General Hospital Has Been Cancelled! – A Need for Renewed Emphasis on Healthcare Supply Chain Management
A Supply Chain Matters Guest Contribution from Rich Sherman
So you think that Obamacare is changing the healthcare industry in the United States? Think again.
It’s just the tip of the iceberg. The healthcare industry is undergoing a fundamental transformation from delivering patient treatments to delivering patient outcomes. And, it’s turning the industry upside down. The television series General Hospital may have celebrated its 50th anniversary last year; but, in real life General Hospital is about to be cancelled.
With the transformation to patient outcomes, healthcare providers simply can’t afford to treat anything generally. Specialty patient outcome centers (SPOC) are emerging throughout the healthcare industry. With nurse practitioners having expanded diagnostic and treatment licensing, general health clinics are appearing in every corner drugstore, 24/7. Emergency treatment and diagnostic centers are emerging in every strip mall. SPOCs, such as oncological, cardiac, ophthalmic, orthopedic, cosmetic, etc. for every ailment are emerging in every city. Quite simply, patient care centers are appearing and proliferating across the country increasing the cost and complexity of healthcare supply chain management as well as operations management in general.
Consider that it is not unusual for supply chain costs to consume 35% or more of the operating budget of a healthcare facility.
Supply chain management is a new term to most hospital and healthcare administrators. Haven’t they got enough on their plate with compliance, reimbursement, Electronic Medical and Healthcare Records (EMR/EHR)? Yet, with the transformation in the industry, administrators have to be more focused on revenue and cost. Effective supply chain management addresses both and healthcare providers have to consider bringing on a new breed of supply chain professionals to their leadership team even to the extent of hiring a Chief Supply Chain Officer. Most other industries are recognizing the significant contribution supply chain excellence makes to the financial health of the organization.
Transforming from materials and procurement management to supply chain management requires a more holistic view of the organization’s operations. Beginning with demand generation, acquiring patients to generate revenue, through demand fulfilment, delivering a successful patient outcome, supply chain management is the support system that enables cost effective, high quality delivery. And, it’s not optional. With the proliferation of patient delivery locations, competition for revenue is heating up. We’re finding more and more of our clients are seeking help in attracting patients just to maintain occupancy and revenue. But, that’s just treating the symptom.
The cure is to be found through providing a successful outcome for operations excellence. Operations excellence requires professional operations management. Medical professionals have to focus on patient outcomes not operational outcomes. This will create a transformation in the leadership structure of many healthcare providers from medical leadership to management leadership. The days of doctor controlled operations are waning. Healthcare providers that are restructuring their organizations for effective supply chain management will lead the way as the industry transformation continues.
General Hospital may be cancelled; but, the requirement for delivering successful patient outcomes will never end.
About the Author: Rich Sherman is an internationally recognized researcher and author on trends and issues across supply chain management. He currently serves as a Principal Essentialist at Trissential LLC in their supply chain consulting practice. His book Supply Chain Transformation: Practical Roadmap for Best Practice Results (Wiley, 2012) has received praise by practitioners, academics, and non-supply chain executives as a great read on business transformation. Rich has been a previous guest contributor to Supply Chain Matters.
The CEO of A. P. Moller-Maersk, operator of the globe’s largest ocean container shipping line as well as various oil exploration and transport services interests, has declared to the company’s investors that the firm will likely experience flat profitability growth through 2016.
Maersk has elected a business strategy to reduce its dependency on the current turbulent ocean container shipping segment by currently investing in oil production, ports and bulk shipping activities. According to a Reuters published report, CEO Nils Smedegaard Anderson once again declared, as was the case in October 2013, that over-capacity remains prevalent across ocean container shipping and that it will be not until at least 2016 until the industry compensates.
Maersk is currently investing in its oil related businesses but profits in the line’s oil and drilling segment are expected to fall in 2014, adding additional challenges to its overall business strategy. However, Anderson declared that Maersk Line, its ocean container unit, still aims to be more profitable than other industry competitors, targeting its profit margins at a rate that is five percent higher than other ocean container shipping operators. In essence, Maersk is declaring that it will make money even if the rest of the industry has zero or negative profits. According to Reuters, during 2013, average freight rates for the Maersk Line segment decreased by 7.2 percent while volumes increased by 4.1 percent. Overall fuel consumption was reduced by 12.1 percent which contributed to lower operating costs and profitability.
The proposed P3 Network that pools the capacity and shipping assets of the top three ocean container operators is still awaiting regulatory clearance from various maritime review agencies. One of the prime motivators for formation of this alliance was to assist the top three lines container lines in terms of volume with alleviating over-capacity and allow for reduced operating costs by saving on fuel and other operating costs. While that may have been the declared collective goal, the Maersk Line’s stated profitability goal stated for its investors seems to fly in the face of the goals of this network alliance.
One of our Supply Chain Matters predictions for the current year called for increased momentum in re-structuring of global surface transportation networks. That prediction is holding true when the ocean container industry leader declare it will exceed the profitability of all its competitors, in spite of industry over-capacity and attempts to consolidate fleet scheduling and shipping operations.
