How is SpendMend Just Like March Madness?!

SpendMend Team

By  Brett Stuebinger, Senior Vice President, Client Value & Innovation

 

March Madness, the annual college basketball tournament, is a thrilling whirlwind of competition, upsets, and nail-biting finishes. But how could SpendMend, the leading provider of cost-saving solutions for the healthcare industry, possibly share any similarities with this highly anticipated sporting event?

 

At first glance, it might seem like a stretch, but upon closer examination, it’s clear that both March Madness and SpendMend offer valuable lessons in strategy, teamwork, and achieving success.

 

Here are the 6 Rounds of similarities between March Madness and SpendMend!

 

First Round: Unpredictability and Discovery

One of the most exciting aspects of March Madness is the unpredictability of the games, where a single moment can change the course of a match. This element of surprise and discovery is also present in SpendMend’s approach to uncovering savings opportunities. Just as fans eagerly watch to see which teams will rise to the occasion, SpendMend diligently sifts through data to reveal unexpected cost-saving possibilities that can propel an organization towards financial success.

 

Second Round: Building a Winning Bracket

Creating a winning bracket for March Madness requires a thoughtful combination of knowledge, strategy, and intuition. Likewise, SpendMend helps organizations build their own “winning brackets” by developing comprehensive cost-saving strategies tailored to their specific needs. By carefully analyzing data and addressing inefficiencies, SpendMend guides businesses through each stage of their financial journey, ultimately leading them to a championship-worthy performance.

 

Sweet Sixteen: Agility and Adaptability

March Madness is all about adaptability, as teams must quickly strategize against a variety of opponents and adjust their game plans accordingly. SpendMend mirrors this adaptability by offering flexible, customized solutions to suit each organization’s unique needs. By remaining agile and responsive, SpendMend helps businesses stay ahead of the curve and achieve their cost-saving goals.

 

Elite Eight: The Power of Data-Driven Decisions

Just as sports analysts and enthusiasts’ pore over player statistics, team records, and game footage to predict the outcome of March Madness games, SpendMend uses advanced analytics and data mining techniques to identify potential cost-savings and inefficiencies in your organization’s spending habits. In both scenarios, data-driven decisions are key to achieving success.

 

Final Four: Teamwork Makes the Dream Work

Success in the NCAA tournament often hinges on effective teamwork and collaboration. Likewise, SpendMend emphasizes the importance of collaboration between different departments within an organization. By fostering clear communication and cooperation, SpendMend helps organizations identify and address inefficiencies, ultimately leading to a more cohesive and high-performing team.

 

National Championship: The Thrill of Victory!

There’s nothing quite like the exhilaration of a hard-earned win in March Madness. SpendMend aims to bring that same sense of accomplishment to organizations by celebrating cost-saving victories and milestones. By recognizing and celebrating these achievements, SpendMend fosters a positive, success-driven culture that motivates teams to continue striving for greatness.

 

The Victory Celebration

While March Madness and SpendMend may seem worlds apart, they share key similarities that reveal valuable insights into strategy, teamwork, and success. By embracing data-driven decisions: leveling the playing field: fostering collaboration: staying agile: and celebrating victories: organizations can harness the spirit of March Madness and translate it into lasting success. So, as you enjoy the exhilarating games of the NCAA tournament, remember to channel that same passion and drive into your organization’s cost-saving efforts – and experience the thrill of victory with SpendMend by your side.

The Uncanny Similarities Between St. Patrick’s Day and SpendMend

SpendMend Team

By Tomás Ó Floinn ( Tom Flynn ), VP of Marketing

 

St. Patrick’s Day, a celebration of Irish culture, is known for its festive atmosphere, community gatherings, and bursts of vibrant green.

 

But did you know that this beloved holiday has quite a bit in common with SpendMend, the leading provider of cost-saving solutions for the healthcare industry? At first glance, these two entities may seem like an unlikely pair, but delve a little deeper, and you’ll discover that they share some remarkable similarities.

