106 episodes

Healthcare management is ever-changing.  Join Lisa Miller and Jim Cagliostro where you will hear from innovators and leaders within healthcare and from other industries. Lisa and Jim will bring you topics on the business and clinical sides of healthcare on strategy, finance, managed care contracting, nurse engagement, physician engagement, new patient care models, patient satisfaction, innovation, leadership, communication, marketing, plus much more.
 
This show will challenge you to think differently through proven strategies and innovative approaches that will help you to elevate your healthcare management and healthcare leadership performance for the ultimate goal of providing exceptional patient care.
 
Enjoy diverse and thought-provoking conversations. Lisa and Jim will present best practices, new strategies, and ideas for you to think about and to implement in your career and your healthcare organization. To contact Lisa Miller, please email: lmiller@viehealthcare.com and on linkedin at https://www.linkedin.com/in/lisamiller/ .

To contact Jim Cagliastro, please email: jcagliostro@spendmend.com and on linkedin at https://www.linkedin.com/in/jimcagliostro/
 
This show is sponsored by VIE Healthcare Consulting; https://viehealthcare.com

The Healthcare Leadership Experience Lisa T. Miller

    • Business
    • 4.6 • 10 Ratings

Healthcare management is ever-changing.  Join Lisa Miller and Jim Cagliostro where you will hear from innovators and leaders within healthcare and from other industries. Lisa and Jim will bring you topics on the business and clinical sides of healthcare on strategy, finance, managed care contracting, nurse engagement, physician engagement, new patient care models, patient satisfaction, innovation, leadership, communication, marketing, plus much more.
 
This show will challenge you to think differently through proven strategies and innovative approaches that will help you to elevate your healthcare management and healthcare leadership performance for the ultimate goal of providing exceptional patient care.
 
Enjoy diverse and thought-provoking conversations. Lisa and Jim will present best practices, new strategies, and ideas for you to think about and to implement in your career and your healthcare organization. To contact Lisa Miller, please email: lmiller@viehealthcare.com and on linkedin at https://www.linkedin.com/in/lisamiller/ .

To contact Jim Cagliastro, please email: jcagliostro@spendmend.com and on linkedin at https://www.linkedin.com/in/jimcagliostro/
 
This show is sponsored by VIE Healthcare Consulting; https://viehealthcare.com

    Waste in the Hospital Supply Chain | E. 105

    Waste in the Hospital Supply Chain | E. 105

    An estimated 40% of expenditure in the supply chain goes to waste. CEO Luká Yancopoulos explains to Jim Cagliostro how Grapevine Technology aims to put the power back into the hands of hospitals.
     
    Episode Introduction 
    Luká explains how Grapevine can help hospitals save up to 80% on a single line item, how even small healthcare businesses spend six figure sums on the supply chain each year, and how to frame the reality of years of overspending to his clients. He also reveals three key ways that hospitals can lower the expense of their vendor management. 
     
     
    Show Topics
     
    The power of building networks
    Supplies are a huge expense in healthcare
    Up to 80% of spend may be waste
    Connecting the source of supply to the end user
    Framing harsh truths on expenditure
    Seeing value every step of the way
    Leadership tip: deliver solutions to real problems



    03:12 The power of building networks
    Luká said Grapevine can help its clients to save 70-80% on a single line item. 
    ‘’So Grapevine is working to make it very easy to basically manage your existing network. We've got healthcare businesses. They usually come to us, and they've worked with a handful of suppliers over the years. They think of each of these suppliers as their supplier for blank, fill in the blank, and Grapevine rewrites that. We think they're all your suppliers, they're all your network. Every time you add an item to cart from one of them, let's make sure it's the best price and that your other suppliers that you already trust and know don't have the same exact product at a cheaper price. Oftentimes, they do. We've basically redirected spend from one major distributor to another major distributor, saving the customer or the healthcare business 70%-80% on a single line item. The thing like a Becton Dickinson or a BD catheter or infusion pump or something they buy, and they have a bad habit of buying it from the wrong guy. So we basically let them link all their suppliers with the click of a button to a single screen, read in their current offerings, and tell them where to redirect their spend, acting as a traffic cop if needed.’’
     
