, nonpharmacological interventions and non-opioid medications should be tried or used concurrently. Opioid dependence is just one potential hazard of opioids. According to the guidelines: ʯ Opioids have pharmacological effects throughout the GI tract. ʯ Constipation is a universal, predictable opioid side effect. ʯ Major psychiatric and behavioral side effects are common, including agitation, anxiety, dementia, depression, dysphoria, euphoria, hallucinations, nightmares, paranoia and psychosis. ʯ Respiratory depression is often listed as a major complication of opioids and can be particularly hazardous for patients with respiratory impairment. Fentanyl carries a strong warning that it can cause serious, life-threatening, or fatal respiratory depression. Other adverse effects of opioid use may include abdominal pain, anorexia/weight loss, apathy, confusion, delirium, dizziness, falls, impaired function, lethargy, pruritus (itchy skin), sedation, urinary retention, and death. 36
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“Many older adults think, ‘I’m achy, so I’ll sit still and feel better.” Nonpharmacological interventions The guidelines stress that nonpharmacological interventions have a role both independently and in conjunction with pharmacotherapy in chronic pain management. Cognitive behavioral therapy and exercise/ movement have demonstrated the strongest evidence of effectiveness. Based on prior research and reviewed in the guidelines, cognitive behavioral therapy involves efforts to change thinking patterns or unhelpful attitudes, beliefs and thoughts, such as “My pain will never get better” or “It will never go away,” or fear that movement or activity will worsen pain. But the guidelines recognize that such therapy requires patients to have insight into triggers for their pain and stress as well as their emotional, behavioral, and physical reactions to pain and
stress. This requirement may limit its applicability among post-acute and long-term-care residents. Movement and exercise have been proven to improve pain severity, physical function and quality of life. Structured exercise can include walking, yoga, tai chi, motor-control exercise, and progressive relaxation. Stretching can improve function and reduce symptoms due to chronic low-back pain. Strengthening exercises may be helpful for painful joints, extremities, and trunk muscles. Physical therapy demonstrates small to moderate effects on pain and disability, and some benefit for anxiety, depression, and quality of life. “Most people don’t move,” says Dr. Resnick. “Many older adults think, ‘I’m achy, so I’ll sit still and feel better.’” Staff and long-term-care residents themselves must believe in the benefits of exercise and movement. For the resident, it’s believing, “If I get up every couple of hours, or get up and walk to the bathroom, my back won’t hurt so much.” Staff need to verbally encourage residents to move to the extent they can, and if necessary, point out others in the facility who are doing so. (“Your roommate gets up frequently.”) Encouraging exercise and movement takes time and effort, but dealing with residents’ pain-related behavior takes even more time, she says. Just going to the medicine cart, bringing medication to the resident, and making sure they take it is time-consuming. “I believe we will continue to develop more nonpharmacological approaches to pain and hopefully continue to develop and use motivational interventions to get individuals to do them. There will be fewer kneejerk responses to give a pill for pain, and more time spent thinking about other options.”
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TRENDS
A Long-Term Care Crisis? Long-term care has faced staffing challenges for years, and the pandemic has only made it worse. By Pete Mercer
In the last couple of years, we have seen the coronavirus
pandemic stretch and exhaust the healthcare industry past any semblance of what it used to look like. The ramifications of the current state of the healthcare system will likely be felt for many years to come, especially in the long-term care sector. Long-term care is currently going through what experts are calling a dangerous staffing crisis that could put the future of this sector of the healthcare industry in jeopardy. The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) represents over 14,000 nursing homes and assisted living communities across the country that provide care to approximately 5 million people each year. The AHCA/NCAL recently released a report showing that long-term facilities are suffering from the worst labor crisis and job loss of any other health care sector, with an employment level drop by 14% (about 221,000 jobs) since the start of the pandemic. Staffing levels in other healthcare sectors have fluctuated in the past couple of years, but nursing homes and assisted living facilities are still experiencing substantial job losses. According to a study conducted by the AHCA/ NCAL in 2021, 86% of nursing homes and 77% of assisted living providers have said that their workforce situation 38
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has gotten worse in recent months, while 58% of nursing homes are even limiting new admissions. This is not only an unsustainable situation for these long-term facilities, but it’s also dangerous and detrimental to a vulnerable part of the population that depends on this industry. In a media release, Mark Parkinson, president and CEO of AHCA/ NCAL, said, “As many caregivers are getting burned out by the pandemic, workers are leaving the field for jobs in other healthcare settings or other industries altogether. Chronic Medicaid underfunding, combined with the billions of dollars providers have spent to fight the pandemic, have left long-term care providers struggling to compete for qualified staff. Parkinson said, “We desperately need the help of policymakers to attract and retain more caregivers so that our nation’s most vulnerable have access to the long-term care they need.”
Why workers are leaving To put it simply, long-term care providers are exhausted. As we have seen over the last two years, when a workforce is understaffed, it creates a trickle-down effect throughout the whole industry. Long-term care facilities have trouble with staffing workers, which creates an unnecessary strain on those who are working, which further perpetuates this cyclical nightmare of exhaustion that so many are experiencing right now. Cristina Crawford, senior manager, public affairs for the American Health Care Association, said, “This pandemic has taken an enormous toll on our staff and residents. Not only have many experienced tremendous losses, but it has also been exhausting – physically and emotionally – battling this virus day in and day out.” www.repertoiremag.com
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TRENDS Essential workers are dropping left and right. Additionally, Crawford described long-term care providers as “chronically underfunded,” which limits any sort of competitive edge they would need to hire new people. Crawford said they “cannot compete with other healthcare settings, like hospitals, that can offer better pay and benefits.” This isn’t a new issue. Longterm care has faced staffing challenges for years, and the pandemic has only made it worse. Crawford said, “Workforce recruitment and retention has been an ongoing challenge prior to the pandemic, and we have been calling for help for years. Now, the pandemic has exacerbated our workforce challenges, and we are in a full-blown crisis.”
