Quản trị kinh doanh - Chapter 17: Health care purchasing and supply management

1Chapter 17:Health Care Purchasingand Supply ManagementPurchasing and Supply Chain Management 3rd edition, Copyright 2013 W. C. Benton Jr., All rights reservedContentInventory control The DRG System and Operating Cost Health Care Supply Chain Group Purchasing Organization (GPO) Opportunities in Health Care Supply Management Process Overview of Capital Equipment Acquisition2The Health Care IndustryHospitals are complex organizations providing services including:Inpatient treatment (nursing units), surgery, radiology, pharmacy, laboratoryDietary, housekeeping, physical plant engineering, administrationOutlookExpected to grow and consume an even greater share of GNPChallengesUncontrollable non-salary costs and declining profits3Inventory and Health Care Inventory control An important component in supporting the objective of providing patient care The 2 primary functions of inventory (in the hospital setting):To maximize supply service consistent with maximum efficiency and optimum inventory investment To provide a cushion between the forecasted and actual demand4Complicating Factors Unique to Health CareInaccurate demand estimations Complex patterns of the length of stay and patient mix (types of patients and diagnoses)More accurate forecasts could be made by using DRG or CPP related practices Communication is vital between:The practitioners (medical staff)The supply management function However, communication has traditionally been difficultHospitals as a set of “little fiefdoms”5Complicating Factors Unique to Health Care (cont.)Safety StockHigh cost of stock outs unique to healthcareClassification of the stockout tolerances:Use-location urgencyFacility-location urgencyRegional-location urgencyNo urgency6Operating Cost in HospitalsThe DRG systemA reimbursement system Based on specific diagnosis-related groups (DRG) Flat rate reimbursement based on a patient’s diagnosis Regardless of the associated costs Under the DRG system, reduction of hospital operating cost has become extremely important7Hospital Supply Management TrendsTraining and education have become a key priority Reduction in inventory levels is becoming less important More of the supply managers report to VP-level upper management Including physicians in the materials acquisition process has shown to reduce costs More hospitals are establishing a corporate supply chain management departmentEliminating nonmoving supplies by implementing a stockless distribution service8Health Care Supply ChainCharacteristics:A prolonged cost-based reimbursement systemHigh buyer’s switching cost and dependence on a supplier because of many buyers and few suppliersThe performance criteria is based on hospital value for patientsThere are a variety of organizations that bridge the suppliers and the hospitalse.g., group purchasing organization (GPO)An oligopolistic environment with a relatively small number of GPOs dominate the market9Group Purchasing Organization (GPO)An organization created to leverage the purchasing power of its member hospitals to obtain discounts from suppliersCurrent trends:Approximately 96–98% of hospitals utilize GPO contracts On average, 2~4 GPOs per facility Annually, more than $175 billion is spent through a GPO10Money Flows Related to GPOs11Opportunities in Health Care Supply Management (cont.)Areas of opportunity in supply management:Supply chain planningProduct managementSourcing and contractingDistribution and inventory managementTechnology enablement Supply management must be elevated to an integral component of the hospital executive management team12Capital Equipment Acquisition ApprovalFactors and Decision Rules If two projects are judged to be of equal financial worth, the project which better satisfies the following factors should be chosen:Community needMarketabilityHospital business objectivesNew technology 13Technological Assessment ProcessPriorities must be set beforehandForm subcommittees (interdepartmental planning) including: Medical personnel who use the equipment Physicians Make the committee tour the facility and become familiar with the equipment on handLook into the possibility of upgrading current equipmentConduct interviews of the personnel who use the equipment Rank the needs within and among the departmentsEnter information into a database Develop a comprehensive database Develop a comprehensive, multi-year plan14The Supplier Selection ProcessThe process:Develop a list of functional specifications Each specification is to be categorized as a: Necessary featureDesirable featureA characteristic that is irrelevant or even undesirable Establishing a bid list/initial base of qualified suppliersArrange a pre-bid conferenceReceive bids 15Questions?16