I’ve talked to hundreds of supply chain leaders at independent, critical access, and rural hospitals across the country. The conversations are different every time. The problems vary. The personalities vary. But one thing comes back almost word for word, every single time: “I wear a lot of hats, and I work in complete isolation.”
That phrase has stuck with me. And the more I’ve sat with it, the more I’ve come to believe it’s the single most important thing to understand about this segment of our industry. The defining challenge for supply chain leaders at these hospitals isn’t budget. It isn’t size. It’s isolation. And most of us have been trying to solve the wrong problem.
Everything Is Built for Somebody Else
Here’s what I mean. Think about all the resources that exist for healthcare supply chain professionals. The webinars. The value analysis content. The GPO programs. The vendor initiatives. The conferences. The educational tracks. Almost every single one of them is designed for larger health systems. That’s not a criticism of anybody specifically. It’s just where the volume is, so it’s where the attention goes.
But it leaves a whole segment of this industry with nothing built for them. A 25-bed critical access hospital in rural America is managing many of the same product categories, the same compliance requirements, the same price increases as a large IDN. The work doesn’t scale down just because the hospital does. The IDN has 150+ people in supply chain, with the GPO team and primary distributor rep embedded in the building and on the team. The independent hospital has a department of two and a never-ending list of things on their plate. They’re slammed every day. The phones are ringing off the hook. They’re just not getting attention from the people who should be paying it.
I talk to vendors regularly who tell me they don’t even pay commissions to reps that call on hospitals under 250 beds. Think about that for a second. The incentive structure of our industry has been designed to route attention away from these facilities.
And the stakes couldn’t be higher. According to the Center for Healthcare Quality and Payment Reform, more than 700 rural hospitals are at risk of closing, with over 300 at immediate risk. The hospitals that are still standing are making impossible business decisions just to keep their doors open. Since 2020, more than 100 rural hospitals have closed their labor and delivery units. Only 41% of rural hospitals still offer L&D at all. I know of hospitals weighing whether to keep their L&D open when they’re the only option for an hour’s drive in any direction, knowing the financial strain of keeping it staffed could force them to close the entire hospital. No L&D, or no hospital at all. That’s the kind of decision these leaders are making.
You’re not running supply chain for a small independent hospital, many of which are hours from a major city, without the recognition or resources your peers at larger systems get, if you’re not mission-driven. These leaders show up every day for their communities. They deserve to have somebody show up for them.
The Community That Didn’t Exist
When I tell industry partners that our focus is these hospitals, the most common response I get is: “There are still independent hospitals?”
Yes. There are. And they’re the backbone of the communities they serve. The more time I spent inside these facilities, the more obvious it became that this segment needed somebody in their corner. Not as a side project. As the main thing.
So with AHRMM’s support, we launched the Independent Link Coalition. It’s the first nationwide initiative built specifically for supply chain leaders at independent, critical access, and rural hospitals. We’re closing in on 100 members, and the community is growing every week.
Here’s the thing that matters most about how ILC works. This isn’t a top-down program where somebody talks at these leaders about best practices. The role I took on was to build the infrastructure. The members are the leadership now. They choose the topics. They run the roundtables. They share the templates. They answer each other’s questions. My role is to create the room. Theirs is to fill it with their expertise and their voices. And they have.
A few months ago, a new supply chain leader at a rural hospital in California posted in our community. He’d just been tasked with launching a value analysis program at his facility, and he’d never built one before. No team to lean on, no playbook, no idea where to start. Within hours, members from across the country were responding. People who had built VA programs from scratch shared their templates, their lessons, their mistakes. He didn’t have to figure it out alone. That’s what this community does.
This isn’t a one-time lunch and learn you attend and forget. It’s monthly peer roundtables on topics the members pick themselves. It’s education sessions on the things the bigger systems already have figured out but these hospitals are being left to solve on their own. How to launch a value analysis program at a small facility. How to use AI tools effectively when you’re a department of two. How to run a modern supply chain with the resources you actually have. It’s a continuous place to turn when the questions come up, because the questions always come up.
To the Leaders Reading This
If you’re a supply chain leader at an independent, critical access, or rural hospital, and you’ve felt like you wear too many hats and work in isolation, here’s the truth. You’re not alone. There’s a community that was built for you, and it’s growing every week. The people in it understand what you’re dealing with because they’re dealing with it too. They’re sharing what works. They’re helping each other get through the hard days. They’re proving that when the supply chain leaders at these hospitals have a place to find each other, the isolation starts to lift.
You deserve support that’s been a long time coming. And you deserve to be in a room with people who get it.
Come join us.
Article by:
Mark Litton, CEO of Howard Medical Company
Mark Litton is CEO of Howard Medical Company, an independent distributor on a mission to bring IDN-level services to independent, critical access, and rural hospitals. Howard Medical gives these facilities visibility into their spend and contracts at no cost, and partners with them to execute on the savings, not just identify them. Mark is also the founder of the Independent Link Coalition, an AHRMM-backed peer network for supply chain leaders at independent hospitals.
Learn more about ILC at https://independent-link-coalition.circle.so/
Connect with Mark on LinkedIn at https://www.linkedin.com/in/mark-litton-48b66252/
Or reach him directly at mark@howardmedical.com.
Articles you may like:
From Decision to Proof: Why Value Analysis Only Succeeds When the System Holds