The effects on the residents When healthcare workers suffer, the patients suffer. Without a stable option in place, residents and families are often left to find care alternatives that are less than optimal. Losing these workers is a dangerous prospect for the residents and patients of long-term care providers. “The workforce crisis threatens access to care for vulnerable seniors,” Crawford said. “More than half of nursing homes are limiting new admissions because of staffing shortages.” Not only are the families put in a difficult position regarding the safety and care of their loved ones, but hospitals are unable to discharge patients if there are no long-term care options available. This also perpetuates the vicious cycle with COVID surges.
“ We desperately need the help of policymakers to attract and retain more caregivers so that our nation’s most vulnerable have access to the long-term care they need.”
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It’s also important to remember that this isn’t a problem that’s going to resolve itself. There will always be an elderly population that will need to be cared for, whether there are places to provide that care or not. “If policymakers do not act, the consequences will be devastating and could result in nursing home closures, which will ultimately affect access to care that our nation’s seniors need and deserve,” Crawford said.
The path forward For long-term care providers to begin the road to recovery, Crawford said they would need immediate assistance from federal and state public health officials to support the frontlines and prioritize resources for long-term care providers. Crawford also argued for a long-term solution to “help recruit and retain the next generation of caregivers and to prepare for a growing elderly population.” “Policy makers must act and support the multi-tiered workforce proposals we have put forth in our reform agenda, the Care for Our Seniors Act,” Crawford said. “These proposals include assistance programs for caregivers like affordable housing and childcare, tax credits, loan forgiveness, and incentives for higher learning institutions to train the next generation of healthcare heroes.” State and federal policy makers also need to do things like fully fund Medicaid, which would allow longterm care providers to invest in their workforce and have a competitive hiring edge. “The strategies laid out in the Care for Our Seniors Act offer a comprehensive approach to recruit more health care heroes to help solve this workforce crisis,” Crawford said.
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TRENDS
Which States Have the Best Telehealth Practices? A new report rates every state’s telehealth policy for patient access and ease of providing virtual care. By Pete Mercer
Despite the challenges that COVID-19 has created for the entire world in the past two years, it has also presented
a unique opportunity for people that still needed access to healthcare. Millions of people in the U.S. tried telehealth for the first time because of the pandemic, made easier by changes federal officials made to the Medicare program as well as governors waving certain barriers to advance health access with flexible provider licensure for new uses of telehealth.
After public health emergencies started to end and executive orders were withdrawn, much of the flexibility that users enjoyed for months disappeared almost immediately. Even the new laws passed by certain states only made incremental changes without a sort “best practices” roadmap. Telehealth was a dynamic solution during an unprecedented time, which makes all of the new challenges with utilizing more frustrating and confusing than before. A new report from Reason Foundation, Cicero Institute and Pioneer Institute rates every state’s telehealth policy for patient access and ease of providing virtual care. With 42
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this in-depth report on the current state of the telehealth landscape throughout the country, this may provide some relief for healthcare providers and patients alike. In a media release regarding the report, Josh Archambault, senior fellow with Cicero Institute and Pioneer Institute and co-author of the report, wrote, “While they cannot and should not replace all in-person medical appointments, virtual visits can save patients time and help them avoid germ-filled waiting rooms. Providers can also take some pressure off overburdened systems as they can see patients from an office or home.”
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TRENDS Best practices for telehealth This report laid out certain best practices for what telehealth should and shouldn’t do, giving policymakers a better picture of a successful telehealth program. These best practices included the following: ʯ Do support modality neutral options Allowing different avenues of access for users is a critical component of a successful telehealth policy. Not only does it further help to establish trust in a patient-provider relationship, it gives the patient the agency to decide what works best for them.
ʯ
Don’t arbitrarily limit provider tools Part of the challenge of providing telehealth opportunities is the inherent limitations that come with providing a diagnosis and treatment over a virtual channel. Any further unnecessary limitations of provider tools only exacerbate the existing challenges of telehealth, while creating new ones altogether.
shown mixed outcomes for certain services over telehealth, can lead to wasteful spending. A mandate also inhibits innovation in care delivery.
ʯ
Do support provider access to telehealth Patient accessibility is crucial to the success of a telehealth program, but it’s just as important to improve provider access. Including providers that possess a license or registration in good standing will help with the continuation of care, as well as increase access in rural communities.
ʯ
Don’t mandate payment rates in law A payment mandate will actively work against any improvement in accessibility. Enforcing a payment parity mandate that requires telehealth visits to cost as much as an in-person visit will hurt vulnerable patients and small businesses that are trying to provide a virtual care option.
Which states have better telehealth policies?
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ʯ
Do support access to care The greatest opportunity with telehealth is increased access to those who are either unable to go to an in-person appointment or looking for a convenient and easy way to schedule a doctor’s appointment. Either way, it’s important for all kinds of providers to utilize telehealth to allow for more team-based care, while prohibiting facility fees from being charged for services that can be delivered from anywhere.
ʯ
Don’t mandate coverage for everything Passing insurance coverage parity mandates that require paying for all services, since research has
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Overall, most of the United States does not require an inperson visit to a physician’s office and there aren’t many barriers to the preferred modality for access. Most states don’t allow providers to cross over states lines. Arizona, Florida, and Indiana are the only three states that allow all providers to easily practice telehealth across state lines. The other 47 states have arbitrary barriers that limit patient’s access to specialists and available appointments based purely on residency. Arizona and Utah both have the least restrictive telehealth policies, as both don’t require an in-person visit, are modality neutral, and allow for providers to cross state lines, even if Utah is less lenient with the out-of-state policies. As it stands with this report, Tennessee has the most restrictive telehealth policy. While most states have removed the requirement that a patient must see a provider in-person before using telehealth services, Tennessee is the only state that still requires an initial in-person visit. Alaska and West Virginia require an in-person visit before certain services can be provided. The report says, “Alaska regulations limit a physician’s provision of services based ‘solely on a patient- supplied history received by telephone facsimile or electronic format.’” For the state of Virginia, the report says, “the statewide telehealth plan definition does mention remote patient monitoring and store-and-forward. However, there are separate definitions for teledentistry and store-and-forward technologies for dentists.”
