In this episode of Hospitals in Focus, we’re pulling back the curtain on an often-overlooked yet truly “critical” aspect of our health care system—the supply chain. It’s the backbone of our hospitals, ensuring that essential medical supplies reach patients in need. But what happens when that chain breaks?

Host Chip Kahn is joined by Ed Jones, President and CEO of HealthTrust Performance Group, to discuss recent events that exposed vulnerabilities in this intricate network. Following Hurricane Helene’s catastrophic impact on a major manufacturing facility for IV solutions, hospitals nationwide faced a sudden, alarming shortage. This crisis underscores that our health care supply chain is a fragile, interconnected network, frequently dependent on a limited number of suppliers and manufacturers.

In this episode, Chip and Ed discuss:

• An introduction to Group Purchasing Organizations (GPOs), and how they help hospitals secure reliable supplies at fair prices.
• Pandemic and Disaster Preparedness: How the COVID-19 pandemic and Hurricane Helene revealed and accelerated shifts in our supply chain, and what parallels these events share.
• The Role of GPOs in Drug Supply: An examination of how GPOs respond to shortages and their impact on supply and pricing.
• International Reach and Recovery: How global supply chains influence our health care systems.
• HealthTrust’s Unique Approach: What sets HealthTrust apart from other GPOs in its approach to building a resilient and cost-effective supply chain.

Guest Bio:

As President and CEO of Healthtrust Performance Group, Ed has overall responsibility for a broad set of capabilities focused on supporting healthcare providers. His primary focus is providing the strategic direction and leadership of a comprehensive spend management and performance improvement business based in Nashville, Tennessee. Jones oversees all dimensions of a $52B portfolio; directs all consulting, managed services and outsourced relationships/alliances, including accountability for HCA Healthcare supply chain, sourcing contingent labor, facility management and clinical education.

Jones’ leadership encompasses several HealthTrust/HCA Healthcare business ventures that strengthen provider performance and competitive advantage, including:

• HealthTrust Workforce Solutions - The clinical labor staffing and consulting company including a proprietary program called StaRN (extensive training program for all new nurses)
• HCA Healthcare Center for Clinical Advancement - Responsible for providing continual education for over 90,000 nurses at HCA Healthcare through a team of approximately 800+ educators and several simulation labs
• HealthTrust Europe, which provides sourcing and supply chain services to HCA U.K. and sourcing services to 39 provider trusts in the U.K.
• HealthTrust Global Sourcing Office in Shanghai, China
• Galen College of Nursing
• Group purchasing organization that delivers clinically integrated solutions and savings across all sites of care

He has 40 years of experience within the Healthcare industry, serving in his current role for the last 11 years and serving previously as the Chief Operating Officer of HealthTrust Performance Group with responsibility for strategic sourcing, clinical operations, custom contracting, supplier diversity, and regional operations. Prior to that, Jones served in several leadership positions within HCA Healthcare for 20 years following front-line roles at a hospital for seven years.

Jones is a founding board member of the Health Sector Supply Chain Research Consortium, and a member and subcommittee leader of the Federation of American Hospitals. He also serves on the board of Galen College of Nursing and is the chairman of the finance committee. Jones also serves on the board of CoreTrust. Previously, he served as board chair on the Healthcare Supply Chain Association (HSCA). He holds a Bachelor of Science degree from Virginia Commonwealth University.

With over nine million veterans enrolled, the Department of Veterans Affairs (VA) is well known for its health care services. However, the VA’s support extends beyond medical care, helping veterans navigate life after military service. The VA has undergone a significant transformation since the establishment of the Veterans Experience Office in 2015, focusing on improving veterans’ experiences through the use of qualitative and quantitative veteran-customer service data.

In this episode, Dr. Carolyn Clancy, Assistant Under Secretary for Health at the VA, shares insights on the organization’s evolving approach to health care and the patient experience by discussing:

• The role of the VA and its evolution in approaches to health care;
• Transformation through leadership and the creation of the Veterans Experience Office;
• Holistic attitude to health care through the ‘My life, my story’ project; and,
• Broader applications of VA initiatives in other health care settings

Guest Bio:

Dr. Clancy serves as the Assistant Under Secretary for Health (AUSH) for Discovery, Education & Affiliate Networks (DEAN), Veterans Health Administration (VHA), effective July 22, 2018. The Office of the DEAN fosters collaboration and knowledge transfer with facility-based educators, researchers, and clinicians within VA, and between VA and its affiliates.

Prior to her current position, she served as the Acting Deputy Secretary of the Department of Veterans Affairs, the second-largest Cabinet department, with a $246 billion budget and over 424,000 employees serving in VA medical centers, clinics, benefit offices, and national cemeteries, overseeing the development and implementation of enterprise-wide policies, programs, activities and special interests. She also served as the VHA Executive in Charge, with the authority to perform the functions and duties of the Under Secretary of Health, directing a health care system with a $68 billion annual budget, overseeing the delivery of care to more than 9 million enrolled Veterans. Previously, she served as the Interim Under Secretary for Health from 2014-2015. Dr. Clancy also served as the VHA AUSH for Organizational Excellence, overseeing VHA’s performance, quality, safety, risk management, systems engineering, auditing, oversight, ethics and accreditation programs, as well as ten years as the Director, Agency for Healthcare Research and Quality.

Before the Change Healthcare cyberattack, hospitals were already grappling with insurers' tactics of delaying and denying payments for patient care. The cyberattack only amplified the challenges providers face—not just in delivering care, but also in getting reimbursed for that care. Despite the crisis, insurers continued to use these tactics. Now, six months later, Matt Szaflarski, a director and revenue cycle intelligence leader at Kodiak Solutions, and his team have uncovered something alarming: a surge in insurers’ initial Request for Information (RFI) claim denials.

Kodiak’s latest report, “Death By A Thousand Requests,” highlights the growing trend of payors denying initial claims due to RFIs, creating an enormous administrative burden on hospitals and providers. In 2024 alone, these tactics are projected to cost hospitals $4.6 billion. Szaflarski returns to the show to explain the impact of these denials on the hospital revenue cycle, which ultimately impacts the hospital’s ability to provide care.

In this episode, Szaflarski discusses:

• Updates on the Change Healthcare cyberattack;
• Rising trends in claim delays and denials, particularly RFI denials;
• Revenue cycle data insights;
• Medicare Advantage, the two-midnight rule, and observation stay challenges; and
• Recommendations for improving processes between insurers and providers.