 

  1. Uncovering Hidden Gems: Patrick’s Day is associated with the mythical story of leprechauns, mischievous creatures said to hide pots of gold at the end of a rainbow. Similarly, SpendMend uses advanced analytics and data mining techniques to illuminate dark data and uncover hidden savings opportunities in your organization’s spend data. In both cases, the pursuit of hidden treasure leads to a delightful reward.
  2. Embracing Transparency: Just as St. Patrick’s Day brings people together in the spirit of camaraderie and open celebration, SpendMend fosters a culture of transparency in business. By providing clear insights into your organization’s spending habits, SpendMend enables you to make informed decisions, streamline processes, and improve overall financial health.
  3. Going Green: When it comes to St. Patrick’s Day, green is the color of choice – it’s everywhere from clothing and decorations to the green-tinted beverages people enjoy. SpendMend, too, promotes “going green” through its cost-saving solutions, which often lead to more sustainable business practices. By identifying areas for improvement, SpendMend helps organizations reduce waste, conserve resources, and ultimately lessen their environmental impact.
  4. Driving Out Snakes: Legend has it that St. Patrick drove all the snakes out of Ireland, symbolizing the triumph of good over evil. In a similar vein, SpendMend strives to drive out inefficient spending and fraud from your organization. By meticulously examining your data, SpendMend identifies potential risks and inefficiencies, helping you to protect your organization’s bottom-line and maintain a culture of integrity.
  5. Celebrating Success: Patrick’s Day is a time for rejoicing and revelry, as people come together to celebrate their shared heritage and accomplishments. SpendMend, too, values the importance of recognizing achievements, both big and small. By partnering with your organization and celebrating your cost-saving victories, SpendMend fosters a sense of unity and pride among team members, motivating them to continue working together for a prosperous future.

 

While SpendMend and St. Patrick’s Day may seem worlds apart, they share some key similarities that can inspire us to think about how we approach spending and financial management in our organizations. By uncovering hidden gems, embracing transparency, going green, driving out snakes, and celebrating success, we can foster a positive, growth-oriented culture – just like the spirited festivities of St. Patrick’s Day.

 

So, the next time you don your favorite green attire and raise a glass to the luck of the Irish, take a moment to appreciate the valuable lessons SpendMend and St. Patrick’s Day have in common.

Slán go fóill

The Hidden Costs of False Positives: Why Preventative Profit Recovery Tools are Not Enough

SpendMend Team

By  David Hewitt, Senior VP of Sales

If your business is currently using a preventative profit recovery tool to address and reverse financial leakage, it’s important to be aware of its limitations and drawbacks. While marketed as a comprehensive solution, these tools have been found to produce numerous false positives and require a significant amount of manual intervention to research, validate, and correct issues. According to industry research, these tools only identify a small percentage of potential losses, usually between 15-20% of actual losses. Furthermore, the implementation of these tools often requires a considerable amount of internal research and resources, which can offset any potential savings.

One of the primary issues with preventative profit recovery tools is their limited scope. These tools often provide only a narrow review of a hospital’s payments and transactions, which can cause them to overlook key areas of potential loss, especially when dealing with contracts that require manual sampling of contracted items and terms, as well as vendor statements which must be collected from hundreds (if not thousands) of disparate locations outside the hospital. As a result, preventative tools will provide some insight, but they do not shed any light on dark data, nor do they offer a comprehensive understanding of financial leakage throughout the entire Procure-to-Pay process.

Further, the high incidence of false positives in payment prevention technology means that these tools require a significant amount of manual research and manipulation to review and validate the issues identified. According to Andreas Weiskam, partner at Sapphire Ventures and investor in the Profit Recovery space, “Up to 60% of claims generated by preventative software could represent false positives.” This can result in additional costs and time spent resolving issues, which can ultimately offset any potential savings. Even if your controls are dialed down, you may still experience a modest 25% false positives and will still require hours of manual effort and research you simply cannot afford – and again, that is only in pursuit of a partial solution.

To address these concerns, companies should remain on the tried-and-true methodology of contracting with an expert recovery audit firm that can provide a more comprehensive solution for profit recovery. These expert firms can leverage all the same (or very similar) algorithmic technology you would have otherwise plugged into your system to identify and recover lost funds quickly and efficiently. In addition, these expert practitioners can also utilize a range of strategies and tools to address financial leakage across the entire Procure-to-Pay process.

