In this special interview with our key Value Analysis Sales Advisor, Mark Copeland, we delve further into the challenges that vendors, clinicians, and health systems run into on an ongoing basis when dealing with new product requests and vendor relationship management. This is not solely a Value Analysis issue, as this involves the entire health system as well as the vendors who supply the most important products and services to our hospitals. Mark has a vast selling and vendor relationship experience in dealing with physicians as well as working with Value Analysis Teams throughout the country. Mark has been jokingly dubbed by a client Surgeon as the “Value Analysis Whisperer” for his ability to get new implants approved by Value Analysis Committees. Mark provides strategies, solutions, and coaching to not only sales representatives and the companies they represent but also to end customers and stakeholders who work in the current Value Analysis Team driven environment. Mark has not only walked the walk with Value Analysis Teams but he continues to grow and learn more about how we can all better understand our unique Value Analysis approaches in order to keep our internal customers engaged and trusting their own health system’s processes. Value Analysis should not be a problem for anyone internally or externally, and Mark has developed some great strategies and best practices that will truly resonate with you and your Supply Chain/Value Analysis Team leadership.
HVAUMM: Could you give us a brief background on yourself and especially how you got involved with the world of Value Analysis (VA)?
MC: I’ve been in medical sales for about 27 years now. I was originally in pharma, which is actually where I first learned a lot about Value Analysis. I worked in pharma for five years, then in biotech (which was very similar for a time) for another five years.
Then I got into medical device sales, hired by a startup spine company, Globus Medical, back in 2005. They’re now one of the largest spine companies globally, but back then, they were almost non-existent. I happened to be in a territory where all these new products were constantly being introduced to our customers. I started to notice that Value Analysis Committees (VACs) were being formalized at my client health systems.
This was around 2008 to 2010 — a time when these committees were put in place to ensure new products were priced appropriately and to assess risks, such as FDA approvals. Because Globus had so many new products, I had to get very good at providing the necessary information to these VA Committees so they could make decisions.
I was able to draw upon my earlier pharma experiences, where we had to call upon the Pharmacy and Therapeutics (P&T) Committee when selling antibiotics and antifungals. The approach to P&T Committee reviews was eerily similar to what I was dealing with in Value Analysis.
HVAUMM: P&T Committees are one of the longest-running Value Analysis Committees in hospitals today, going back to the seventies or longer. When you look at what they do — finding functional/therapeutic alternatives at a lower cost with equal quality and outcomes — you realize they are very much Value Analysis Committees.
MC: It was fascinating working with P&T Committees, as you started to learn who was influential and who wasn’t. Plus, my company trained us to understand that you’re selling to a group of people, not just one clinician.
I went on to sell sleep medicine products and promptly forgot everything I knew about P&T Committees for about five years. Then, these Value Analysis Committees started popping up again, and they seemed very similar. To hear you describe P&T as a Value Analysis Committee makes me feel like I was reading that right.
For the past 10 years, I’ve been working with small medical device companies, focused mainly on the operating room but also other clinical departments like ICUs, ERs, and NICUs. Most of these companies are not well known, but they all have hope for their transformative technology.
I started to understand the selling side of Healthcare Value Analysis better because of this experience. I realized that, especially with smaller companies, if we didn’t figure out how to sell to VA Committees, the products weren’t going to get off the launchpad. Oftentimes, these companies would pay me to help them understand the Value Analysis dynamic, develop a winning strategy, and communicate it in a professional, accurate, and honest way that both their sales teams and the VA Committees would understand.
This wasn’t what I originally set out to do, but by happenstance, here I am. Some of my clients call me the “Value Analysis Whisperer,” given the results they’ve achieved from our working relationship.
The New Sales Dynamic
HVAUMM: Let’s get right into it. Tell us what you see out there regarding the “New Sales Dynamic” occurring with Value Analysis Teams today.
MC: Having worked with over 60 companies and hundreds of salespeople over the past couple of years, here’s what I see from the vendor side. The business of selling has traditionally been Business-to-Consumer (B2C) or Business-to-Business (B2B). The vendor side has been struggling because selling directly to clinicians — surgeons, doctors, nurses, etc. — is no longer the norm.
What worked for years was selling to those clinicians who mostly got what they wanted because they had the influence. That has shifted for two main reasons.
First, B2B selling has become large-enterprise B2B because health systems have merged, and acquisitions of doctors’ practices are a major factor. When 75% of doctors work for the health system, their influence is diluted because they are now employees.
Second, we’re now selling to sophisticated buying entities, not just sophisticated clinical facilities or end customers. We still must be able to talk to doctors about our products in the B2C world first, as they are the end user and stakeholder. But a lot of sales professionals are struggling to accept the shift that there are now more players involved.