MARKETING MINUTE
Getting Your Message Across Tips for effective healthcare organization content marketing. The third most common online activity in the United States is seeking online health information. Eighty percent
of adults have sought health-related information, especially about a specific disease (66%) or a treatment plan (56%).
Organic content is a highly effective marketing channel for healthcare organizations. Mayo Clinic, for example, has become a leading online authority with global reach thanks to strategic content marketing. If you’ve ever Googled a healthrelated query, you’ve probably seen a Mayo Clinic article ranking among the top results. Content marketing has become a highly competitive field. Simply churning out large quantities of poor content isn’t going to help your brand rank on the search engine results page (SERP) or give you a return on your investment. To create effective content, follow these tips:
No. 1: Understand Your Target Audience Before you start writing, you need to know who will be reading your content. It’s tempting to write about topics you enjoy, but it’s much more important to write about what your audience wants to read instead. For example, is your target audience potential patients or medical suppliers? Is your goal to provide health advice or boost medical device sales? The topic, tone, and vocabulary in your content will be drastically different for those intended audiences.
also allows you to build upon your authority in your field. If you’re an eye doctor, for example, readers are likely to trust your articles about eye health. They’re much less likely to feel you’re qualified to give advice for a sprained ankle.
No. 3: Write Like a Human
Take the time to research your audience demographics and understand what kind of content they prefer to engage with. From there, you can start brainstorming topics and determine what content forms and channels you’ll use.
No. 2: Focus on Your Expertise The most successful content marketing strategies target a well-defined niche rather than a broad subject. “Healthcare” or “medical field” is way too vague and has too much competition with thousands of other content creators targeting those keywords. Your healthcare organization’s content marketing plan should focus on its area of expertise. Not only does this increase your chances for Google to understand your website and rank your content, but it
Most people searching for health information on Google won’t be looking for advanced scientific studies filled with technical jargon. Healthcare organization content marketing can sometimes struggle to find balance between demonstrating academic authority on a subject and connecting with average readers. Remember that search engine optimization (SEO) ranks content that is useful and easy to read. Keep your audience in mind and use language they understand. Break up text with headlines, bulleted lists, and graphics so people can easily skim to find information. While engagement is important, your organization should have clear guidelines set in place for appropriate conduct. All content must comply with HIPAA, and your team should know when to escalate issues and advise people to contact 911 for medical emergencies To read the full article, visit https://sharemovingmedia.com/ 5-tips-for-effective-healthcareorganization-content-marketing. www.repertoiremag.com
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PEOPLE
In Good Hands Mark Zacur, healthcare industry executive, reflects on an unprecedented time to be in the healthcare supply chain. To say that the last two and a half years have been chaotic for the med/surg industry would be an understatement.
At the beginning of 2022, Mark Zacur announced his retirement from Owens & Minor as executive vice president and chief commercial officer. Zacur said it’s been a “crazy, but immensely satisfying two-and-a-half-year run, as teammates came together and transformed the company … to a dynamic industry leader.”
Zacur oversaw the commercial operations of the company – which came front and center during the pandemic. Prior to Owens & Minor, Zacur worked for Thermo Fisher Scientific in several roles, including vice president and general manager of Fisher Healthcare. He spoke with Repertoire about Owens & Minor’s pandemic response, how the supply chain has changed in such a short period of time, and what skills distributor reps will need to be successful with today’s clients. Repertoire: Commercially, did the pandemic accelerate what Owens & Minor was able to accomplish because of the collaboration and changes happening? Mark Zacur: Owens & Minor was well positioned pre-pandemic. For starters, Owens & Minor has an established America’s based PPE manufacturing footprint with raw materials being manufactured in North Carolina and the products finished in either the Americas or the United States. This gave Owens & Minor an advantage as our PPE manufacturing and supply chains were not impacted by the shutdowns overseas that were happening during the most intense periods of the pandemic. Also prior to the pandemic, Owens & Minor made the decision 46
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to expand raw material production, a decision that allowed us to expand finished goods manufacturing much faster than would typically happen. The O&M team pre-pandemic certainly had things going in the right direction. When the pandemic hit, all of a sudden the sale of domesticmanufactured product was in demand and O&M was able to respond to the industry’s need.
