Memorial Healthcare System Collaboration with Premier in Clinical Decision Making

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

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

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

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 $1.9 million Infliximab $1.7 million Sugammadex $1.6 million Darbepoetin Alfa $1.1 million Vasopressin $1.1 million Insulin Detemir $1.1 million Natalizumab $975,100 Albumin Human $929,800 Immunoglobulin G $770,300 Sodium Chloride Dinoprostone Enoxaparin Botulinum Toxin-A Insulin, Aspart Iopamidol Rituximab $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 CareScience 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;