Regional Purchasing Coalitions

Transcription

1 1 RPC Survey 2009

2 2 RPC Survey 2009 The Emergence of The Emergence of Introduction The New Dynamic Regional purchasing coalitions (RPCs) are emerging, or some would say re-emerging, as a critical force in healthcare contracting. This trend has been widely noted in the industry over the last year, and is creating buzz up and down the supply chain. RPCs, which could under different circumstances represent a challenge to the major national group purchasing organizations (GPOs), are in the current market environment actively being nurtured by many GPOs. To better understand how this trend is unfolding and how the industry itself views the new direction, the Journal of Healthcare Contracting in late 2009 conducted a survey of industry administrators, supply chain representatives, clinicians and other stakeholders. The 226 respondents represent a broad cross-section of titles and departments in the industry, and can fairly be said to be representative of the industry as a whole. Some Background RPCs have existed in some form throughout healthcare group purchasing history, but the trend over the past 20 years, until recently, had been one of increasing aggregation and consolidation of RPCs into larger and larger GPOs, or their marginalization into strictly local contracting for goods and services not provided by their massive cousins. The large GPOs focused on consolidation right through the first part of this decade, as has been discussed elsewhere. That trend perhaps reached its apex in the partnership of Consorta with HealthTrust in But a significant and now booming counter-trend can reasonably be traced to the re-emergence of self-contracting among some larger IDNs, such as when Sisters of Mercy Health System (Chesterfield, MO) in 2002 established Resource Optimization & Innovation (ROi). Sisters of Mercy saw that its sheer size and ability to drive compliance enabled it to cut better deals in many cases than could be obtained through the national GPOs, with the added advantage of regional focus. ROi very quickly grew large itself, with 1,400 members and 24 acute hospitals, but continued to be strictly regional and local. In no small measure, ROi s ability to see, understand, and control exactly what it was getting for its money, sparked interest among other IDNs in the renewed potential of the regional model. Transparency, savings and control have been powerful enticements to many who felt that the nationals were growing ever more opaque, unwieldy and divorced from local and regional needs. Over the last half-decade, the contracting organs of existing hospital associations have blossomed and many new regional organizations have been born. In addition, the national GPOs themselves have bought into the trend and become active partners in creating and nurturing the regional organizations. MedAssets, Novation and Premier lead the pack in the number of RPCs they support, but the other national GPOs are not far behind. Survey Summary Respondent Breakdown The Journal of Healthcare Contracting survey, below, received responses from 226 industry professionals, including 97 (43%) supply chain executives, 46 (21%) department heads and 31 (14%) contracting specialists. More than 50% of respondents were IDN-based, with just over 40% hospital-based. Nearly 90% of both hospital and IDN respondents were from not-for-profit organizations. All the major GPOs were represented, with Novation (33%) and Premier (26%) together accounting for more than half of all respondents. Forty percent of respondents currently participate with an RPC, and 60% do not. Key Findings 1. The potential for growth of RPCs is at least suggested by the fact that 70% of the respondents whose organizations are not currently members of an RPC report that they have not yet been approached by one. 2. Of those who have been approached by an RPC but have not elected to join, the largest percentages come from hospitals with beds and IDNs with 2-5 hospitals. 3. The percentage of respondents whose RPC is a GPO associated LLC (48%) is exactly twice as large as the percentage whose RPC is member organized (24%) and more than three times as large as those whose RPC is a state/regional association (14%). 4. More than three-quarters (77%) of RPC-participating respondents who believed that better tier pricing was the primary reason to join, found value in the relationship. 5. By far the largest percentage of RPC-participating respondents (78%) identified med/surg as the category of purchasing that has most benefitted from the RPC relationship, with the distribution of opinions much more evenly divided on the question of second most benefit (with pharma winning at 28.9%). 6. More than half of RPC-participating respondents (52%) indicated that less than 25% of their organization s total purchasing goes through an RPC contract, with 20% reporting 25-50% RPC throughput, 17% reporting 51-75% RPC throughput and 11% reporting % RPC throughput. 7. Eighty-nine percent of RPC-participating respondents believe they will continue to be part of an RPC in the next five years.

