Integrity, trust respect

In its mission to improve health and wellness, Coastal Carolinas Health Alliance relies on some basic guiding principles.

Anything is possible when you stick to your principles. Ask Derrick Billups, MSM, FACHE, director of operations and corporate contracts of Coastal Carolinas Health Alliance, Inc. (CCHA). Responsible for a range of initiatives at CCHA, including operations, budget management, corporate negotiations, contract management and clinical education, Billups helps guide the 12-hospital (three of which are critical access hospitals), 3,400-bed alliance, reaching out to about a million residents in North and South Carolina. The trick to its success is simple, he says: Since its inception in 1991, the alliance has never veered from its original principles – integrity, trust and respect. CCHA was established by leaders who believed in these principles, which have since served as the foundation of CCHA culture, he points out.

Billups was no stranger to supply chain management when he joined CCHA. He brought to the alliance 18 years of experience with Charleston Area Medical Center (Charleston, W. Va.), where he worked as a value analysis manager and director of purchasing. He has always regarded CCHA as “a way to build stronger peer relationships among hospitals throughout southeastern North Carolina and northeastern South Carolina, [while] improving the health and wellness of those residents through collaborative efforts.” Today, his role includes helping bridge the relationship between clinical leadership and hospital executives, supporting cost-savings and quality initiatives, contract negotiations, clinical education, performance improvement and more.

Group effort
The key to leveraging buying power is “joint efforts with a common goal in mind,” says Billups. “In today’s healthcare market, no hospital is immune to the need for enhanced efficiencies and decreased cost,” he points out. “Healthcare leaders have more pressure than ever to improve quality and efficiencies, while lowering operational costs. Aggregate volume – dedicated or proposed – helps the alliance secure cost effective opportunities. When members identify and combine their common needs, enhanced pricing and value-added services are often achievable.”

In its early years, the alliance focused on a select number of large, collective needs, he continues. Recently, given changes within the healthcare market, these needs “have often inspired new programs and strategic initiatives,” he says. “Over the years, the drive for savings has grown more diverse. CCHA has maintained a vision for both quantifiable and value-added savings, which requires innovative thinking and a watchful eye on the shifting market. Over our 22-year history, we have found that savings are directly proportional to how active and engaged our committees and members are in collaborative solutions. As a result, we have accomplished a healthy return on investment due to the mutual integrity, trust and respect demonstrated by dedicated individuals from our hospitals and hospital systems.

In fact, in FY2012, CCHA recorded $6 million in quantifiable savings attributed to commodity and purchased service agreements, including pharmacy distribution, blood services, food products, freight management, reference lab services, transcription services, insurance products, human resource services and regulated waste. That same year, the alliance recorded $1 million in value-added savings, generated by educational conferences, its annual residents reception, consulting services and various grants.

The alliance continues to save money through its medical simulation program (MSP), notes Billups. “CCHA owns a commercial truck [with a] customized interior that has been specially equipped as a functional hospital patient room, providing trainees with a visceral, interactive teaching experience,” he says. “The MSP clinical scenarios are conducted with life-like human simulator mannequins. This benefits training participants, as they are able to walk through the steps of a given emergency without risking irreversible consequences to the patient. Since 2009, the MSP has trained over 2,855 individuals, representing a variety of clinical disciplines while awarding nearly 2,200 continuing education units. This program supports cost-effective training for clinical staff and physicians at each hospital by avoiding both costly employee travel and excessive time away from their patient care duties. And, the MSP was nationally recognized with a 2012 Amerinet member achievement award for community impact and innovation.”

Taking care of business
There are 13 full-time employees who support the CCHA in its purchasing/contracting and educational efforts and health information exchange network, notes Billups. In addition, regularly scheduled meetings provide the alliance members with an opportunity to identify clinical and operational needs of each facility, and review solutions and new opportunities. “All alliance agreements result from the recommendation and approval of these committee members,” says Billups. “CCHA has 13 clinical and resource committees comprised mainly of department directors, which meet on a regular basis. Our committees span a diversity of operational areas and initiatives, including materials, lab, pharmacy, information technology, human resources, physician recruitment, health information management, nursing education, emergency medicine, and nutrition services. Typically, these committees meet monthly, while our executive level committees – CNOs, CFOs, COOs, and CEOs – meet quarterly. Locations and venues typically rotate between member hospitals.