Something has got to give, as shippers continue to be caught in the middle of conflicting business goals.
What’s your view?
Last week, Home Depot named Craig Menear to be its new president of U.S. retail operations, assuming leadership of this retailer’s over 2200 retail outlets.
The Wall Street Journal characterized this appointment as a “transfer of power” and marked the end of the previous rebuilding era for Home Depot, including investment in a more streamlined and responsive supply chain capability which Supply Chain Matters has praised.
This appointment is part of the home improvement retailer’s succession planning, paving the way for the eventual retirement of current CEO Frank Blake whose leadership has done wonders for the retailer’s current stock performance. The WSJ, cites in-part, Blake’s achievements as the following: “He ushered in a huge overhaul of the company’s supply chain and technology systems, spending billions of dollars to make its operations more efficient and move more workers out of the back rooms and onto its sales floor.”
Menear previous role was head of merchandising, responsible not only for the assortment and pricing of all Home Depot products but also its suppliers, supply chain and online operations. In essence, if this succession plan comes to pass, we will have another CEO with operations, supply chain and procurement leadership as a part of their resume.
What makes this development more interesting to our community is that Blake’s leadership efforts included the hiring of a new cadre of supply chain management leaders. That included the hiring of Mark Holifield, a highly experienced retail and consumer products supply chain leader. The new appointment of Menear as president of retail operations includes the elevation of Holifield to the role of executive vice president supply chain and product development, reporting to Menear. Another executive brought in to transform U.S. distribution was Charles Armstrong, vice-president of distribution, who has outlined the transformation of Home Depot’s distribution networks at prior CSCMP annual conferences.
It has long been the contention of Supply Chain Matters that companies with critical value-chain dependencies are increasingly seeking senior management teams with solid grounding and understanding in principles of operations and supply chain management. These firms often desire that the supply chain continues to serve as a competitive differentiator for business outcomes. There are many industry examples. We can reflect on the CEO’s if firms such as Apple, McCormack Foods, and global apparel retailer Zara, part of Spain’s Inditex Group. Each came to their role with solid supply chain wide leadership experience and grounding. There are others as well.
The takeaway for those future leaders aspiring for a path to the top leadership role within an industry with critical value-chain dependencies is that focusing your career in cross-functional supply chain leadership can indeed be favored over backgrounds in solely financial management or sales, marketing or merchandising. Responsive product lifecycle management is an added experience differentiator, especially when coupled to integration to value-chain needs.
These trends continue to reinforce how important responsive and resilient supply chain business processes, supported by differentiated enabling information technology capabilities, are becoming paths to the top. While some in supply chain leadership may feel, at-time, unappreciated, your experience and insights really do matter.
There is positive news to report regarding the previous stalemate that could have led to a significant delay in the planned expansion of the Panama Canal.
Reports indicate that the Panama Canal Authority and the consortium of European construction companies who are responsible for the widening have agreed to end their ongoing dispute. A deal was reached Thursday night and calls for independent arbitrators to help determine which party should pay for the incremental construction costs needed to complete the project. According to a published Bloomberg report, the “conceptual” deal, still needs to be signed, with the Canal Authority and construction firms each providing $100 million to enable work to resume at its normal pace. The canal won’t pay the companies’ claims for cost overruns, while it may extend a moratorium for the repayment of advances until 2018, when added canal revenues begin to flow.
As part of the reached agreement, the locks must be completed by December 2015, a year later than the initial completion date, which was originally set to coincide with the waterway’s centennial. However, other news reports quote the head of the canal authority as indicating that the canal widening will not be finished until early 2016, while the construction consortium indicates that completion hinges on the final outcome of arbitrations.
In any case, global shippers and U.S. east coast ports can breathe a little easier this weekend, knowing that they were not facing a potential two or more year delay in the canal widening.
There are a lot of critical global logistics strategies that were riding on the timely widening of the canal, allowing both mega container and bulk cargo carriers to more expeditiously traverse voyages from the Asian ports to the U.S. east coast and Gulf ports. It further provides U.S. east coast port operators a better, albeit a bit more delayed, sense of timing for completing individual port infrastructure upgrade projects to be able to service more mega-ships.
Supply Chain Matters has provided a number of previous commentaries regarding when is it appropriate to execute a more vertical integration strategy within a specific industry supply chain. Our commentaries on this strategy focused on General Electric in aerospace engines, Delta Airlines in airline service operations, Hon-Hai Precision in high-tech contract manufacturing services and Hyundai Motors in automotive manufacturing.