    05:14 Supplies are a huge expense in healthcare
    Luká explained that even small healthcare businesses are spending six figure sums on supplies every year. 
    ‘’Certain medical specialties get hit harder than others. If you're performing surgery, obviously, you're burning through a lot of supplies, you're using anesthesia, you're using all sorts of things that maybe your average urgent care clinic won't need. So we focus on specific specialties that have a high consumption rate of important and expensive technologies, things like oncology, dermatology, surgery, these sorts of things. Even a small healthcare business is spending six, seven figures on medical supplies and pharmaceuticals, like, a customer that comes to mind, a family-owned dermatology practice in upstate New York, and Rochester, New York is spending $200,000 a year pre-Grapevine on medical supplies. So like the instruments and whatnot, they're using sutures and implants and this and that, and then they're spending another million a year on injectables. Things like lidocaine, fillers, and different sorts of things of that realm.’’
     
    08:38 Up to 80% of spend may be waste 
    Luká explained why a single supplier can’t offer hospitals the lowest price for every item. 
    ‘’I think that, in some cases, it's as much as 80% of the spend on supply is fruitless and extraneous. As far as what makes up those inefficiencies, there's a number of things. There's a classic idea that I am a strong believer of, that no one person or entity can be the best at everything. So even if you're comparing suppliers of the same business model, these large distributors, we could talk like McKesson, Henry Schein, Medline, the list goes on and on. Every one of those has built supply chains like warehouse fulfillment, shipping teams, cus

    • 27 min
    Using AI to Enhance the Hospital Supply Chain | E. 104

    Using AI to Enhance the Hospital Supply Chain | E. 104

    The US healthcare sector has struggled to put innovations like AI into practice. Mara Cairo explains the advantages of applying machine learning and AI for hospitals to Jim Cagliostro.
     
    Episode Introduction 
    Mara explains why the first step towards successfully embracing AI is literacy, the challenges hospitals face in system integration and why AI isn’t intended to replace humanity in patient care. She also illustrates the benefits of AI for healthcare, including predicting patient no-shows, effectively managing inventory, and reducing costs, and explains why successful leadership means getting out of the way. 
     
    Show Topics
     
    Taking the first step towards AI literacy
    The challenges of AI in healthcare
    Applying AI across industry sectors
    Anticipating patient no-shows
    The impact of AI on cost reduction initiatives
    Leadership tip: Hire the right people and get out of their way 



    03:48 Taking the first step towards AI literacy 
    Mara said AI literacy helps to overcome resistance to AI.
    ‘’Really the most important thing is AI literacy. It's just like learning what AI is, what it isn't, the types of problems it's really great at, the types of problems you shouldn't use it for. On the earlier side of the spectrum, we have lots of training and education really meant to get industry partners, but also the general public. We're working even with K-12 teachers and students now ... to make sure that everyone has that literacy because it's just becoming more and more important to kind of arm yourself with the information because we're being inundated with information and news articles and scary stories. So it starts with literacy, that's the first part, and then kind of evolves from there hopefully.’’
     
    05:46 The challenges of AI in healthcare
    Mara said the complex needs of healthcare mean hospitals struggle with system integration. 
    ‘’There are different disciplines. Each maybe has their own labor agreements, regulation and whatnot. So when we think of human resources as a piece of inventory, that gets quite complicated quickly. Another thing, supply level. Inventory levels are complex. We kind of all saw it in COVID. The demand can spike really, really quickly. And you don't necessarily know when that's going to happen, right? So these surges can catch everyone off guard. And maybe traditionally it's been harder to anticipate when these surges might appear. Luckily, maybe machine learning is a tool that can help us with that. Also, just I think the shelf life of different supplies is unique to healthcare. You have to be really, really careful about storage and transportation requirements. And all of that is compounded by distance and transportation costs. Especially in Canada, in the far north, those care locations, they're really dependent on certain supplies, but if there's a road closure or a snowstorm or something, it's further complicated. The inventory supplies and healthcare are potentially life changing, right? So it's just so much more important that that is managed properly. And that complicates things. I think overall, in general, we've just seen that healthcare systems can struggle with system integration.’’
     
    08:30 Applying AI across industry sectors
    Mara gave examples of how AI helps with demand forecasting and warehouse management. 
    ‘’Some of the really cool projects we've worked on with our industry partners in the supply chain space, but more in the kind of consumer goods area are things like demand forecasting. So helping them better predict what items they're going to need and when. What's really great again about working with our supply chain partners is they have a ton of data, historical data. And that's really, really important. When we start looking to build machine learning solutions, we often rely heavily on that historical data to be able to make those predictions about the future. So the demand forecasting problem is really ripe for

    • 25 min
    Data and Research in Healthcare Analytics | E. 103

    Data and Research in Healthcare Analytics | E. 103

    2024 has been described as a financial ‘’make or break’’ year in healthcare. SpendMend Research Supervisor Zachary Markham explains to Jim Cagliostro why time and data are money for hospitals.  
     