“These committees have been pivotal in identifying needs and collaborative strategies,” he continues. “Just recently, CCHA formed two new [ones] – an operations committee and a critical access hospital committee. The alliance committees are core to the organization’s collaborative success as hospital representatives come together to network and create cooperative solutions.” They often find that a pressing issue at one facility is an issue for others as well, he adds.

While CCHA has both formal and informal working relationships with various GPOs, it considers itself GPO-neutral, notes Billups. “CCHA has a number of local contracts in its portfolio, as well as contracts through national group purchasing organizations,” he explains. “A number of alliance hospitals can access a GPO as a secondary source, as long as the GPO is currently contracted with CCHA.”

A look ahead
For Billups, the continuous “dedication and commitment” of the member hospitals at CCHA has been extremely rewarding. “This extraordinary commitment has fueled continued success, which has been well-documented since the beginning of the alliance,” he says. “The day-to-day accomplishments are the result of hard work and devotion from our clinical and resource directors committees, in addition to the enthusiasm and vision of the CCHA C-suite representatives and its board of directors. Routinely having all of the member hospital CEOs at the table for ongoing collaboration in support of the alliance and its activities is a testament to the tremendous value of regional partnership. This partnership is continuing to produce documented results and value.”

That said, there’s always room for improvement, he admits, and if he could change one thing about the way CCHA works, it would be to continually search for new data exchange methods. “Data is one of the main driving forces behind today’s healthcare market,” he points out. “Due to data’s connection with overall cost, reimbursement, and quality outcomes, it continues to grow increasingly important to hospitals and care providers. Meaningful use, value-based purchasing, patient outcomes, evidenced-based medicine, and core measures are just some of the critical data elements required of hospitals and providers. The need for this data is coming at a rapid pace from multiple entities. CCHA is no different [from other alliances] in that there is the need for specific data types and exchange. For the Alliance to continue the identification and monitoring of opportunities with its members, the process and methods for data exchange and assessment must continue.
“Efforts are underway at CCHA to enhance the data exchange and assessment process,” Billups continues. “This will continue to support the overall pursuit of alliance opportunities related to the utilization and standardization of supplies and services. The inability to capture and properly manage system and outcomes data will create substantial operational inefficiencies and stifle the pursuit of continuous improvement. CCHA is working with its members to ensure these processes and methods are in place to support alliance opportunities and process improvement.”

Looking ahead, Billups anticipates that CCHA will continue to be “a proactive and reliable source for its member hospitals in relation to their respective visions and strategies.” After all, he points out, hospitals with vision and clarity likely will have a greater impact on the communities they serve. As healthcare providers continue to adapt to new market demands, changing regulations and shrinking reimbursement, so must CCHA, he notes. “Whether by approach of accountable care organizations, value-based purchasing, education and/or continued regional purchasing strategies, CCHA will continue to serve as a means for integrated strategies and opportunities targeting quality, efficiency and cost effectiveness,” he says. “This will [continue to be] accomplished over the next five years, thanks to the ongoing collaboration and guidance of the hospital leaders who make up the alliance.”

On track

CCHA has pursued several initiatives over the past year and a half, including:

  • Blood services. “With executive support, the CCHA lab directors committee identified and pursued a service agreement with a national blood product service provider,” says Billups. “This initiative not only led to an active working relationship between the alliance and the service provider, but also a cost-effective solution without compromising patient quality.”
  • Information technology access and assessment. “The CCHA chief information officer committee identified and pursued a service agreement with a national provider for the purchase of information technology hardware/software and assessment services,” he says. “As a result of aggregated volumes, this initiative has led to significant savings and has required IT assessments supporting both system needs and regulations.”
  • Regional courier service. The CCHA lab directors, [together] with the CCHA materials directors committee, identified a need for expanded courier services within the alliance region,” he says. “Through a collaborative effort among our hospitals and committees, the alliance established a new service agreement with a regional carrier, providing 24 hour/7 day a week services to alliance members within its 250-mile radius.”

About the Author

Laura Thill
Laura Thill is a contributing editor for The Journal of Healthcare Contracting.
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