This week, general, business and social media as abuzz with the announcement that electric automobile maker Telsa Motors has announced audacious plans to build its own $5 billion electric battery “gigafactory” capable of supplying up to 500,000 electric vehicles per year. This strategy is fairly savvy, given that when one reflects on the entire value-chain and cost-of-goods sold (COGS) for an electric powered automobile, the batteries are indeed the highest portion of cost. The location of this factory is stated as somewhere within the U.S. Southwest, with locations in Arizona, New Mexico, Nevada and Texas all being explored. The area of the U.S. is an obvious choice because of its proximity to the supply of lithium carbonate, a key raw material for lithium-ion batteries. Another neat aspect to the proposed 10 million square foot production facility are plans to have the factory green and sustainable, including solar and wind farms for supporting internal power needs. Telsa’s blog features a presentation that describes the conceptual plans for the proposed “gigafactory”.
According to published reports, the total cost of the plant is estimated in a range of $4-$5 billion, with $1.6 billion raised through a convertible bond issue and a $2 billion investment from Telsa. Panasonic is the current primary supplier for Telsa’s lithium-ion batteries and in its reporting, the Wall Street Journal indicated the possibility that Panasonic and other unnamed Japanese suppliers could contemplating a $1 billion investment in this proposed facility. Reports caution, however, that Panasonic’s plans are still fluid.
Telsa currently supplies batteries for the Toyota RAV4 EV and the Mercedes B-Class electric. In its reporting, the San Jose Mercury Times notes that Telsa’s prime assembly facility in Fremont California is directly located on a Union Pacific railway spur line and that the “gigafactory” will more than likely be serviced by rail as well, to control transportation costs in shipping batteries to the final assembly point.
Telsa expects that the new factory would reduce its current battery costs by 30 percent in its first year, which as we all know, is a significant contribution to COGS, and further opens up opportunities to produce electric cars for the mass market. The WSJ further reported that Telsa is attempting to break through the $200 per kilowatt hour cost point which affords the opportunity for these types of batteries to be economical as backup power supplies for electric utilities along with other forms of static energy storage. Telsa CEO and principal owner Elon Musk also is chairmen of SolarCity Corp., a solar energy provider, and that is fueling additional speculation among certain Wall Street analysts that Telsa could morph to become a power storage company.
From an industry value-chain perspective, reports that that the proposed facility will produce more lithium-ion batteries than the entire global supply for 2013 has incredible meaning with the implication for establishing a highly significant alternative energy value chain capability within the United States. It is obviously an attempt to provide a more competitive lithium battery sourcing strategy from current areas such as China, South Korea and other countries. By our view, is a rather exciting and bold announcement, one that has the potential to add more to U.S. manufacturing and value-chain momentum for alternative energy, high-tech, consumer electronics and other industries.
Investors seem also impressed since Telsa stock has shot-up since the announcement.
Forms of vertical integration or closed supply chain strategies do indeed have their applicability and seem to be garnering additional favor.
In late August of 2011, three of Japan’s liquid crystal display (LCD) component producers, Sony Corporation, Toshiba Corporation and Hitachi Ltd. merged their, at the time, money-losing LCD manufacturing operations to form a single company that was named Japan Display. Each of the former suppliers could not financially afford to continue to compete with the likes of other industry competitors such as Samsung Electronics and Sharp Corp., who were major suppliers to Apple and some other consumer electronics OEM’s. This new venture was financed primarily by $2.6 billion in funding by The Innovation Network of Japan, a government backed agency with strong industry influences. Each of the merging companies was reported to hold 10 percent ownership in the new venture while the government agency held 70 percent ownership. The goal at the time was to position Japan Display and its technology in strategic markets related to small and mid-sized LCD displays, and to have the new company operating as an independent entity by early 2016.
This week, Japan Display announced its intent to raise upwards of $4 billion in an initial public stock offering (IPO) which the Wall Street Journal characterized (paid subscription) as the largest IPO from Asia this year. The WSJ further noted that if successful, it would represent a rare turnaround for Japan’s manufacturing industry. The report indicates that Japan Display currently supplies LCD displays for Apple’s iPhone 5S and iPhone 5C and its customer list now includes other top Asian and U.S. smartphone makers. The supplier has been skillful in improving the overall energy efficiencies of its LCD products while integrating touch sensors directly into the display, eliminating the need for a separate touch screen layer. Japan Display also appears on Apple’s 2013 listing of its top suppliers, and according to the WSJ report, garners up to a third of its current revenues from supply agreements with Apple.
While Japan Display made a small profit for its fiscal year ending in March 2013, it has not indicated to business media what its profit figures are for the current fiscal year. That information should presumably come with the IPO disclosures.
Reports indicate that $1.7 billion of the IPO proceeds will be utilized to enhance production capacity and develop new technologies. The remaining proceeds will be directed at current investing shareholders who will be unloading their stakes
With this announcement, it would appear that the timetable for Japan Display to become an independent operating company may be accelerating. Then again, with current favorable basis of Japan’s currency, the IPO may have more to do with opportunistic timing.
In either case, this IPO marks a significant positive milestone in resurrecting previous un-competitive LCD suppliers in Japan into a singular entity that is now holding its own. It represents another positive indicator that industry and government came come together to resurrect a supply eco-system, similar to what has occurred in Europe and the U.S.. It provides a reference model for other suppliers and supply ecosystems as well.