    Episode Introduction 
    Zach explains why the lack of timely, accurate data can delay recovery of credits, and why most hospitals only have 50% visibility into their spend and accounts payable processes. He also shares why duplicate payments and credit on spend are the top two methods for recovery of costs, and highlights how uncovering dark data saved SpendMend clients $413 million in 2023.
     
    Show Topics
     
    Data analysis identifies duplicate payments
    Timely data is vital to maximize cost savings
    The significant cost savings potential hidden in dark data
    3 challenges to gathering hospital data
    Positivity and communication skills are essential in leadership
     
     
    02:18 Data analysis identifies duplicate payments 
    Zach provided a ‘’birds eye view’’ of data analysis.
    ‘’So, when we initially get a client's data in, a hospital's data, we jump right on that data and we go ahead, we search account numbers and vendor contact information for each. So, if it's a larger healthcare system, we'll search for each entity within that healthcare system. We'll search for account numbers for all those, as well as the contact information for vendors. And then, for duplicate payments, that's a large revenue stream for us. So, that starts in the data scrub team. They scrub down the data and identify some good potential duplicate payments. And a duplicate payment is just an invoice that was paid twice for one reason or another. And once the data scrub team is done with that, they'll pass it off to us and we'll go into our client's imaging systems, where they store their invoices and we will pull those invoices and pass it back over to the data scrub team for validation. And I guess the third one here would be just various invoice pull requests for other departments, including the tax team, purchased services, as well as med device, just to name a few. And then, the last one I'll cover here just for the bird's eye view, PHIQ, which is protected health information. So, we've talked about data and it's extremely important to obviously protect our client's data, but it's equally, if not more important, to protect the patient's data as well.’’
     
    05:24: Timely data is vital to maximize cost savings
    Zach said hospitals sometimes don’t obtain credits for years if price discrepancies aren’t found quickly.  
    ‘’I'll give you an example from my time as a pricing analyst. So, as a pricing analyst, we would review data price discrepancies that were about one to two years old from present from what they were currently paying, the hospitals were paying. So, we'd go through identify, "You're paying this vendor $20 for this item, when you should be paying $10 for that item," just as an example. And we would get that and working one to two years behind them. I guess the quicker that we would finish our review and then turn that back into the client, they'd be able to mend the price that they're paying, get it back to the contracted or agreed upon price. And also, collect the credits that were outstanding for the time that they were overpaying. So, I guess the sooner you can identify that you're paying at a higher rate than the contracted price for items, the sooner that you can correct it and get credits from the vendors.’’
     
    07:44: The significant cost savings potential hidden in dark data
    Zach said hospitals only have 50% visibility into their spend and accounts payable processes. 
    ‘’Dark data is information that is hidden or not visible to a hospital for a variety of reasons. But it comes down to them not having the time, resources, or insights to uncover their own data blind spots. And I like to think of this kind of as a puzzle. So, when a hospital or healthcare system hands over the

    • 23 min
    Workforce Development: Building the Next Generation | E. 102

    Workforce Development: Building the Next Generation | E. 102

    US healthcare is facing a severe shortage of workers at every level. 6.5 million are expected to leave their jobs by 2026. Geoffrey Roche addresses the challenges in building a new workforce with Jim Cagliostro. 
     
    Episode Introduction 
    Geoffrey highlights the impact of the current staffing crisis in healthcare, and why leadership needs to evolve from a transactional to a heart-centered approach. He also explains why delays to access in care can cost hospitals up to $1 million every month, how one community college turned away over 13,600 qualified students from a program, and why every healthcare leader should become a mentor.
     
    Show Topics
     
    The impact of an ongoing workforce crisis
    A changing approach to healthcare leadership
    Industry and academia must connect to support the workforce
    Access to care delays may cost hospitals $1 million every month
    Delayed care leads to poorer patient outcomes and higher costs
    Qualified students can’t access vital healthcare programs
    All healthcare leaders should mentor
     
     
    02:33 The impact of an ongoing workforce crisis  
    Geoffrey said the staffing shortage, combined with retention challenges, are impacting access to care. 
    ‘’… we sit at a huge inflection point. Probably without question the most challenging time in our nation's healthcare workforce is, as we speak today, certainly not that dissimilar from 2023. And when we look at it, we've got a significant supply and demand challenge. We know that there are not enough individuals graduating from college in pretty much every aspect of a healthcare program. We also know that retention still remains a very significant challenge, whether it's a clinical role or a nonclinical role. I think we have to be honest though about the impact that we are all seeing and will continue to face, particularly in the licensed areas of our healthcare system. It doesn't go a day where I talk to somebody and they share an access to care delay, whether it's in imaging, whether it's in lab, whether it's in outpatient or inpatient services. We're certainly at a very, very difficult time.’’
     