3 Breakdown of the respondent s area of responsibility relative to their primary GPO Area of responsibility Amerinet Inc Broadlane Inc Consorta HealthTrust Purchasing Group MedAssets Supply Chain Systems Novation LLC Premier Inc ROi Other N/A Total Administrator Clinician Contracting Specialist Department Head Operations Executive Purchasing Agent Sales Supply Chain Executive Value Analysis Other Total Other 16 Value Analysis 4 Supply Chain Executive 97 Sales 5 Purchasing Agent 7 Operations Executive 8 Department Head 48 Contracting Specialist 31 Clinician 3 Administrator RPC Survey 2009

4 Respondents Organization Type Organization Type Count Percentage Hospital % IDNs % Other % Total % Respondents Organization Type relative to the size of the IDN (number of hospitals in the IDN network) Organization Type Total For profit IDN Not for profit IDN Total Respondents Organization Type relative to the hospital size (number of beds in the hospital) Organization Type ,000+ Total For profit Hospital Not for profit Hospital Total Other 24 IDNs 120 Hospital Count of of Organization Organzation Type Type 4 RPC Survey 2009

5 Breakdown of the respondent s Primary GPO relative to the respondent s Organization Type Primary GPO For profit Hospital For profit IDN Not for profit Hospital Not for profit IDN Other Total Amerinet Inc Broadlane Inc Consorta HealthTrust Purchasing Group MedAssets Supply Chain Systems N/A Novation LLC Premier Inc * ROi Other Total *Note: Premier s membership is not for profit. Other 12 ROi Premier Inc 5 58 Novation LLC 74 N/A 7 MedAssets Supply Chain Systems HealthTrust Purchasing Group Consorta 2 Broadlane Inc Amerinet Inc RPC Survey 2009

6 Does your organization participate in a Regional Purchasing Coalition? Count Percentage Yes 90 40% No % Total % No 136 Yes Count 6 RPC Survey 2009

7 Organization Type for the respondents that are not in an RPC, and have not been approached by one in the past Organization Type Count Percentage For profit Hospital 8 6% For profit IDN 11 8% Not for profit Hospital 42 31% Not for profit IDN 61 45% Other 14 10% Total % Other 14 Not for profit IDN 61 Not for profit Hospital 42 For profit IDN 11 For profit Hospital Number of respondents in each organization 7 RPC Survey 2009

8 Have you been approached by an RPC? (this question was asked only to the respondents that are currently not in an RPC) Count Percentage Yes 41 30% No 95 70% Total % No 95 Yes Count 8 RPC Survey 2009

9 Breakdown of the respondents that are not part of an RPC, but have been approached by one in the past by IDN size Number of Hospitals Count Percentage 1 2 4% % % % % % Total % by Hospitals Number of beds Count Percentage % % % % % 1, % Total % by primary GPO GPO Count Percentage Amerinet Inc 4 4% Broadlane Inc 1 1% HealthTrust Purchasing Group 2 2% MedAssets Supply Chain Systems 6 7% Novation LLC 40 44% Premier Inc 29 32% ROi 5 6% Other 2 2% N/A 1 1% Total % 9 RPC Survey 2009

10 10 RPC Survey 2009 The Emergence of For the respondents that are part of an RPC, how long has the organization been part of the RPC? Length of time Count Percentage less than 1 year 11 12% 1-2 years 21 23% 2-3 years 1 1% 3-5 years 22 24% 6-7 years 12 13% 8-9 years 5 6% 10 or more years 13 14% unknown 5 6% Total % unknown 5 10 or more years years years years years years 21 less than 1 year Count

11 What type of RPC are you in? Breakdown of the RPC category relative to the respondents primary GPO RPC Amerinet Inc Broadlane Inc HealthTrust Purchasing Group MedAssets Supply Chain Systems Novation LLC Premier Inc ROi Other N/A Total GPO associated LLC Member organized State/Regional association Other Total RPC Survey 2009

12 The primary GPO of the respondents that selected the primary reason to join an RPC is to get a better tier pricing of GPO Contracts. GPO Count Percentage Amerinet Inc 3 5% Broadlane Inc 1 2% HealthTrust Purchasing Group 1 2% MedAssets Supply Chain Systems 5 8% Novation LLC 29 44% Premier Inc 24 36% ROi 2 3% Other 1 2% Total % Did these respondents find value in participating in an RPC? Count Percentage Yes 51 77% No 15 23% Total % 12 RPC Survey 2009