The added challenge is being able to talk to Supply Chain, Risk Management, and Value Analysis Committees. They are like the prefrontal cortex of the health system’s brain. The struggle on the sales side is what I am coaching and strategizing to assist with in this new dynamic.
HVAUMM: Are new product request portals or VA new product workflow software part of this dynamic?
MC: Having interviewed over 60 people in Value Analysis, my impression is that VA is trying to do a couple of things: Get an apples-to-apples comparison of what they’re buying, try not to violate existing vendor agreements, and ensure everything is safer and better for patients.
On the surface, we have to go through this whole process, which isn’t unreasonable. But when it becomes submitting through portals to the Supply Chain, and it’s no longer just the highly influential doctor saying, “I want this,” it becomes impersonal. We’re in the era of big healthcare, and big business becomes impersonal.
Submitting a product through a portal — that’s the easy part. The question is, what should be going through the portal, and who should be doing it? I don’t want to submit or have my product champion submit anything until I know what the people on the other end of the portal require to make an educated decision. I didn’t say approval, I said decision.
What I often see is a marketing document that someone erased “Marketing” on and wrote “VAC Pack” on, and they submit it, wondering when they will hear about approval. It’s almost a joke: You did the bare minimum on your new product request submission, to the point where you couldn’t do any less.
I try to be a Rosetta Stone back to vendors. I tell them there are no boogeymen there, but they are not talking to Value Analysis in the language or with the information they need to make an educated decision.
Frustration and Solutions
HVAUMM: How do physicians and clinicians feel about the Value Analysis Teams that are bottlenecking their new products? What do they really want?
MC: They hate it. They don’t understand it. They’re frustrated by it. And like anybody, when something used to be easy and now you’re making it hard, they get irritable. I feel bad for them, frankly, because they don’t feel as important anymore.
Worse, I’ve seen very few places where doctors and nurses know what is needed or how to submit something themselves. They feel like they need an MBA. I’ve talked to the highest revenue-producing surgeons and the most important people who run Emergency Departments and ICUs, and they say: “If it’s not cheaper on contract or if you’re not an approved vendor on our GPO (Group Purchasing Organization) contract, they’re going to shut you down. Don’t even bother.”
I ask them if they even know what the process is, and they say no. Then you talk to the Value Analysis people, and they say, “We’re very clear with our process. We tell all our clinicians what it is.” I think maybe they’re speaking French and the clinicians are speaking English. They have no idea what VA wants.
This is frustrating for them, and the med device companies react the same way. They get irritable and think, “It’s not fair, it must just be bean counters pushing for cheaper prices.” You and I know that’s not actually the case.
HVAUMM: Now you’re adding more boxes to check, which are the right boxes, like reimbursement. Are you going to get reimbursed? Can you cover the cost? And it’s not just covering the cost dollar for dollar because of all the overhead involved. You were looking at the cost to start an orthopedic case or the value of shaving off time in the OR. Can you tell us about that?
MC: It’s difficult. I call them “Back of the Envelope” analyses because if you try to calculate everything, your head will explode — there are too many variables. We put together a high-level analysis and say, “Look, these are generally accepted numbers, or I’ve talked to your organization, and here’s their number for this.” We provide perspective.
I’m not going to tell you an ENT case per minute costs more than a robotic da Vinci case, but we give them the tools to put that number in if they need to dive deeper. When you try to do a complex Harvard Business Review analysis, you end up getting published but you don’t help your clinicians or health systems make the best choices for their system because they are so siloed.
We do these analyses because I have a personal problem when people tell me that 10 minutes in the Operating Room doesn’t matter unless we can book another case. That’s patently absurd. You don’t need to book another case. I know this because I’ve looked at other industries and talked to business people who run an OR or an ER, and they say, “Hold on, who told you that? Of course, 10 minutes matters to us.”
We can redeploy nurses to do something else. Sterile processing can do something else. We don’t have to call the post-call team back in, which gets expensive. We have a limited amount of anesthesia people, and we need to maximize what we can do. Every 10 minutes counts.
Now, they may not think it’s worth what I want to charge for my product to deliver that extra 10 minutes, and that’s okay. But these things are hard to calculate. If we don’t help customers come to their own conclusion, they just say, “Yeah, send it to the portal, and we’ll get to it — maybe in 14 months.” That’s because you’re not solving a problem for them; you’re just “schlepping a product.”
This is complicated stuff. They should have great processes for us to work through. You, Bob, have taught me more about how to follow up and report back on perceived savings because of the scope involved. The IV example you frequently use is such a good one, where a simple, lower-priced item here can be double the price there because they don’t see the other costs. This happens all the time.
It’s my job to make it easy for vendors to calculate and capture that stuff and be very clear and honest about it. I don’t think med device companies have been great at that, frankly, for a long time.