With a deep bench of experts at their disposal, hospitals can rest assure they are receiving the most accurate and comprehensive view of their financial records, as well as prompt and thorough recovery of lost funds. Add to that, many recovery audit firms actively generate tangible recommendations for real-time and forward-thinking improvements that will demonstrably prevent errors from ever happening again. Payables prevention and screening technology does not do this.

Industry experts also echo these concerns regarding the limitations of preventative profit recovery tools. According to Rob DeVincent, VP of Product Marketing at Corcentric, “Organizations need to have the right people, processes, and technology in place to address these issues proactively.” Similarly, Tom Bohn, CEO emeritus of the Institute of Accounts Payable Professionals, notes that “Preventative measures can help, but without the right people and processes, the lasting benefits of these tools will be limited.”

In summary, hospitals should be aware of the limitations of preventative profit recovery tools and consider investing in a proper recovery audit firm to fully address and reverse financial leakage across the entire Procure-to-Pay process. By taking a more nuanced approach to profit recovery, hospitals can minimize losses, maximize savings and save time and resources. As Dan Andrea, Director of Research at Gartner, advises, “Organizations should work to balance tools and solutions with strong processes, people, and governance in order to truly optimize recovery efforts.”

SpendMend Pharmacy 340B Legislative Update 2023

SpendMend Team

By Rob Nahoopie, PharmD, MS, ACE

Greetings, 340B community! It’s been a while since my last blog article. For those who have been with us for many years, you may recall that prior to joining SpendMend and even before the inception of Turnkey Pharmacy Solutions, we had “The 340B Program Blog.” You’ll note, we borrowed theThe from The Ohio State University – it added an air of authority.  This blog was our beacon to the 340B Community.

Nowadays, I’m proud to say we’ve expanded our outreach beyond our blog and into webinars, newsletters, speaking at shows, and of course the 340B Unscripted podcast, which I have the pleasure of co-hosting with the world’s best moderator (and coolest dude), Greg Wilson.  Add to all of that, we’ve continued to assemble a growing team of experts who have a great deal of experience and a lot to share. As a result, I really only get around to writing one, or maybe two of these blogs per year.

Before diving too deeply into my analysis of current and potential legislation, I want to acknowledge, that as a community, we are very fortunate to have such reliable journalists to serve as our advocates in this increasingly complex (and contentious) space.  340B Health, a membership-based 340B advocacy organization, keeps their finger consistently on the pulse of all things 340B advocacy and legislative. We also have the 340B Report, which always looks out for breaking news and reports to the 340B community. At SpendMend Pharmacy, we see our role as complementing these outlets and sharing our experience, in the trenches, with the covered entities we support.

Although I will be summarizing current legislation, my hope is to add my personal commentary and, where possible, prognostication of where things might go and how that could impact covered entities.

While we are still early in 2023, we have already seen an unfavorable 340B bill introduced. Senator Rosendale (R-MT) introduced H.R. 198  – Drug Pricing Transparency and Accountability Act. It has not made it past introduction and sits in two committees, likely due to it having impact in both the Energy and Commerce and Ways and Means. This bill has a few main goals; 1) to have a 2-year moratorium on non-rural hospital and child site registration, 2) transparency with 340B savings, and 3) modifiers for all Medicaid (FFS and MCO) and Medicare (traditional and managed) claims. This bill has not made it very far, and due to its one-sided nature, likely will not make it through both the House and Senate. With this said, it does create some interesting negotiation points. In fact, if you take a step back, you can see the chess match starting. Move one, introduce a fairly one-sided unfavorable bill to set the negotiation table without offering much in favor of 340B covered entities. Next, we may see a favorable 340B bill that tries to address contract pharmacy restrictions, PBM discrimination, or maybe even Orphan drug exclusion clarifications. It is also possible this step is skipped entirely, and we go right to a mixed bill; one with appropriate give and take for both covered entities and drug manufacturers.