13 Which sector of purchases has most benefitted from your association with an RPC? Sector For profit Hospital For profit IDN Not for profit Hospital Not for profit IDN Other Total Percentage Capital Equipment % Medical/Surgical Supplies % Pharmaceutical % Services such as Food, Laundry, Etc % Other % Total % 13 RPC Survey 2009

14 Which sector of purchases has seen the second most benefit from your association with an RPC? Sector For profit Hospital For profit IDN Not for profit Hospital Not for profit IDN Other Total Percentage Capital Equipment % Medical/Surgical Supplies % Other % Pharma % Services such as Food, Laundry, Etc % Total % 14 RPC Survey 2009

15 For the respondents that are in an RPC, what percentage of purchases are through RPC contracts (whether associated with a GPO or not)? Percentage For profit Hospital For profit IDN Not for profit Hospital Not for profit IDN Other Total of Purchases 0-24% % % % Total RPC Survey 2009

16 16 RPC Survey 2009 The Emergence of Have you found participating in an RPC has provided the value you expected? Below are explanations from respondents that said no. At the current level it takes a lot of work for little to be accomplished, hard to get people to agree, sometimes even then you get to implementation and people back out, has to be teeth to any agreement At times, too large of a group to get consensus Expenses and technology challenges. Independent RPC would be a more effective route. It has been slow to build so far, but in time we will get there. Large IDNs do not always need these types of contracting strategies. These regional relationships will be used in specific situations only! Limited acceptability for change Member hospitals rarely all participate in high value aggregate agreements. Our own line item pricing is typically leveraged to obtain better line item pricing for the sister sites and the rebate dollars back have little impact to the bottom line of the cost centers driving volume Outcomes do not meet stated goals Pricing is higher than we could get on our own. Should clarify - not yet. Our system is still in the growing stages although we are seeing pricing advantages quickly. Should stabilize over the next six months with better answers available then. The Novation/VHA model has not generated the types of aggregation opportunities that I have experienced in other organizations. The model employed by Yankee Alliance (Premier) is much easier and, in my opinion, more effective than the VHA model. The savings dollars have been less than expected. Vendors will cater to the larger Hospitals in the group and the smaller Hospitals usually are paying higher prices. We have just started and are working on at least 10 or so items and have not had any results yet. We have struggled with leadership issues and are currently without an operation manager. Also, the rules of operation were changed by the GPO thereby the process more cumbersome. We were a larger member getting most of the pricing already. It really benefitted the smaller members

17 Do you believe your organization will continue to be a part of an RPC for more than the next 5 years? Count Percentage Yes 80 89% No 10 11% Total % No 10 Yes Count 17 RPC Survey 2009

18 18 RPC Survey 2009 The Emergence of What is the one area your RPC can do better? 1. More rapid expansion through contracting 2. Faster deployment of purchasing strategies, aggregation of volume and/or commitment. 3. Innovation and creativity is balanced with accuracy and thoroughness,,,,, which sometimes slows down the process. Access to broader range of contracts and to provide resources to assist to quantify data. Additional analytic and benchmarking support. Aggregation tiers pre-negotiated into contracts, so there isn t as much time spent processing paperwork and more time realizing savings. Audiology products. Basic commodity supplies. Benchmarking Better credit terms. Most contracts are Net 30 - next to impossible in this area. Tiers by percentage of spend not dollar volume. A smaller hospital may be spending $100,000 with a vendor and that can only achieve tier 1 pricing but that $100,000 is 100% of what the hospital spends on that commodity so we should be at a much higher tier. Capital & Services Capital equipment Capital equipment purchases Commodities Concentrate on the commodity items that are easier to tackle as a system. Continue to maintain those GPO contracts for the benefit of the group. They are doing a good job with this now. Continuum of Care facilities Contract growth into non-traditional areas of spend. Contract management and optimization Contracting for local services and contracting with local diversity companies. Contracts outside of the GPO Currently focused on Non-PO purchases. Either moving to contracted vendor or obtaining contract for this volume. Data analysis Data cleansing Define areas of opportunity within total spend and bring additional value propositions forward. Develop CSC is the goal Develop other shared services and programs. Developing strategic partnerships with key suppliers. Diagnostics (Imaging, Pathology, etc.) Enforcing contract terms & conditions Equal Pricing across the entire RPC Spectrum. Facilities I would like to see greater savings. I d like to see us get out of the GPO. Information Technology Coding Software 3m Improve the technology used by the members. Large dollar commodities (stents / crm devices / ortho implants) Legal Finance Diversity Supplier contracting Look outside for contacts as well Mandated compliance; greater transparency from members. med/surg supplies physician preference items Medical devices More cohesive acceptance More commitment to conversions More initiatives. More input from participating members as to where the next contracts should concentrated in. More market analytics/intelligence More PPI More robust analytics

