Implementing a Clinical Supply Utilization Management (CSUM) program is an important first step, but it should never be considered the finish line. In fact, having a CSUM program and having a proficient CSUM program are two very different things. The real measure of success is not whether the program exists, but whether it consistently identifies provable savings opportunities, guides decisions, validates results, and continues to produce improvements over time.
For years, healthcare organizations have focused heavily on price, contracts, and standardization. Those areas remain important, but even the best pricing cannot compensate for excessive consumption, waste, inefficient utilization, unnecessary product features, or other utilization misalignments. Price and utilization are separate components of cost, yet they are closely connected. A health system can have excellent contract pricing and still spend far more than necessary because it is using too much of a product or using products in ways that are not aligned with best practice.
That is where CSUM proficiency becomes critical!
A proficient CSUM program provides an ongoing pulse on the supply chain, using patient-volume-centric measures, benchmarks, trends, and utilization data to determine what is really happening across product and service categories. Rather than waiting for a budget variance or a significant cost increase to raise a red flag, the organization can identify changes as they occur and determine where action is warranted.
But identifying an opportunity is only part of the equation. What happens next is what separates a CSUM program from a proficient CSUM program.
The information must be used to prioritize the right savings opportunities, engage the appropriate Value Analysis or clinical teams, investigate the reason behind the variation, and implement changes when needed. Just as importantly, the organization needs to measure what happens afterward. If a contract change is projected to save $500,000, did it actually save $500,000? If utilization is reduced, did the improvement hold? If a category is already performing at a best-practice level, did the organization recognize that before making an unnecessary change?
This ongoing measurement also uncovers something many organizations never realize which is that savings are often happening without anyone knowing exactly how much is being saved. A supply category may experience a significant reduction in utilization without a price change, or a contract change may generate more savings than originally projected. A proficient CSUM program captures these results rather than allowing them to disappear unnoticed.
Perhaps one of CSUM’s greatest advantages is its ability to show organizations where not to focus. If a category is already performing at a best-practice level, that information is just as valuable as identifying an area of opportunity. High-performing departments and facilities can become internal benchmarks, allowing the organization to understand what they are doing differently and replicate those practices elsewhere.
Proficiency also means recognizing that utilization management is not a one-time event. Healthcare is constantly changing. Products, physicians, procedures, patient volumes, contracts, policies, and clinical practices evolve, and those changes can create new utilization patterns and cost pressures long after an initial opportunity has been addressed. A CSUM program that identifies opportunities once and then sits on a shelf will eventually become another reporting tool rather than a management system.
The healthcare organizations that get the greatest value from CSUM understand that the program must remain active, relevant, and accountable. They continually measure performance, investigate variations, validate savings, establish new baselines, and use the results to determine where their next effort should be directed.
Ultimately, CSUM proficiency is not about having more reports, but about having better answers. Where are we performing well? Where are we out of alignment? What changed? Why did it change? What should we do about it? Did the change work? And, perhaps most importantly, where is the next opportunity to move the needle?
A CSUM program should be expected to deliver more than information. It should deliver real results and a continual pipeline of opportunities for improvement. That is the difference between simply having a CSUM program and having one that is truly proficient.
Article by:
Danielle Miller, Healthcare Supply Chain Analyst, SVAH Solutions
Danielle is a healthcare supply chain analyst at SVAH Solutions with more than 14 years of experience in healthcare supply chain management and value analysis. She supports cost optimization, savings validation, benchmarking, and category management initiatives and serves as Managing Editor of Healthcare Value Analysis and Utilization Management Magazine.
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