    06:00 A changing approach to healthcare leadership
    Geoffrey said leaders in a multi-generational workforce need to demonstrate empathy and not judge. 
    ‘’I think leadership as a whole is taught very differently, right? And different points in time, different generations, the way that they have been taught leadership in some ways was command and control, which some would argue is more like transactional. And as we further see, we've got how many different generations, some people say five, some people say six. Whatever the number is, we've got more generations in the workforce than ever. And what we know is that our younger and our future generations have a much different view of leadership than previous ones. And we know that connection, respect, empathy, really this desire to understand that it's not going to just be the status quo, is not going to be the future of leadership when we look at all the different generations. And so it's really incredibly important that we have leaders in healthcare that can relate and understand and demonstrate empathy and not judge. I always say nobody should be judging on generations. I am the first to say I'm a millennial, but that doesn't mean right away go in and talk about, "Well, millennials leave jobs." That has no business in this conversation. What does have is how do we work together to achieve outcomes and results? And ultimately, I think if a leader can find connection with a person and help drive them, mentor them to achieve results, everyone's going to be rowing the oar in the right direction.’’
     
    08:08 Industry and academia must connect to support the workforce
    Geoffrey explained why collaboration is vital to improve access to care delays. 
    ‘’….we have significant access to care delays in the healthcare system today where whether you're going for

    • 19 min
    Sufficiency in the Midst of Uncertainty | E. 101

    Sufficiency in the Midst of Uncertainty | E. 101

    Tom Pierce, the President of Integrated Information Systems Incorporated provides valuable insights based on his diverse background in problem-solving, logistics modeling, and consulting. 
     
    Introduction Our guest, Tom Pierce, the President of Integrated Information Systems Incorporated provides valuable insights based on his diverse background in problem-solving, logistics modeling, and consulting. The episode explores the impact of technology and human behavior on the supply chain, challenges in decision-making related to expenses and stock management, and the importance of honesty, transparency, and human connections in supply chain management.
     
    Topics Covered The mindset required for effective decision-making in healthcare expenses
    The social and psychological dimensions of business decisions
    Transparency and human connections in supply chain management
    Data quality challenges and human intervention with digital technologies
    Overseas supply procurement and its implications
    The importance of truthfulness in buyer-supplier communication
    The bullwhip effect and technology's role in accelerating it
    Cost-risk versus schedule-risk: organizational motivations
    The impact of just-in-time vs. just-in-case inventory strategies
     
    2:45 The Impact of Technology on Problem Solving
    "Once computers made their appearance, and yes, I am so old that I learned how to use a slide rule and the calculator was in advance, so I'm that old, but as computers came on the scene, the only reason I was interested in them was because they could help me do things to solve problems quicker, more efficiently, all of that. So I've grown up with the introduction of technology into previously very human, very brute force, mental math, pencil and paper, problem solving, but it's very hard to condense 40 years of what technology has done to the ways we solve problems and the ways we create new ones. Everything we did humanly good and bad has been accelerated and amplified by technology.:
     
    6:17 The Impact of Technology on Human Behavior
    "It's rather amazing how much our computers have been created in our own image and exemplify, manifest the same flaws that we as people exhibit when relating to each other, but it's less inhibited."
     
    10:34 The Impact of Financial Incentives in Organizations
    "I don't think that's a bad thing. I think people should be rewarded financially and get fairly compensated for their investment in in technology, you know, and people that do well should be rewarded for doing well. I got no problem with that."
     
    13:26 "Just in Time Inventory Practices"
    Well, if it's not broke, don't fix it. Well, that doesn't mean don't have spare batteries. When my flashlight goes out in the middle of the night, I want to be able to go into my pantry or my workshop and get more batteries, but that's not lean unless you can predict exactly how many batteries you're going to need and then the ideal becomes, "Well, we'll just have an Amazon ready to deliver to batteries same day," and just reduce and reduce and reduce the carrying cost of your inventory, and I blame the Walmarts and the Targets of the world for doing just that. They leaned out their own cost by offloading those costs to their suppliers, so the just-in-case part, right? In case of disaster, well, that's your vendor's problem, because your big and powerful and you can insist, if you want to do business with us, then you've got to maintain stockage objectives and you've got to reply 24/7 replenishing my shelves, because I don't want to maintain a big warehouse. I just want to move parts through.
     