19 19 RPC Survey 2009 The Emergence of What is the one area your PRC can do better? (continued) My input is biased since I am basically the RPC manager (for contracting) and not the internal customer. I would like to see more improvement in general project management including nontraditional areas such as architecture. Would like to see broader and more consistent application of tools to reduce process variation (i.e. Six Sigma), but not likely given the type of org structure (we are combination of controlled via holding company via the Dartmouth-Hitchcock Health and loose affiliations via a service organization, the New England Alliance for Health, LLC). obtaining fixed costs for clinical lab supplies (reagents, etc..) Offer resources to help on data gathering and conversions Pharmaceutical Spend Pharmaceuticals Pharmacy Pharmacy and Purchased Services Physician Preference Items Physician Preference Items Physician preference items Physician preference items - implants, Cath/EP, Vascular products Physician Preference Items It is now on the table and negotiating tactics are being established PPI PPI Items Products/commodities that are not contracted through the GPO Programs/contracts going through the process faster. Pursuing non-gpo agreements. RPC is doing a good job. RPC s need to look at those lines or commodities that may not be underneath a GPO contract however a regional collaborative may benefit by pooling resources on like spend. Services... Still too new to know where we may have limitations. Surgical Items Synergy. Our regional collaborative recently merged with another collaborative, Western North Carolina Health Network. We expect to see the contract portfolio grow and the savings potential to increase. We also hope to see more benchmarking data. There are many areas we have to worked on that could be beneficial we get caught up in the day to day issues and take our focus off the many opportunities the RPC could offer They do a great job now. They need to be more organized Tools Utilization initiatives and evidence-based clinical documentation We are now a part owner of a consolidated service center that, at this point, still incorporates our sourcing collaborative. We expect that the CSC will be able to bring greater savings due to the huge volumes that the owners represent, standardization of product and economies driven by the CSC controlling its own distribution network. We are ready to do some creative contracting for both clinician and physician preference items. We are still in the infancy of this here in So Cal as this is the first attempt where we have pushed MedAssets to participate and offer this option. Without a doubt, physician preference items, e.g., implants

20 Organization Type # of beds in hospital # of hospitals that are in the IDN Primary GPO How long has the respondent s organization been part of a PRC? What advice would you give to suppliers as they work with your RPC? For profit Hospital 0-74 Amerinet Inc 1-2 years Give us your best price the first time! For profit Hospital 0-74 HealthTrust Purchasing Group 8-9 years They are doing great job. Not for profit Hospital 0-74 MedAssets Supply Chain Systems 3-5 years Consistent pricing for all members. Not for profit Hospital 0-74 Broadlane Inc 6-7 years Work closer with all the hospitals in the group. Not for profit Hospital 0-74 Novation LLC 8-9 years Work closely with them. Not for profit Hospital 1,000+ Premier Inc 1-2 years Look for volume dollars and not market share percentages Not for profit Hospital Premier Inc 1-2 years Our group is committed to the concept of the regional entity working within the GPO contracts. Work to provide the best pricing based on this. Not for profit Hospital Amerinet Inc 1-2 years No BS please. Not for profit Hospital Novation LLC 1-2 years Coordinate all initiatives. Not for profit Hospital Premier Inc 3-5 years Seize the initiative; don t wait for a member hospital to launch an idea for savings. Be proactive and bring demonstrated value to the group. Not for profit Hospital Novation LLC less than 1 year Look at the bigger picture Not for profit Hospital Premier Inc 10 or more years Understand the potential volume associated with the group Not for profit Hospital Novation LLC 10 or more years Get involved or expect to lose the business Not for profit Hospital Premier Inc 1-2 years lower compliance expectations Not for profit Hospital Novation LLC 1-2 years Be a lot more aggressive with the members on following through. One meeting a month to review where we are does not make it. Not for profit Hospital MedAssets Supply Chain Systems 1-2 years Suppliers should be cost conscious Not for profit Hospital Premier Inc 3-5 years Be serious about discounts & savings to the customer... don t repeat the GPO contract, a waste of time! Not for profit Hospital Novation LLC 3-5 years Be prepared to bring your best offer to the table at the beginning. We have the power to move market share and if you are not putting your best offer out there you will not be chosen. Not for profit Hospital Premier Inc 10 or more years Work quick; things don t need to drag on and on. Not for profit Hospital Premier Inc 10 or more years To take us seriously, be open to more locally negotiated contracts. 20 RPC Survey 2009