What do we know? On March 2nd, 2023 we heard reports related to the Senate hearing on community health centers (CHCs), and also reported by our 340B outlets noted above, that the National Association of Community Health Centers (NACHC) and the Pharmaceutical Research and Manufacturers of America (PhRMA) may be teaming up to make some combined recommendations to congress that will have both pros and cons for 340B covered entities. Some potential areas in play were announced on March 7th by NACHC as part of their NACHC Capitol Hill Day and a 2-page flyer that was planned for use on March 9th with congress. They outlined five key principles for reform:

  • Preserving: Focuses on making sure the 340B program is stable so that it can fulfill its mission. [No specifics here, but good to clarify and confirm]
  • Reforming: Essentially stating that covered entities who do not provide significant amounts of care to safety-net patients should be removed from the program. [Hmm, seems to be targeting hospitals or at least some of the recent bad press that has occurred]
  • Incorporating: This is targeting contract pharmacy, but in both a manner to allow for contract pharmacy without restrictions and to protect against abuse. [Our CHCs have had significant 340B savings losses due to contract pharmacy restrictions and if they worsen, it could cripple CHCs’ ability to provide the level of charity care they currently provide]
  • Establishing: Here is where we get to transparency and accountability and reporting of 340B information. [CHCs are already required to be transparent, so this seems to be another balancing item that will impact hospitals even more]
  • Create: This focuses on PBM/Payor 340B discrimination. [Both CEs and PhRMA can get behind this one, sorry PBMs and Payors, this one seems inevitable]

I feel like they missed the boat on a great acronym. If they switch 4 and 5 it is PRICE versus PRIEC. And the tag line could be, “If we don’t act now to reform 340B, the PRICE of lost 340B savings will be felt by  patients of our safety net hospitals and clinics.” Also, they should consider changing Create to Creating, my OCD is flaring over here. Just unsolicited advice in case they read this.

Now, I am not sure if this was part of the NACHC and PhRMA joint development, but the pros for covered entities and cons that are more hospital specific are interesting, don’t you think? Regardless, I think it is very possible we see a bill that is in line with these key principles. Think about this: the House is GOP, which is more likely to be in line with something that has a little give and take as outlined above. Then, we have the Senate HELP committee, although Chaired by Bernie Sanders (I-VT), whose Ranking member is Bill Cassidy (R-LA), and Cassidy has been critical of hospitals in the 340B program. So, I am saying there’s a chance!

I initially thought that 340B legislation was a long shot with a GOP House and Democratic Senate; however, there appears to be a deal that can be made here. Currently, the hospitals may be on the outside looking in. It is time for all hands on deck. I am looking at the Senate HELP committee membership right now and I can see I have work to do. Mitt Romney (R-UT) is on the list, so I will be reaching out personally to share how important the 340B program is to our community. Although, I think hospitals need to plan on transparency as the olive branch here. The question is if it is just transparency or use of savings as well.

The fun part about writing a blog article like this is that you get to see if your crystal ball is broken or not. However, this story is not over, you can still make an impact. Don’t just watch things unfold like you are reading a John Grisham novel. Work with your advocacy staff, if you are lucky enough to have one, and if not, then make it happen yourself. Our senators and representatives will only know how important the 340B program is if you help educate them.

Hopefully we get to see many of you at 340B Coalition in San Diego. We have booth 319, SpendMend Pharmacy, back middle-left; come say hello and talk some 340B shop with us. Aloha everyone!

 

Hold the phone! We were about to hit the publish button and just saw the 340B Health update on the NACHC/PhRMA “potential” recommended changes they may make to congress. And all I can say is “Wow” and not in a good way. On March 9th, this group has come forward with a new name and a 10 point Principles list for ensuring the 340B Program benefits patients and “true” safety-net providers (I added the quotes on “true” as it seems to be an intentional word). The new group is named the Alliance to Save America’s 340B Program (ASAP 340B) and includes NACHC, PhRMA, and ten other organizations. I won’t turn this into a dissertation, and this will be a hot topic as we move forward. So, everyone go and read the 10 principles at asap340b.org.  As we are now accustomed to, the main constant with the 340B program is change.

