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PubMed1996

Retooling without layoffs.

Hospitals nationwide are looking for ways to cut expenses in hopes of attracting managed-care contracts and in preparation for expected restrictions in the growth of the Medicare and Medicaid programs. But they're learning that the pink slip usually isn't the best way to achieve those cost reductions.

Cost Control↗
PubMed1996

Bracing for survival.

As health care continues to move toward smaller, more consolidated support services, materiel managers will face constricted promotion and employment opportunities. Flexibility and a willingness to embrace change as the occasion for personal and professional advancement will be two hallmarks of success. This article focuses on outsourcing and integrated delivery networks by discussing the challenges and opportunities they present.

Contract Services↗
PubMed1997

The cost management organization: the next step for materiel management.

With Materiel Management's transition over the last decade from simple logistics to analysis and cost management, it has gained recognition as a key part of the management team responsible for supplies, equipment, standards, and associated processes to identify, purchase, store, distribute, issue, and dispose of supplies and equipment. The materiel manager's job consists of putting the right product in the right place at the right time and in the right quantity at the best total delivered cost. In this context, Materiel Management has made powerful impacts to lower costs associated with: Distribution--costs have been lowered by actively adopting advanced supply channel management techniques such as primary suppliers, JIT, stockless programs, case cart/custom kit/procedure based delivery systems, modified stockless programs as well as margin management through cost plus, flat fee, or margins paid per activity. Cost of goods--lowered through aggregated purchasing in the forms of regional and national purchasing alliances and local capitation or other gain/risk share programs. Internal process costs--lowered by out-sourcing and/or integrating supplier processes and personnel into operations via partnership approaches. We have also reduced transactional costs through EDI transaction sets and the emerging use of the inter and intranet/electronic commerce, procurement cards, and evaluated receipt settlement processes. De-layering--We have lowered the operating costs of Materiel Management overhead by re-design/re-engineering, resulting in reduced management and greater front line authority. Quality--We have learned to identify and respond to customer and supplier needs by using quality improvement tools and ongoing measurement and monitoring techniques. Through this we have identified the waste of non-beneficial products and services. We have adopted supplier certification measurers to ensure quality is built into processes and outcomes. With so much already accomplished, it should be easy to rest on these laurels and simply operate. However, we believe that this is just a beginning. A new generation of highly educated leaders are emerging and taking advantage of the contributions of pioneers who laid the ground work. These new leaders will have advanced management, statistics, and behavioral sciences skills. They will be analysts and organizational motivators. Their goal will be to improve financial and clinical performance measured by real time process and performance data. The new leaders will have information at their fingertips thanks to significant leaps forward in data collection, automated continuous replenishment processes, and software designed for better management of clinical and cost outcomes. This article documents significant Materiel management accomplishments and conceptualizes cost management processes. The cost management organization is the logical evolution in our efforts for better outcomes in healthcare Materiel management.

Contract Services↗
PubMed1995

Accounting for the transition from inpatient to outpatient surgery.

This article reports on some of the factors that have advanced and impeded hospital progress in moving from inpatient to outpatient surgery. Early on, patients, physicians, and hospital administrators all agreed that outpatient surgery had an intuitive appeal. Patients liked it because they didn't have to go in the hospital. Physicians liked it because they could get in and out of the outpatient surgery center more easily than the main hospital operating room. Administrators recognized the inherent appeal of outpatient procedures but were unable or unwilling to switch services from inpatient to outpatient for a variety of reasons. First, empty hospital beds and diminished scope of inpatient operations are a threat to the power of administrators. Moving surgery from inpatient to outpatient settings reduces inhouse operations. Second, reimbursement incentives were definitely in favor of continued inpatient care long after technology was in place for outpatient care. The third and most critical reason was that cost data on outpatient operations were just not available for making decisions on when to move into the outpatient setting. This review of the literature was intended to document the lack of relevant cost-based accounting. Instead, many other factors that more directly slowed progress were encountered. More than anything, this illustrates the erratic course of progress in health care reform.

Ambulatory Surgical Procedures↗
PubMed1998

No cost-saving target too small for this hospital's product reengineering program.

It pays to put every product purchase under the microscope. By creating a multidisciplinary value analysis committee to review staff ideas on potential savings for products, as well as internal services and processes, this New Jersey health care provider is slashing costs and standardizing products across clinical service lines. Learn how the committee operates and what it's doing to get vital employee participation, plus read about specific products targeted for cost reduction.

Cost Savings↗
PubMed1998

Short supply. In California, consolidation threatens emergency care.

In the wake of hospital downsizing wrought in large part by managed care, California is witnessing an alarming shortage of emergency services capacity. In one prominent case last year, a woman injured in an automobile accident died after emergency personnel carted her to three hospitals trying to find an ER that was staffed to care for her properly. Officials warn that it's an issue that has national significance.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1998

Laboratory consolidation. Minimizing the angst and aggravation.

In response to decreasing payment structures, many labs have begun considering those programs that strike fear in the hearts of employees everywhere--consolidation. To avoid whispers of layoffs, salary cuts, and scheduling disasters that become grist for the rumor mill, try constant communication and a structured management.

Health Facility Merger↗