GPO Pharmacy Clinical Decision Making How Memorial Healthcare

GPO Pharmacy Clinical Decision Making- How Memorial Healthcare System works with Premier in Portfolio and Therapeutic decision making Alan H. Mutnick, Pharm. D. , FASHP Director- Pharmacy Contracting Memorial Healthcare System

Outline • • • Premier Overview Memorial Overview Premier- Memorial Collaboration Tools of the Trade Summary

Premier Overview • 4, 000 + US Hospitals and health systems are Premier members; • More than 165, 000 alternate sites/other provider organizations; • $60 billion in group purchasing volume; • Data on more than 45% of all US hospital discharges; • Approximately $18 billion saved, with more than 200, 000 deaths avoided; • 163 Total number of Member Owners

• Alignment Premier Overview – Members own ~ 60% of equity – 10 health system board members – Premier field force embedded in member hospitals/systems • Commitment – Member owner average tenure of ~ 19 years (82% at 10+ years) – Members view Premier as a strategic partner • Co-innovation – Co-develop solutions with members – Committees composed of ~ 195 member hospitals – ~1, 400 hospitals in performance improvement collaboratives

Board of Directors Member Value Improvement Committee Strategic Advisory Committee Member Quality Improvement Committee Member Technology Improvement Committee Clinical Strategic Advisory Council Core Service Lines Pharmacy Program Foodservice Program Cardiovascular Continuum of Care National Pharmacy Foodservice Facilities, Construction and Environmental Svcs Imaging/Radiation Oncology Pharmacy Affairs subcommittee Information Technology Pharmacy Contracting subcommittee Laboratory Materials Management Nursing Purchased Services Supplier Diversity Surgical Services ASCENDTM Clinical Nutrition subcommittee

Memorial Overview • Memorial Healthcare System is a public, non-profit hospital system governed by the South Broward Hospital, District Board of 7 Commissioners; • Commissioners appoint the President and CEO, who lead the Memorial executive team; • In 1947, county residents approved a referendum to create a health district and to adopt a millage rate to support the mission of healthcare for all residents, regardless of ability to pay;

Statistical Overview • • • 13, 000+ Employees 6 Hospitals Level 1 Trauma Center 3 Neonatal ICU’s 1 Home Health Agency Memorial Health Network Providing 100, 000+ covered participants with High-quality care • • 1 Nursing Home 7 Community Health Centers Graduate Medical Education Memorial Medical Staff Employed Physicians: 266 Affiliated Physicians: 1, 713 Total: 1, 979

Premier- Memorial Collaboration • Committee representation within Contract sourcing; • Representation at National Pharmacy Committee, along with select “Task Forces”, “Ad hoc” efforts; • Member of large Premier-Aggregation Group; • Active participation in monthly conference calls, educational webinars, review of submitted papers for annual “Breakthroughs” meeting; • BOTTOM LINE: Value associated with Premier partnership is directly related to the interest, commitment, and effort you make to be a part of it;

Tools of the Trade • Weekly Contracting Newsletter • Access to Supply Chain Advisor and contract portfolio • PRN contact with key contracting leads regarding product issues, comparisons etc • Weekly legal update; “What’s up in Washington” • Up-to-Date Inflation Database for budgeting projections along with Budget tool; • Access to “Quality Advisor” Database and its metrics • Service Line Analytics Database

Service Line Analytics (SLA) • On-line database, which utilizes data obtained through Premier’s Quality Advisor to provide outcomes metrics for Premier members; • Health systems are able to pull a multitude of data/metrics which evaluate select clinical outcomes, identify utilization patterns; down to the Diagnostic level to compare to various levels of Peer groups; • Peer groups can be “specialty, site, system-wide, top-performers” in order to identify potential areas for improvement; • SLA is organized by searchable terms which focus on “drug name, MS-DRG’s, Primary Diagnosis, Surgical Procedure etc.

Key Pharmaceuticals- Usage Review December 1, 2017 – November 30, 2018 • • Alteplase Infliximab Sugammadex Darbepoetin Alfa Vasopressin Insulin Detemir Natalizumab Albumin Human $1. 9 million $1. 7 million $1. 6 million $1. 1 million $975, 100 $929, 800 • • Immunoglobulin G Sodium Chloride Dinoprostone Enoxaparin Botulinum Toxin-A Insulin, Aspart Iopamidol Rituximab $770, 300 $767, 900 $756, 700 $666, 000 $658, 800 $653, 500 $652, 700 $640, 900

Explanation of Outcomes • The four outcomes of O/E values (Length of Stay, Readmissions, Mortality, and Complications; • Based on the Care. Science Analytics Risk Adjustment method used within Quality Advisor;

Summary • Collaboration with GPO’s is a critical need within todays’ dynamic, highly charged, and highly regulated healthcare arena; • Silent partnering can be of value; “Go along and benefit can occur, and does occur”; • However, the more one puts in to the collaborative spirit, the more ALL parties benefit; the GPO as well as the Health System;