Total Cost of Ownership VAHRMM 2014 FALL CONFERENCE

Transcription

1 Total Cost of Ownership VAHRMM 2014 FALL CONFERENCE October 17, 2014

2 Objectives Recognize the impact of supply chain to profitability Understand core elements of total cost of ownership model Establish an action plan for improving accountability and implementation Empower team to have information and skills to make decisions

3 Total Cost of Ownership Total Cost of Ownership is a methodology used to ensure that all associated costs over a given time period are considered when acquiring an asset

4 Fun Facts Total Cost of Ownership Cell Phone Small Pet Child Home

5 The Total Cost of Pet Ownership $12, pound dog (living in the Midwest) $1,977 first year cost $807 yearly cost x 14 years National Average

6 The Total Cost of Cell Phone $2, iphone, Warranty, Accessories, Tax $599 x 8% = $ $60 Cellular Plan + Taxes & Fees x 24 Months = $1560

7 The Total Cost to Raise a Child $ 241,080 Each!

8 The Total Cost to Own a Home $1,073, Years Home Purchase Price $290,000 Interest at 6.41% = $291,000 (after tax: 33% bracket); $195,000 Insurance ($6k / year): $180,000 Maintenance ($300 / month): $108,000 Major Repairs & Improvements: $300,000

9 Understanding the Supply Chain Total Cost of Ownership

10 The Simple Truth The only supply chain activity that generates value for a health system is the use of a product on a patient. 10

11 The Basic Process is Simple Invoice/Bill Order Ship/Use Pick/Pack The Basic Process Receive Put-Away Requisition Store

12 Now What's Missing? Comprehensive, Interdependent, Complex Evaluate Contract Order Pick Ship Receive Inventory Pick Deliver & Select & Pay & Store Use & Charge Provider Customer Manufacturer Distributor Provider Customer Dispose or Reprocess

13 TCO Metrics If your organization spends 1.5M on a new Breast MRI, what is the total amount your organization will spend on that MRI over 10 years? What are the 2 largest on going costs for the MRI?

14 Breast MRI Example Reference: Hamilton, Terry. "Understanding Total Cost of Ownership." Healthcare Purchasing News. N.p., Sept.-Oct Web.

15 Broader Approach to Savings Direct Purchases 18% Typical Hospital OPEX Breakdown Distribution 6% Depreciation 1% Bad Debt 1% Other 1% Purchased Services 22% Labor 51%

16 Breast MRI Revisited Total Cost of Ownership is a methodology used to ensure that all associated costs over a given time period are considered when acquiring an asset Direct Costs Capital Purchase Price Distribution / Transportation Rental Fees Service Fees - Repair costs, upgrades, warranties, and maintenance Inventory Cost Disposable Products: IV start kit, IV tubing and contrast Installation costs Indirect Costs Labor Expense Opportunity Costs (space, time, productivity etc) Physician/Clinician Satisfaction Revenue Capture Support & Training Reference: Hamilton, Terry. "Understanding Total Cost of Ownership." Healthcare Purchasing News. N.p., Sept.-Oct Web.

17 Understanding the Components Total Cost of Ownership

18 Total Delivered Costs Medical Disposables Financial Reconciliation Unit Cost Reverse Logistics Disposal Acquisition Utilization Possession Distribution Requisition

19 Unit Cost & Acquisition Unit Cost Price Contract Compliance Volume Commitment Acquisition Order entry Shipping Receiving

20 Possession & Requisition Possession Storage Shrinkage (Loss/Damage/Expiration) Requisition Requisition from Department Assembly/Processing Sterilization

21 Distribution & Utilization Distribution Delivery to department Put-away Counting/Replenishing Utilization Quantity used per patient Opened but not used Formulary management Value Determination

22 Reverse Logistics Disposal & Financial Reconciliation Financial Reconciliation Invoice matching Voucher/check payment G/L reports Disposal Waste reduction Returns

23 Total Delivered Costs Capital Infrastructure Support Change Management Depreciation Insurance Cost of Capital Hidden Costs Operating Environmental Implementation Upgrade Acquisition Purchase Obvious Costs Maintenance

24 Tracking Success Metrics & Measurements

25 How Do You Measure the Performance of Your Supply Chain? Some Examples: Our Supply Chain Manager is a tough negotiator. If our supply costs go up faster than the rest of our expenses, we have a problem. Everyone likes to work with Tom! I don t hear any complaints, so things must be going well. We are supportive of our GPO.

26 How Should We Be Measuring Supply Chain Performance? Our supply chain cost as a percent of total expenses has not increased over three years. Our clinical coordinators in Materials Management really gained the respect of the OR staff, particularly the physicians. Our invoiced increase in supply cost per adjusted discharge is less than the healthcare supply inflation factor. Tom has engaged all internal and external aspects of our supply chain through collaborative planning, goal setting and measurement. Tom s strategic plan is aligned with and part of our strategic plan and includes all supply-relevant departments.

27 TCO Shortcuts Examples: Surgical Services OR Supplies Expense per Case Pharmacy CMI Weighted Drug Expense per Adjusted Discharge Cardiac Cath Lab Interventional Supplies Expense per Procedure Radiology Specials Supplies Expense per Procedure Clinical Lab Lab Supplies Expense per Billable Test Dietary Food Cost per Meal Equivalent

28 Real Life Examples Total Order Calculator

29 Case Study Total Cost of Ownership

30 Total Cost of Ownership of Mustang?

31 Total Cost of Ownership of Mustang? Assumptions Expenses for 5 year period Traditional Financing, not leasing Above average credit rating 10% down payment Loan term 60 months Cash Price for unit: $32,998 Drive 15,000 miles per year

32 Total Cost of Ownership of Mustang? Reference:

33 Thank You