“Having the Tough Conversations”
Collaboration and Relationship Building in Intermountain’s Journey to Purchased Services Proficiency
In 2005, Joe Walsh’s global sourcing and procurement leadership roles at non-healthcare-related multinational corporations were pointing him toward a satisfying and successful career path; he had no intention of leaving his position at a Fortune 500 company. But the loss of both his parents – four months apart, in two different hospital systems in Buffalo, N.Y. – convinced him to change his plans.
“At a time when each of my parents were most vulnerable, neither received the compassionate, high-quality, affordable care they each deserved,” he says. “The impact to my parents and to our family–clinically, financially and emotionally–was devastating. If I had not experienced extraordinary care outside my hometown, I might not have otherwise known of the wide variation of capabilities, performance and practices across hospitals. These events changed my life in many ways. Most relevant, I decided to do whatever I could to help ensure every person in our country has access to excellent healthcare, where the process from diagnosis through treatment to palliative care is transparent and trusted, and where patients and family members are fully engaged in in the decisions they’re making.”
As a result of this personal experience, Walsh decided to commit the rest of his career to healthcare so he could be part of bringing into reality an ideal vision of healthcare. His vision is one by which we can all be inspired:
Imagine a world where we experience healthcare the way we experience wellness…our way, on our terms, on our time. Imagine a world where we play an active role in our own care, in our environment, where we have reliably consistent access to proven treatments regardless of where we live or what insurance plan we carry. Imagine a world where caregivers serve us on our time and talk to us about our health and treatment options in a manner we can understand, where we have a voice in the decisions that are made about our care.
I believe that every family deserves access to a broad set of healthcare services, across the entire continuum of care, where they are engaged in their care, and they can rest at night knowing the care they are receiving will help them achieve the outcomes they desire.
Admitting he’s not a clinician, Walsh also realized other skills could make a difference as well. “I certainly can contribute to this effort by helping hospitals and the supply chain become more integrated, efficient and effective,” he says. Walsh joined Intermountain Healthcare in 2008, initially to lead its non-clinical strategic sourcing team. In time, his responsibilities grew, and today, as AVP, procurement, he oversees strategic sourcing/value analysis, contract management, purchase-to-pay and supplier collaboration.
As it turns out, a Fortune 500 background is helpful when it comes to steering the procurement for a system the size of Intermountain Healthcare. With 22 hospitals, 200 clinics, over 2,500 licensed beds and $1.5 billion in annual purchased supplies, services, software and equipment, the system has offered a good opportunity for Walsh and his team to make positive impacts on cost, quality and outcomes.
Intermountain Healthcare Stats and Structure
Intermountain Healthcare, established in 1975, is a Utah-based system that integrates a broad range of healthcare industry organizations, including an insurance company, a home care organization, a medical group, life flight operations, etc. The IDN employs more than 34,000 people, and had 2013 revenues of $5.4 billion. Intermountain provides about half the inpatient care in Utah and also serves southern Idaho and southwestern Wyoming. Intermountain is defined in MDSI’s The MAX as a strategically integrated health system (“System IV”), meaning that it has an exceptionally high degree of centralized, integrated automation and control, enabling it to drive compliance among its member facilities. In fact, for more than a decade, Intermountain has been named the nation’s first or second most integrated healthcare system by more than one industry rating tool, measuring factors such as services and access, technology, hospital utilization and financial stability.
National Recognition of the IDN
Intermountain Healthcare has been singled out at the national level for its evidence-based care that has resulted in extremely high efficiency, lower than average costs, and superior results. President Barack Obama and the Congressional Budget Office have studied the system as a model of efficiency and lower costs in the effort to craft a workable health care reform effort.
Intermountain Healthcare is also a leader in disease management. There are disease management programs available for asthma, congestive heart failure, hypertension, depression, arthritis, COPD, diabetes mellitus, angina, low back pain, and acid-peptic disease.
To maintain this success, the system focuses on its mission and aligned business objectives at all levels within the organization, from the executive level down through office administration, physicians and unit clerks. In addition, each new employee is trained to achieve the company’s mission and goals.
Intermountain’s Approach to Purchased Services
The IDN is unusual in the industry in having never addressed supply-chain spend without including purchased services. When Intermountain built its supply-chain organization, from day one, services were never out-of-scope.
“We didn’t start with med-surg, and then go to pharmacy, and then implants, and then decide to try and purchase services next.” Walsh says. “We don’t ever really talk about just one sliver of our spend. We always talk about our total expenditures. We talk about our total spend management.” While acknowledging that an all-encompassing supplies and services spending approach isn’t necessarily the right pathway for everyone, he says Intermountain uses the same processes, infrastructure, governance and talent to manage both the supply and purchased services sectors in spite of their inherent differences.