    15:07 Just in time versus just in case
    "If your only motivation is profit, that's a really good business model for a finance person. Mhmm. It's not a great business model if what you're really trying to do is continuously improve your product and your service and the delivery times and, you know, customer lead times, all that."
     
    19:30 The Dec

    • 34 min
    Healthcare Cost Savings: Surprises & Predictions | E. 100

    Healthcare Cost Savings: Surprises & Predictions | E. 100

    After 25 years and $1 billion of hospital cost savings, Lisa Miller is joined by Rich Dormer, Bryan Covert, and Pandu Mitre to celebrate this landmark episode of THLE.  
     
    Episode Introduction 
    Together, the team discuss the cost savings surprises of 2023 and look forward to 2024. Insights include the two-tiered approach to cost savings goals that all hospital leaders might want to consider, and why difficult vendor negotiations will continue in 2024. The team also review the potential impact of AI on cost reduction, why finding hidden costs always comes back to line-item data, and why every hospital needs a spend data strategy in 2024. 
     
    Show Topics
     
    Building strong teams in a post-Covid era
    Vendor negotiations became more difficult in 2023
    ‘’It always goes back to the line-item analytics’’
    A two-tiered approach to cost savings goals
    The hidden cost savings in AI 
    Vendors will continue to say ‘’no’’ in 2024
    Two keys to an efficient supply chain
    More buying power doesn’t always equate to ‘’best pricing’’ 
     
     
    02:26 Building strong teams in a post-Covid era 
    Rich said healthcare systems are hiring people with a broader skillset that need an accelerated learning curve. 
    ‘’…one of the biggest things that we saw this year, or I saw specifically was a lot of organizations were building those sourcing and supply chain teams. Where in the past they've been really lean and relying on GPO or other types of resources. But with COVID and the need to really do a lot of contracting, a lot of complicated agreements, most organizations recognize that they really needed to build their teams. But the issue that a lot of them have is that there's really only a limited pool of seasoned players on the market essentially. Therefore, when they look to hire, they're hiring a lot of people that are either early in their careers or they come from a different industry which when we look at healthcare it's really unique and complex. So bringing someone from the manufacturer industry coming in and looking to do a sourcing or some sort of negotiation in healthcare, it's very different. So with these large obviously needed cost savings goals for organizations, these newer teams that are being put together need to really accelerate their learning curve. So we've seen a lot of conversations around the support that they need. Right? And probably the biggest one that we keep hearing is that access to data, really that line-item invoice level data is critical to be able to do these large initiatives that a lot of them are working on now and they struggle to get that information. Because the biggest piece is to really do analytics around it and they're doing it off of projected data or vendor supplied information which is not always accurate. So those are the biggest pieces for a lot of these teams coming in and really trying to meet these aggressive goals that are needed for these organizations to maintain their profitability and not only with analytics and data but also negotiations.’’
     
    12:06 Vendor negotiations became more difficult in 2023
    Bryan said utilization and market data are just two elements hospitals can us to combat vendor refusal to reduce costs. 
    ‘’I think the most surprising thing for me was just how difficult negotiations with vendors became in 2023. To your point and Rich's, point earlier we saw on the hospital side more investment in supply chain teams, probably some of the largest cost savings goals we've seen at our clients throughout the years. Just because costs were going up and they're trying to come up with ways to combat them, the vendors had a really solid narrative. We had 8% inflation; their costs were up. They're also coming out of a time with COVID where a lot of the vendors had to really step up in supply services and crunch time, so they really developed stronger relationships with the stakeholders at the hospital. And then we'

    • 51 min

Customer Reviews

4.6 out of 5
10 Ratings

10 Ratings

The Medical Strategist ,

The Healthcare Leadership Experience with Lisa Miller

I found the show to be quite interesting and it shared some helpful points to implement in the future.

Top Podcasts In Business

The Ramsey Show
Ramsey Network
Money Rehab with Nicole Lapin
Money News Network
NerdWallet's Smart Money Podcast
NerdWallet Personal Finance
The Diary Of A CEO with Steven Bartlett
DOAC
Planet Money
NPR
The Money Mondays
Dan Fleyshman

You Might Also Like

Healthcare Leadership Excellence
Karl Pister
Coaching for Leaders
Dave Stachowiak
Freakonomics Radio
Freakonomics Radio + Stitcher
The Daily
The New York Times
Up First
NPR
Pod Save America
Crooked Media