Maximizing Cost Savings: SpendMend’s Proven Approach to Reducing PPI Costs in Hospitals

SpendMend Team

By  Lisa Miller, MHA

As healthcare costs continue to rise, hospitals are under increasing pressure to find ways to reduce expenses without sacrificing the quality of patient care. One area where hospitals can achieve significant cost-savings is in the management of Physician Preference Items (PPIs), which are medical devices, implants, and supplies that are selected by physicians for use in surgical procedures and other treatments. PPIs can account for a significant portion of a hospital’s supply expenses, and without proper management, these costs can quickly spiral out of control.

That’s where the SpendMend PPI cost-savings solution comes into play. With almost three decades of experience in the healthcare industry, we specialize in helping hospitals optimize their resources and their bottom-line by reducing PPI costs. Our three-step approach has been honed over years of working with hospitals to develop the most complete and successful savings strategy for PPIs.

  1. True Understanding of your Physician Preference Items Cost: We constructand compare costs across vendors and compare to competitive pricing in the market.
  2. Collaborative Physician Engagement Strategy: We provide cost-transparency, understanding of current and future trends, and create a strategy that aligns physicians’ needs with the organization.
  3. Negotiate Savings with Your Vendors: We ensure that the organization is aligned behind the negotiation, communication of clear expectations, and present a competitive and achievable tasks.

To support these three pillars and to optimize the cost-savings potential of hospitals’ PPIs, we follow a six-step strategic approach:

  1. Build out a 12-month historical utilization analysis by physician.
  2. Benchmark by construct for true-cost and cost-savings opportunity, and align comparable constructs across vendors.
  3. Identify achievable cost-savings through market intelligence.
  4. Create a strategy to initiate a conversation with physicians.
  5. Have a collaborative discussion with physicians to gain alignment.
  6. Align the organization behind the most effective strategy and executing vendor negotiations.

Our approach delivers numerous benefits that include reducing costs for supplies and services, balancing cost reduction to maintain or improve healthcare quality, and utilize analytics and resources that generate ROI. Our clients have achieved pricing better than industry norms and their peers, obtained physician buy-in and internal engagement, and empowered physicians to drive savings through PPI selection. SpendMend has also reduced costs for supplies and services and maximize savings through professional negotiation services.

Our success is not just due to our approach, but also due to the passion and determination of our team. We are able to create substantial savings in high-cost areas.  A recent client, Kerry Loudermilk, the Senior Vice President & CFO of a large Georgia-based health system had this to say about our solution, “SpendMend’s measurable cost-impact on our organization’s bottom-line was both immediate and sustaining. I could actually see the implemented savings documented on the invoice level. VIE Healthcare Consulting, –a SpendMend company, brought a level of professionalism, creativity, and drive that was infectious to the management leadership throughout our organization and led to many successful cost-savings initiatives for the Health System.”

SpendMend has been providing its PPIs cost-savings approach to the healthcare industry for almost 30 years. During this time, our team has worked with hospitals of all sizes and types, and we have consistently delivered significant cost-savings to our clients. By following our three-step approach and six-step strategic approach, hospitals can achieve meaningful and measurable cost-savings in just a matter of days and weeks, rather than months or years. Our approach has been designed to be as efficient and effective as possible, with a focus on minimizing disruptions to hospital operations while maximizing savings.

The benefits of our approach go beyond just cost-savings. We also help our clients maintain or improve the quality of their healthcare services by ensuring that cost reductions do not compromise patient care. Our team of experts collaborates with physicians and other key stakeholders to ensure that our cost-saving strategies align with the unique needs and goals of each hospital. As a result, our clients have been able to reduce supply costs and contracted costs in multiple areas, such as medical devices, pharmaceuticals, and laboratory supplies, among others.

At SpendMend, we take pride in our ability to deliver measurable results for our clients. Our proven track record of success and our commitment to client satisfaction is what sets us apart in the healthcare industry. We look forward to continuing to help hospitals across the country achieve significant cost-savings while maintaining the highest standards of patient care.