Mark Zacur
Repertoire: How do you think the pandemic has changed the supply chain permanently, both for Owens & Minor and distributors overall? Zacur: There are several things. Certainly, transparency is much more important than it’s ever been. Transparency
from the perspective of all involved parties – manufacturers, distributors and providers. From the provider perspective – what are their demand signals? Obviously, in a pandemic, it’s dramatically different. But even in normal circumstances, provider demand signals are key. Are they going to have a demand increase because they’re bringing on a new practice or there’s a new initiative around certain procedures, that sort of thing. In the pandemic, all parties worked together to optimize PPE supply. Using real-time data helped to identify when there was a product shortage and where to allocate a product, so we could send PPE into hotspots while maintaining continuity of supply in regions that weren’t seeing dramatic spikes. Similarly, when there’s supply disruption from the manufacturer, the distributor and the manufacturer have to be very open about it and communicate the status proactively to the providers. Moving forward, this timely and transparent three-way communication is really critical. I see this with the global supply chain challenges the industry continues to deal with today. Since this is an industry-wide problem and everybody’s in the same boat, the transparency has gotten better. The test will come when as an industry we
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PEOPLE get back to a sense of normalcy; will the transparency and collaboration commitments still be a priority? The other piece is the visibility of the Country of Origin for different products. Providers need to mitigate the risk associated with products originating in distant parts of the world. This complicates the situation and poses questions about alternative product availability, inventory investment, product standardization, etc. Even with U.S. manufactured product, there could be a reliance on components that come out of Asia, for example. Together, manufacturers, distributors and providers need to have a deep understanding of their mutual supply risk and build plans to mitigate those risks. Repertoire: What skills do you think are now imperative for distributor reps when they’re helping customers? Zacur: That’s a really good question. Some of it is clearly sales fundamentals – sales process, product knowledge, pipeline management, etc... For me, the most critical imperative, which is also fundamental, is responsiveness to the customer needs. The best sales processes in the industry won’t matter if the representative (and their support teams) aren’t attentive to customer needs. In my experience with many different companies, the farther away from the customer, the less urgency is felt. Obviously, lack of responsiveness is not a formula for success, and I speak from personal experience that the Owens & Minor teammates work really hard to ensure that customer needs are met proactively and that a sense of urgency permeates the entire team. From the customer perspective, this urgency starts with the distributor representative. 48
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One other point is that we all need to be comfortable selling and serving the customer virtually. The scale/criticality of decisions being made through Zoom calls is really eyeopening. I’m a firm believer in being physically together with the customer whenever possible but those opportunities are dramatically fewer now and will remain that way in the future.
who is the patient that you’re going to help today by making sure that the clinicians have all they need for a successful day. For all of us, it’s such a great privilege to be in healthcare and help patients and clinicians. Clinicians treat the patients literally every single day, and over the last two years in the midst of a pandemic our roles in healthcare have never been more critical.
In the pandemic, I was speaking to our customers routinely, and the passion that they all had for the patients and the communities they serve was evident during every single conversation. Repertoire: Looking back on your career track, what resonated with you when it came to working in the supply chain? Zacur: I’m a big believer in encouraging employees from the heart. I use a story of my nephew Mike, who was diagnosed with Stage 4 glioblastoma at 29 years old. That was seven years ago, and thankfully he’s through that and continues to remain healthy. Eventually we’re all going to have someone that we know and love who is going to go through a hard time medically. When that happens, as a family member or concerned friend, you want to make sure that you’ve got the best doctors, you have the best care available at the best hospital with the best products and the best supplies. And you have this passion and fervor around making sure everything is perfect for the patient – essentially an advocate for your loved one. What I always have tried to encourage, and sales teams are typically very receptive to, is making “the why” about having a patient advocacy mindset when you’re doing your job. To make this personal, I ask my teams: “Who’s your Mike?” In other words,
Sure, there were (and continue to be) extraordinarily long days. Through much of 2020, we had team calls seven days a week for months on end with government representatives, our customers and our own teammates. It was exhausting, but there was no better time to be in healthcare. Because literally every single day we shipped PPE and those critical supplies got somewhere to protect a clinician and enabled a clinician to care for a patient. For me, it’s not about being in supply chain, it’s about the privilege to be in healthcare. In the pandemic, I was speaking to our customers routinely, and the passion that they all had for the patients and the communities they serve was evident during every single conversation. I don’t know that I can find another profession where you have that connectivity that’s right in front of you. Many businesses can concoct stories that tie their work to the greater good, and they’re sincere in doing so. But when you’re in healthcare, you don’t need a long, thought-out mission statement to connect your work to serving people as we literally do that every hour of every day.
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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.
HIDA
HIDA Launches Workforce Development Advisory Council HIDA to tackle workforce development, attract recent graduates into industry HIDA recently launched the Work-
By Wyeth Ruthven, Director of Public Affairs
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force Development Advisory Council, starting at the source of the talent pipeline in an effort to recruit recent graduates into internships and entrylevel jobs. The Council is composed of leaders in our industry with wide experience in talent acquisition and human resources. The Council will work on: ʯ Identifying career paths in the healthcare distribution industry, so applicants can learn how entry-level positions can mature into lifelong careers. ʯ Developing a diverse pipeline of applicants for internships and entry-level positions, so that our industry will continue to attract the best and brightest and benefit from a diversity of perspectives and experiences. ʯ Building and launching online resources, in conjunction with the HIDA website, where prospective applicants can browse listings and apply for jobs. ʯ Conducting physical, personto-person outreach through
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our networks to spark renewed interest in healthcare distribution as a profession. This will include outreach to schools with established supply chain courses of study, alumni councils, and social and civic organizations. A number of short-term and long-term factors in the labor market underscore the need to consider a robust strategy of workforce development at this time. ʯ New entrants into the distribution market compete with healthcare distributors for the same pool of talent. E-commerce has transformed the ability of companies to sell and ship direct to customers. ʯ The pandemic has altered the way college students look for work. Remote-learning makes it harder for students to visit the career counseling office, and on-campus recruiting by major corporations was suspended. ʯ A new approach is needed so that recent high school and college graduates can access the full range of opportunities and careers available to them. HIDA welcomes the input of everyone in our industry about their success stories in workforce development, and we encourage you to share your experiences with us. In order to kick off brainstorming about workforce development, ask yourself the following questions: ʯ Why pursue a career in healthcare distribution? What would you tell a younger version of yourself about the career they are about to begin? ʯ How are you making your organization attractive to new entrants in the workforce? What are your strategies for filling internships and entry-level positions? How do prospective employees find out about jobs at your company? ʯ Where are you searching for talent? Are there particular programs in supply chain management whose graduates you tend to recruit? What outreach have you done with Historically Black Colleges & Universities (HBCUs) and Hispanic Serving Institutions?