Solutions for Vendors and VA Practitioners
HVAUMM: What are some solutions that just make sense for VA Practitioners and Sales Reps to follow to smooth the road for all and achieve everyone’s objectives?
MC: From the vendor side, we need to be talking to the people who do Value Analysis, just like we talk to doctors who create products. Every company has 10 KOL (Key Opinion Leader) doctors they bring in to ask, “What do you think of this? What keeps you up at night?”
I tell these companies, stick with eight KOLs, and bring in two people who run some of these VA places. Ask them what matters to them. Don’t argue with them. Don’t fight them. Learn from them, just like you would the doctors. If vendors do that, they’ll go, “Oh, now I know what to do.” They need to do market research and understand what these people pay attention to and what keeps them up at night. That’s what vendors should be doing.
What I would urge health systems to do is educate, educate, educate, and then educate some more. I mean, educate their clinicians and their vendors. I recently listened to Joe Palona from Piedmont Health speak, and they seem to do a pretty darn good job of teaching both their vendors and clinicians.
Health systems need to train and teach. You can’t just send an email with a new acronym and expect everyone to understand, especially when health systems merge or acquire others. I would urge health systems to say, “We have to keep teaching our people how to do this, and teach our vendors.” The more they know, the easier this will get.
Vendors will sit in meetings to learn this stuff if, instead of being lectured to, they are taught. If you just said to vendors, “Here’s a good example, here’s a bad example, here’s what we need to know, we don’t care about this,” I think they’d be shocked at how much smoother the wheel rolls. Those vendors are also talking to doctors and can tell them, “Listen, I was at the meeting, here’s what they want to see.” Word gets out, and I think it might actually make the Value Analysis job easier.
HVAUMM: Not everything in a Value Analysis Team or Committee involves new product requests. That might take half the meeting, or sometimes all of it.
MC: That’s something I’ve learned from you and several others — the time spent on things they’ve already implemented and reporting back. When I started telling other people about that, they were surprised. I was out there giving the word from Value Analysis people back to the vendors, and all of them were thinking, “Huh, I didn’t really think about it that way.”
That’s why I say, educate. There’s a massive communication gap. And using a term like “Value Analysis” is an oblique term. What it really means is, “We want to be able to buy the single best products that we can for our patients, for the best patient outcomes, at hopefully the lowest price possible, with the most ease.” It’s really not much more complicated than that.
HVAUMM: What do you see in the future for Sales Reps and the new product requests handled by Value Analysis Teams?
MC: I think vendors are getting smarter, and I think Value Analysis and health systems are getting smarter. Hopefully, we will be able to come to market with better products that not only help patients and make things easier for clinicians but also have a good business rationale behind them.
A business rationale can be anything. I just saw one today for a positioner that lets one clinician do a task that previously required two, reducing the risk of workplace injuries. That’s a business rationale. You’re going to see products that come out with a great clinical case, but also, “Here’s some other things we noticed: fewer FTEs (Full-Time Equivalents), less workplace injuries, better patient experience.”
It’s not just about dollars and cents, but then we also have to be able to clearly say, “Here’s what it costs, and here’s what your expected spend would be.” The companies I deal with need to be strategic partners, not just transactional. We’re going to get there; we’re just not quite there yet.
HVAUMM: So, when you get the phone call from somebody who wants to engage with you, they’re often saying, “How do we get around these Value Analysis Committees? They’re killing me.” You’re basically going to say, “You can’t get around them.”
MC: Yes. As a matter of fact, I tell people that attitude has to change immediately. My old coach comes out in me. I tell them, “These people are not a hurdle. They are not something to get around. They are the customer.” The sooner you start thinking of them as a customer, the sooner you’ll start thinking of them not as the enemy but as somebody you need to persuade. Once you realize they’re the customer, you realize you need to understand what matters to them.
HVAUMM: I mean, the VA people are not really even the quarterback; they’re the coach on the sideline. They could put you into the game, or they could sit you on the bench very easily.
MC: They’re human beings. If you treat this process with the respect that everybody deserves, you will find incredible success. It doesn’t mean everyone will fall in love with your product, but if I know what matters to them, and I know typically how they make their decisions, I can give them what they need so they can decide where my product or service belongs for them.
I get calls all the time where people are looking for tricks to get around them, and I have to say, “You called the wrong guy. I don’t have one.” The attitude is changing, but there is still a long way to go.
Interview with:
Mark Copeland, Vice President, Sales, 3T Medical Systems, Inc.
Mark Copeland is a 28-year healthcare sales professional with the last 20 spent in startup medical device companies.
His company, 3T Medical Systems Inc, manufactures and sells innovative medical devices to health systems globally, and Mark teaches companies how to present their new product requests in a way that meets the value analysis requirements.
Contact Mark at mcope67@gmail.com for more information, or visit ValueAnalysisExpert.com.
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