21 Organization Type # of beds in hospital The Emergence of # of hospitals that are in the IDN Primary GPO How long has the respondent s organization been part of a PRC? What advice would you give to suppliers as they work with your RPC? Not for profit Hospital Novation LLC 1-2 years Focus on cost of goods reduction and streamline supply chain costs; steer away from rebates, probates and like incentives Not for profit Hospital Novation LLC 1-2 years Understand each individual hospitals needs. Have flexibility with RPC. The all or nothing demand is not working. Think outside of the traditional box for supply contracts. Not for profit Hospital Premier Inc 3-5 years Take the RPC seriously Not for profit Hospital Premier Inc 6-7 years If the RPC is solid take it seriously - we have had to move business just to get the attention of a supplier Not for profit Hospital Premier Inc 6-7 years Network with the other members to achieve the best aggregate pricing possible. Not for profit Hospital Premier Inc unknown Lower your prices and make it more flexible. For profit IDN 2-5 Novation LLC 3-5 years Identify total volume as a system with pricing incentives to make change. Not for profit IDN 1 Novation LLC 6-7 years Forget the past. No product or service category is off the table from consideration by our virtual IDN. We will move market share. Not for profit IDN 1 Novation LLC less than 1 year To take us seriously as we do want to reduce cost with commitment. Not for profit IDN Novation LLC less than 1 year Understand that we are one entity coming to market with one strategy. Not for profit IDN Novation LLC 1-2 years Work the RPC as though they were one of the larger GPO s if they want access to IDN s Not for profit IDN Novation LLC 1-2 years Recognize RPC as a system. Not for profit IDN Novation LLC less than 1 year Look at the big picture and join with us in identifying efficiencies that will benefit both sides of the table. Not for profit IDN Premier Inc 10 or more years Don t be afraid to negotiate with an RPC; you will not lose your GPO standing or advantage. Not for profit IDN Premier Inc 3-5 years There is value created both ways in working with aggregation groups like the Catholic Contracting Group. Not for profit IDN Novation LLC 1-2 years RPCs have a real ability to move market share, including in clinical decision making. Those that don t work them will lose out. 21 RPC Survey 2009

22 Organization Type # of beds in hospital # of hospitals that are in the IDN Primary GPO How long has the respondent s organization been part of a PRC? What advice would you give to suppliers as they work with your RPC? Not for profit IDN Premier Inc 3-5 years Make sure you keep pricing consistent with RPCs Not for profit IDN Novation LLC less than 1 year Be proactive in supporting RPC. The incumbent, entrenched suppliers may be at risk to suppliers with significant upside business potential. Not for profit IDN Premier Inc 3-5 years Participate at a high level. Health Systems/IDN s are more willing than ever to commit volume for aggressive pricing. Don t sit back and wait...get engaged! Not for profit IDN Premier Inc 1-2 years They should be prepared to take the collaborative seriously. Not for profit IDN Novation LLC 2-3 years Be flexible. You should gain better compliance if you are. Not for profit IDN ROi 6-7 years They are growing - challenge them to define how they are different and honor the differences if they drive down cost. Not for profit IDN Novation LLC 1-2 years Buckle Up! Not for profit IDN Novation LLC 3-5 years When we contract as an RPC we precommit and then deliver that commitment upon making the award. Not for profit IDN ROi 6-7 years Realize the strength of compliance that the system drives Not for profit IDN 2-5 Novation LLC 3-5 years Push for access to the RPC, even if you are a non-gpo contracted vendor. Not for profit IDN 2-5 MedAssets Supply Chain Systems 10 or more years Be open to the concept and create programs that support RPC s. Allow for aggregation opportunities. Not for profit IDN 2-5 Premier Inc 10 or more years Take into account the percentage of a hospital s spend not just the dollars. Not for profit IDN 2-5 Premier Inc 3-5 years Patience. Not for profit IDN 2-5 Novation LLC less than 1 year Since the RPC are geography related, they need to develop sales programs around those efficiencies. Not for profit IDN 2-5 Novation LLC 1-2 years To date suppliers have come to the table with value, the biggest thing for them is to keep the targets reasonable Not for profit IDN 2-5 MedAssets Supply Chain Systems 10 or more years Cooperate Not for profit IDN 2-5 Novation LLC 3-5 years Be flexible. Provide a good sales person Not for profit IDN 2-5 Premier Inc 10 or more years Recognize us as for aggregation! Not for profit IDN 2-5 Novation LLC 3-5 years Provide robust conversion and implementation support directly with the members. 22 RPC Survey 2009