Mobile Adjustable Height Lead Acrylic Window Barrier With the same great protection you get from a Wolf barrier, this model features the ability to position the clear lead at any level between 45.25” and 74” for the ultimate in patient and operational visibility. It’s great for dozens of applications. Best of all, the internal counter balance mechanism makes it easy to lift or lower…it requires minimal •
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HEALTH NEWS
Health News and Notes 52
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Blood test helps predict who may benefit from lung cancer screening A blood test, combined with a risk model based on an individual’s history, more accurately determines who is likely to benefit from lung cancer screening than the current U.S. recommendation, according to a study published today in the Journal of Clinical Oncology led by researchers from The University of Texas MD Anderson Cancer Center.
A personalized lung cancer risk assessment, combining a blood test based on a four-marker protein panel developed at MD Anderson and an independent model (PLCOm2012) that accounts for smoking history, was more sensitive and specific than the 2021 and 2013 U.S. Preventive Services Task Force (USPSTF) criteria. The study included participants from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial with at least a 10 pack-year smoking
many years, has been to develop a simple blood test that can be used first to determine need for screening and make screening for lung cancer that much more effective,” said Sam Hanash, M.D., Ph.D., professor of Clinical Cancer Prevention and leader of the McCombs Institute for the Early Detection and Treatment of Cancer. “Our study shows for the first time that a blood test could be useful to determine who may benefit from lung cancer screening.”
General Catalyst and Outsiders Fund. This news comes roughly a year after the company announced its $14 million Series A funding round. The company developed the Heart Seat, a toilet seat that is able to capture health metrics over time. The seat is designed to measure a person’s blood oxygen level, blood pressure and heart rate. This data is sent to a care team’s dashboard, along with overall trends about a patient’s health over time.
As a registered pharmaceutical wholesaler, Mark Cuban Cost Plus Drug Company (MCCPDC) can “bypass middlemen and outrageous markups,” the company said in a release. Private insurers must cover cost of at-home COVID-19 tests
history. If implemented, the blood test plus model would have identified 9.2% more lung cancer cases for screening and reduced referral to screening among non-cases by 13.7% compared to the 2021 USPSTF criteria. “We recognize that a small percentage of people who are eligible for lung cancer screening through an annual low-dose CT scan are actually getting screening. Moreover, CT screening is not readily available in most countries. So, our goal, for
Private insurers will have to cover up to eight rapid over-the-counter (OTC) COVID-19 tests per month per individual covered. Consumers with private insurance will be able to obtain the tests without any cost sharing like deductibles, coinsurance or copayments. Insurers are encouraged to set up partnerships with retailers and pharmacies so individuals covered can get free OTC tests directly without paying anything upfront or having to submit a claim for reimbursement. Reporting by The Wall Street Journal.
Heart health-monitoring toilet seat lands funding According to mobiehealthnews, Casana, a startup building a heart health-monitoring toilet seat, landed $30 million in Series B funding. Morningside led the round with participation from Matrix Partners,
Mavs owner opens online pharmacy Billionaire and Dallas Mavericks Owner Mark Cuban recently opened an online pharmacy that offers generic prescription drugs to consumers. As a registered pharmaceutical wholesaler, Mark Cuban Cost Plus Drug Company (MCCPDC) can “bypass middlemen and outrageous markups,” the company said in a release. The pharmacy’s prices reflect actual manufacturer prices plus a flat 15% margin and pharmacist fee, according to a release. Patients will also enjoy reliable prescription fulfillment and delivery through Truepill’s nationwide pharmacy footprint, the release said. “We will do whatever it takes to get affordable pharmaceuticals to patients,” said Alex Oshmyansky, CEO of Mark Cuban Cost Plus Drug. “The markup on potentially lifesaving drugs that people depend on is a problem that can’t be ignored. It is imperative that we take action and help expand access to these medications for those who need them most.” www.repertoiremag.com
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WINDSHIELD TIME Chances are you spend a lot of time in your car. Here’s something that might help you appreciate your home-away-from-home a little more.
2023 Toyota Sequoia Capstone
Automotive-related News Uber Health hires first chief medical officer Uber Health, Uber’s healthcare arm, announced its first chief medical officer, Dr. Michael Cantor. With over 20 years of leadership experience spanning the healthcare industry, Dr. Cantor will enable Uber Health to continue building innovative solutions that address the needs of patients, clinicians, and care coordinators, the company said in a release. As a board-certified geriatrician, his experience designing clinical programs for older adults and vulnerable populations gives him unique insights into the most pressing gaps in care–and how technology can provide the flexible solutions needed to deliver care more efficiently. 54
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“I’ve seen first-hand how important leveraging transportation is in both improving clinical outcomes and creating care systems that allow patients to live independently in their community,” said Dr. Michael Cantor, Chief Medical Officer of Uber Health. “That’s why I’m excited to join Uber as the team continues to build relevant solutions that aren’t just more efficient for healthcare providers but also help bring care more directly to patients at home on a community-wide scale.” This news comes on the heels of massive growth for Uber Health. Increasing demand for innovative patient transportation, critical deliveries, and other mobility solutions across the healthcare industry has resulted in 71% gross bookings growth for the business unit from Q4 2020 to Q4 2021. Throughout 2021, Uber announced partnerships with innovators in the healthcare space and have grown its base to over 3,000 healthcare customers.
Toyota redesigns the Sequoia In January, Toyota announced the redesigned 2023 Sequoia, to be available this summer. The third-generation Sequoia is completely redesigned. All 2023 Sequoias will feature the twin-turbo V6 hybrid i-FORCE MAX powertrain. First unveiled on Tundra, this hybrid produces 437 horsepower and 583 lb.-ft. of torque. Sequoia will be offered in 2WD or the available part-time 4WD system on SR5, Limited, Platinum and Capstone grades. TRD Pro will be offered only in 4WD. The three-row SUV offers a range of configurations for seating and cargo. Depending upon the grade, secondrow passengers get bench seating or captain’s chairs, either of which recline for passenger comfort or fold down/ tumble forward if larger cargo space is needed. The thirdrow passengers benefit from a spacious reclining backseat with available power folding, but the third row also gets one of the most noteworthy new features on Sequoia: the exclusive Sliding Third Row with Adjustable Cargo Shelf System. This segment-first feature allows the third row to slide with 6 inches of adjustment range. The third row can also fold down to complement the different storage positions of the new Adjustable Cargo Shelf System: a removeable shelf that can be set in a variety of storage positions depending upon the situation. The Cargo Shelf System is designed to offer the ultimate flexibility in rear cargo and storage needs.
Last Passat rolls off U.S. assembly line Car and Driver reported in January that the last U.S. Volkswagen Passat has rolled off VWoA’s Chattanooga,
Tennessee, assembly line. The Passat enjoyed a long run in the United States, one that dates back to 1974, when the model was known as the Dasher. Worries that the Passat had grown too expensive led VW to divorce the U.S. version from the European model, starting with the B7 Passat that debuted in 2006 as a sedan and 2007 as a wagon.
Nissan recalls nearly 700,000 Rogue SUVs CNET reported that the National Highway Traffic Safety Administration (NHTSA) and Nissan announced a recall for 699,946 2014-2016 Nissan Rogues over concerns that a faulty electrical connector could start a fire. The recall specifically pertains to an under-dash connector that can corrode if exposed to water and/or road salt from the driver›s footwell. If the connector becomes corroded, it can heat up and potentially cause a fire. “There is currently no fix available for the issue, but when one comes, we suspect it will be something along the lines of a bettersealed connector,” CNET reported.
Worries that the Passat had grown too expensive led VW to divorce the U.S. version from the European model, starting with the B7 Passat that debuted in 2006 as a sedan and 2007 as a wagon. Used cars prices to fall – eventually Good news is on the way regarding used car prices. According to a study conducted by Ally Financial and highlighted by Auto News, the average price of a used car will fall by 15% from current levels by the end of 2023. CNN reported that J.D. Power forecasts that the average wholesale price of used cars should fall about 9% from the fourth quarter of last year to the fourth quarter of this year, and that prices should continue to decline in 2023. Automakers are expecting the supply of chips and other parts to improve this year, which should help with inventories, and take the pressure off prices, experts told CNN. “That could lead to a return of consumers paying less than the sticker price, a big break for buyers, even if the price in the window doesn’t go down.” www.repertoiremag.com
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NEWS BD collaborates with ReturnSafe to help employers manage COVID-19 testing BD recently announced a collaboration with ReturnSafe, the all-in-one software solution for COVID-19 employee health, safety and compliance, to integrate the BD Veritor™ At-Home COVID-19 Test directly within the ReturnSafe testing management platform. “The BD Veritor™ At-Home COVID-19 Test enables people to test from home, without a proctor, while ensuring verifiable results because test results can only be read using a smartphone,” said Dave Hickey, president of Life Sciences for BD. “The test eliminates human subjectivity in reading the result, because there is no guessing game about one line or two, as is sometimes the case with visually read tests. You get a definitive ‘POSITIVE’ or ‘NEGATIVE’ digital display that is dated and
time-stamped in the app, and reporting of the results to a business or organization can also be fully automated. This combination of interpretation and secure reporting significantly reduces the potential for test results to be manipulated or misreported. The addition of ReturnSafe simplifies and streamlines the management of testing results and workplace health and safety solutions.” The BD Veritor™ At-Home COVID-19 Test uses a mobile app to interpret and provide a digital display of testing results in 15 minutes. The test is one of the only at-home tests to fully automate reporting of results to federal and state public health agencies and provides a streamlined experience for optional reporting to businesses and schools. The addition of ReturnSafe gives
those organizations the insights and tools to manage their testing programs at scale. By using the BD Veritor™ At-Home COVID-19 Test with ReturnSafe, employers can effectively collect test results, track who has completed testing requirements on time, quickly identify positive cases to act, manage isolation and quarantine workflows, as well as collect data for compliance reporting. By using the BD Veritor™ AtHome COVID-19 Test, employees can upload their test results from the comfort of their own home via technology that digitally reads and verifies the result and imports it directly into the ReturnSafe Command Center. This removes the need for proctors or manually reviewing tests uploaded into the ReturnSafe system.
UnitedHealthcare extends coverage to Abbott’s neurostimulation therapy for nerve pain Abbott announced that UnitedHealthcare (UHC) has updated its ‘Implanted Electrical Stimulator for Spinal Cord’ medical policy to expand patient access to Abbott’s dorsal root ganglion (DRG) neurostimulation devices for people suffering from chronic pain when medical policy criteria are met. This updated medical policy covers 26 million UHC commercial members and will go into effect on March 1, 2022. UnitedHealthcare’s new coverage assessment provides access to Abbott’s non-opioid DRG stimulation, 56
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the world’s only neurostimulator specifically designed to treat complex nerve pain conditions caused by complex regional pain syndrome (CRPS) or peripheral causalgia, which are forms of chronic pain that that affect the lower extremities up to the hips, including the pelvis, after an injury or surgery, according to a release. An estimated 50 million Americans suffer from chronic pain for whom DRG stimulation represents an important new treatment option. “The addition of coverage for a DRG stimulation therapy by one of the nation’s largest insurers is an
important development for patients living with chronic pain who have exhausted other treatments,” said Kiran Patel, M.D., Spine and Pain Institute of New York. “The new clinical guidance from UnitedHealthcare means that people will now have the ability to consider Abbott’s DRG treatment as an accessible option to manage their chronic pain.” CRPS and causalgia usually follow trauma, amputation, or surgery, such as hernia repair, knee or hip replacement, and result in chronic burning or stinging pain, numbness,
hypersensitivity to touch, and chronic persistent pain in the lower limbs. These conditions have historically been challenging to treat because of the disruption in how the nervous system processes or transmits pain signals often resulting in long-lasting disabling chronic pain. “Neuropathic pain is one of the most prevalent and under-treated forms of chronic pain,” said Pedro Malha, vice president of Abbott’s neuromodulation business. “The new coverage guidance by UnitedHealthcare to
offer these patients DRG stimulation is yet another step forward in providing people with a safe and effective treatment alternative for their chronic pain. We are working with a number of other commercial payors to continue to extend the benefits of DRG stimulation therapy so as many people as possible can benefit.” DRG therapy works by stimulating the dorsal root ganglia (DRG), a bundle of nerves located on the outside of the spinal cord. These nerve structures along the spinal column are
made up of densely populated sensory nerves, and act like traffic lights, regulating signals and sensations that travel through nerve fibers along the spinal column to the brain. DRG stimulation therapy involves implanting a small battery device, typically in the abdomen or buttock, and running thin insulated wires, called leads, near the DRG. The leads deliver electrical pulses to the nerves, which block pain signals from traveling to the spinal cord and the brain thereby reducing pain in specific locations in the body.