23 Organization Type # of beds in hospital The Emergence of # of hospitals that are in the IDN Primary GPO How long has the respondent s organization been part of a PRC? What advice would you give to suppliers as they work with your RPC? Not for profit IDN 2-5 Premier Inc 3-5 years Do not try to divide and conquer... Not for profit IDN 2-5 Novation LLC 8-9 years Work directly with the person coordinating the efforts. Give your best deal upfront. Expect compliance. Don t fight it. Not for profit IDN 2-5 Novation LLC 6-7 years The CSC is willing to go outside of the Novation GPO, if necessary, to gain value. Suppliers will need to realize that having a Novation agreement is not a guarantee of business with the CSC and should take the RFP s and RFE s very seriously and respond accordingly. Not for profit IDN 2-5 Novation LLC 1-2 years Recognize that Sourcing Collaboratives and Purchasing Coalitions/LLCs are a reality. Work with us as we will deliver committed volumes. Not for profit IDN 2-5 MedAssets Supply Chain Systems less than 1 year Give serious consideration to working with the RPC as this may evolve into the way business is done with or without a GPO. Not for profit IDN 2-5 Amerinet Inc unknown I would suggest that they realize that RPC can do a much better job at delivering volume commitment. Not for profit IDN 50+ Novation LLC 3-5 years Do not be bullied by the GPO and it s representatives Not for profit IDN 6-10 Premier Inc 3-5 years Communicate with your regional and local representatives so that they understand what the PRC means to their customers. Not for profit IDN 6-10 Novation LLC unknown Negotiate based on IDN need not industry in general. Not for profit IDN 6-10 Novation LLC 10 or more years Recognize the RPC can typically drive better compliance than a GPO large national GPO contract. Not for profit IDN 6-10 Other 6-7 years The RPC allows the suppliers to get much closer to the hospital purchase. In addition, having a contract with an RPC is a committed contract and not simply a license to hunt for opportunities within the hospitals. Not for profit IDN 6-10 Premier Inc 3-5 years Understand the potential impact of the organization Not for profit IDN 6-10 Novation LLC 3-5 years Be creative in approach to committed contracting Not for profit IDN 6-10 Novation LLC 3-5 years Working fine Not for profit IDN 6-10 Premier Inc 1-2 years The risk of gaining/losing marketshare is much greater in a non-segmented market as suppliers will inherently need to drastically reduce price points if they intend to conduct business with regional purchasing coalitions. 23 RPC Survey 2009

24 Organization Type # of beds in hospital # of hospitals that are in the IDN Primary GPO How long has the respondent s organization been part of a PRC? What advice would you give to suppliers as they work with your RPC? Not for profit IDN 6-10 Novation LLC 1-2 years Always know who your customer is. Other Premier Inc 8-9 years Stop selling to physician. Healthcare facilities pay for products and equipment not the physicians. Other ROi 6-7 years Stay open minded Other N/A 6-7 years I think RPC and/or IDNs are still in their infancy but will still become a greater influence than what we ve seen. Other Novation LLC 10 or more years Vendors need to do a better job demonstrating the value the provide and quantitative measurements of the quality of service. Most vendors data has been biased and unreliable. Availability of good inexpensive data is key to measuring current performance and developing improvement plans. Many of our vendors are still not using third party credentialing services to verify they provide environmentally preferred products (i.e. Ecologo, Green Seal, EPEAT... requiring the RPC to collect and organize such information. Other Premier Inc 3-5 years Support those RPC s that can influence marketshare. Do not support organizations that cannot influence marketshare. Other Other 8-9 years Continue to support all aspects of GPO s Other Novation LLC 10 or more years Provide value for all 5 UC hospitals Other ROi 6-7 years Ensure the right level of representative is calling on us. 24 RPC Survey 2009