can be viewed via Ember’s proprietary cloud-based dashboard. This patented technology allows for precision control, so medicines and vaccines arrive at the required temperature range, ready for use. Cardinal Health plays a leading and critical role in delivering logistics
solutions for specialty pharmaceutical products, which often have unique temperature requirements. As global spending on cold-chain pharmaceutical products grows to more than $21 billion by 2024, it will be increasingly critical to support the market with secure and sustainable cold
Industry News Cardinal Health and Ember Technologies partner to transform the pharmaceutical cold chain Cardinal Health and Ember Technologies, Inc., announced a partnership to offer “the world’s first selfrefrigerated, cloud-based shipping box – the Ember Cube,” according to a release. Ember and Cardinal Health will collaborate to deliver a cold chain solution that ensures product integrity and security throughout the supply chain, while significantly reducing shipping waste in the transport of temperature-sensitive medicines. The Ember Cube is a digital shipping box that features cloud-based temperature reporting, GPS location tracking, and return-to-sender technology, versus the current industry standard for transporting temperature-sensitive medicine which includes single-use ice packs, Styrofoam, and cardboard. The Ember Cube uses an onboard cellular radio to report realtime temperature and humidity tracking and GPS location information that
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NEWS storage solutions. Through its partnership with Ember, Cardinal Health will leverage its technology infrastructure and national presence as a leading distributor of pharmaceutical and medical products to hospitals, pharmacies, and physician clinics to deploy Ember’s cold chain technology, ensuring patients can access lifesaving therapies. Ember’s return-to-sender technology allows each Ember Cube to be reused hundreds of times, reducing waste, and eliminating single-use packaging. Once a healthcare provider has received its shipment of medicine, the Ember Cube uses its built-in cellular radio to communicate with the shipping service to schedule a pickup, automatically providing its current GPS location. Once the Ember Cube notifies the shipping service that it is ready to be picked up, it generates a new shipping label on its e-ink screen and is returned to Cardinal Health’s distribution center.
Healthcare providers expand into shopping malls, replacing anchor retail tenants According to a recent Wall Street Journal report, the Marketplace Mall in Rochester, N.Y., has a food court, arcade games and plenty of fashion boutiques. Soon, it will perform hip replacements and rotator cuff surgeries, too. A closed Sears department store and an adjacent wing of the mall are being reborn as a roughly 350,000-square-foot orthopedic healthcare campus. It will include operating rooms, outpatient facilities and medical and administrative offices. The University of Rochester Medical Center’s $227 million project is part of the recent boom in mall-to-medical conversions. Malls have long been home to urgent-care facilities or doctor’s offices. But in 58
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recent years more property owners have started turning entire sections over to hospitals or clusters of medical tenants.
B. Braun receives FDA approval of Daytona Beach pharmaceutical manufacturing site B. Braun Medical announced that the company has received final approval by the FDA for its new pharmaceutical manufacturing plant in Daytona Beach, Florida. The site will produce 0.9% Sodium Chloride for Injection available in B. Braun’s Excel® Plus IV Bags in 1,000 mL and 500 mL sizes. Consistent with B. Braun’s decades-long commitment to protect patients from exposure to harmful chemicals, the Excel Plus IV bags are not made with PVC, DEHP or natural rubber latex. The new Daytona Beach facility is part of B. Braun’s commitment to invest over $1 billion dollars to alleviate IV fluid shortages by creating additional supply and manufacturing capacity in the United States, the company said. Together with B. Braun’s existing IV solutions plant in Irvine, CA, the company now has strategic manufacturing locations on both coasts. “FDA approval of our stateof-the-art pharmaceutical manufacturing plant in Daytona Beach is a win for patients across the United States,” said Jean-Claude Dubacher, Chairman and CEO of B. Braun of America. “By investing in domestic manufacturing, we are helping to ensure a reliable and consistent supply of vital IV fluids that healthcare providers rely on to treat patients, especially as COVID-19 continues to endanger our communities.” Delivery of products from the Daytona Beach facility are expected to begin in late February.
Medicare ACO participation falls flat in 2022 The number of accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP), the country’s dominant value-based payment program, only modestly increased to 483 in 2022. “Following multiple years of flat or declining ACO growth, the announcement is disappointing and should send a wake-up call to an administration whose goal is to have all traditional Medicare patients in an accountable care model by 2030,” the National Association of ACOs (NAACOS) said in a release. There are still fewer patients in ACOs and ACOs in the program than there were in 2020. There are 46 ACOs starting their first initial agreement period this year, but of these many have previous experience in Medicare ACO programs, including the now-expired Next Generation ACO Model. The MSSP hasn’t rebounded from where ACO participation was before CMS’s 2018 rulemaking, dubbed “Pathways to Success,” that forced more ACOs into risk. Following a high of 561 MSSP ACOs in 2018, participation fell the next two years and to 477 in 2021. Last year, the CMS Innovation Center set a goal to have all traditional Medicare beneficiaries in a care relationship with a provider who is accountable for their quality and total cost of care by 2030. That includes ACOs, and while it’s a lofty goal, it’s one NAACOS strongly supports, but it won’t get there with just wishful thinking. Action is needed to increase participation in ACOs. NAACOS has offered several suggestions to attract new ACOs while retaining existing ones, including increasing ACO shared savings rates, fixing key benchmarking and risk adjustment issues, allowing
How can you help distribution reps sell more while improving outcomes and taking care of the caregivers?
Share Moving Media is committed to providing the med/surg community with timely, important content to help reps thrive during a crucial point in the industry’s history. Reps are turning to Share Moving Media platforms for content in record numbers. Consider the following:
Repertoire’s Web traffic is up 180% over 2021
2-Minute Drills taken are double in 2021 verses 2020
Repertoire Podcasts are up 265% over last year
Repertoire being read digitally is up 225% over 2021
Contact Amy Cochran to learn how Share Moving Media can be your content resource for 2022. 770-263-5279 acochran@sharemovingmedia.com
Share Moving Media is dedicated to providing our customers with the tools to increase their market-share through our publications, educational services and associations for providers, manufacturers and distributors in the business of healthcare.
NEWS more time before requiring risk, minimizing administrative burdens, rethinking quality reporting requirements, and providing more timely and complete data.
PDI announces strategic partnership with APIC PDI has announced a strategic partnership with the Association for Professionals in Infection Control and Epidemiology (APIC) for 2022. APIC is the leading association for infection prevention and control (IPC) professionals, with more than 15,000 infection preventionist (IP) members. The APIC Strategic Partner program establishes long-term relationships with industry partners united in the common goal of advancing the science and practice of infection prevention and control in healthcare facilities and beyond. APIC Strategic Partners play an important role in supporting many of the educational initiatives and services that benefit APIC’s membership, which is comprised of nurses, physicians, epidemiologists, microbiologists, public health professionals and other individuals dedicated to preventing the spread of infection. “PDI is pleased to support APIC as a Strategic Partner this year,” Keith H. St. John, MS, CIC, FAPIC, Vice President, Clinical Affairs, PDI said. “We trust our continued partnership over the past several years helps strengthen APIC’s efforts to create a safer world through the prevention of infection.”
Could port congestion ease in first half of 2022? A report from Supply & Demand Chain Executive says that imports at the nation’s most congested container ports are expected to grow in the first half of 2022. 60
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“We’re not going to see the dramatic growth in imports we saw this time last year, but the fact that volumes aren’t falling is a clear sign of continued consumer demand,” NRF VP for supply chain and customs policy Jonathan Gold says. “Last year set a new bar for imports, and the numbers remain high as consumers continue to spend despite COVID-19 and inflation. The slowdown in cargo growth will be welcome as the supply chain continues to try to adapt to these elevated volumes. Unfortunately, many experts
expect ongoing disruptions throughout 2022 for a variety of reasons.” Congestion has stayed consistent on both coasts; the Port of Los Angeles alone has about 40 ships waiting to dock. With more ships arriving each day and further delays pushing the unloading of cargo until the following month, shifts in import patterns can be difficult to follow. Global Port Tracker reports that U.S. ports are expected to handle 13 million TEUs during the first half of 2022, up 1.5% from the 12.8 million TEUs from the same period in 2021.
Health o meter Professional Scales’ introduces digital and mechanical height rod options for antimicrobial digital platform scale Health o meter® Professional Scales has announced two new height rod options for the Antimicrobial 3001 series scales, a digital height rod 245EHR-3001 and an enhanced mechanical height rod 3001HR. Both height rods have quick and easy to assemble brackets. The 245EHR-3001 market-leading digital height rod provides the most accurate height measurement in its class, with a graduation/resolution of 1mm / 0.1” and a full measuring range of 11 ¾” – 79 ½” / 30cm – 202cm. The new accessory uses solid-state technology, which provides a facility confidence
that a patient’s height will be measured accurately, and workflow will not be interrupted. The built-in reset feature increases accuracy and reliability, and the folding headpiece limits the height rod’s profile, providing safety to patients and caregivers. The 3001HR is a durable aluminum height rod that withstands frequent use, and rigorous
laboratory testing shows that it lasts 2 ½ times longer than similar products. The easy-to-use smooth sliding headpiece and telescoping rod allow the caregiver to read the height measurement quickly and easily. The folding headpiece limits the height rod’s profile, providing safety to patients and caregivers. The 3001HR has an extensive measuring range of 2”-90” in 1/16” increments (6 cm-230cm in 1mm increments). The 245EHR-3001 and the 3001HR are available for purchase exclusively through Health o meter Professional Scales authorized distributors.
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Midmark 626 Barrier-Free® Examination Chair with the Patient Support Rails+ accessory and IQvitals Zone Vitals Signs Monitor shown.
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Accurate, Consistent BP Capture
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= Better BP Contact your Midmark Representative to start the conversation. See all 3 at midmark.com/3BP
Bluetooth is a registered trademark of Bluetooth SIG, Inc. © 2022 Midmark Corporation, Miamisburg, Ohio USA
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EMR Connectivity
™
Tough on germs
At Sri Trang infection prevention is our calling. Ventyv® is the premier brand of Sri Trang USA, Inc. Sri Trang is a proven glove producer protecting the world against infection since 1991. We look forward to protecting you and your patients.
Visit sritrangusa.com/rep or ventyv.com for more information Hello@ventyv.com • Sri Trang USA, Inc. • 5820 W. Cypress St., Ste H • Tampa, FL 33607 Call 1-844-784-5683 (844-STGLOVE)
