CWS 3.0: November 6, 2013

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VMS/MSP Prove Contentious at Healthcare Staffing Summit

Contingent buyers in the healthcare industry are among the last to adopt vendor management systems and managed service providers, and many staffing suppliers have concerns about their use.

VMS and MSP proved a controversial topic at the Healthcare Staffing Summit held last month in Chicago — an event that brought together healthcare staffing firms from across the country.

VMS/MSP concerns aired during the conference included lower bill rates, lack of transparency and, in the case of MSPs, being forced to work with their competitors.

On the other hand, VMS and MSP supporters argued such systems could even the playing field among firms, improve payment terms and allow staffing suppliers to sell into large organizations without the need for a big sales force.

MSPs have been around for 20 years and VMS around for 17 years, but VMS and MSP in healthcare have been around only about a decade, said Bob Livonius, president, strategic workforce solutions, at AMN Healthcare Inc., in a talk at the conference.

The final frontier. And while VMS and MSP are already being adopted for healthcare staffing segments such as nurse and allied healthcare, locum tenens ranks among the last of the healthcare segments to get VMS. This is happening even as more firms enter the locum tenens segment (provision of temporary doctors), with healthcare staffing buyers getting inundated with sales calls.

“We are driving our clients nuts in the locums sector,” Livonius told the audience of healthcare staffing firms.

He cited three myths as to why locum tenens won’t go through VMS:

  • “Physicians are ‘different.’”
  • “Physicians can only be presented by the company that ‘represents’ them.”
  • “We have to talk with clients directly.”

Livonius, whose company provides an MSP and VMS, said locums is the last labor category where potential savings can be achieved, and healthcare organizations are under enormous pressure to find ways to control costs.

However, concerns over VMS and MSP were aired at the conference as well.

Widely panned. Colleen Mills cited a survey of independent healthcare staffing firms where she said 100 percent of the responses included negative comments on VMS and MSP. Mills is senior vice president, standards and government relations, at the National Healthcare Staffing Alliance.

Concerns cited by Mills during her presentation included arbitrarily lowered bill rates, lengthened payment terms, staffing suppliers prohibited from directly contacting managers at buyer sites, lack of transparency and lack of feedback on workers sent to buyers among other things.

Mills’ survey found that 50 percent of independent healthcare staffing firms reported a decrease in rates of 10 percent. Further, 38 percent of firms reported a 15 percent decline in rates.

Many hospitals do not know staffing firms are not allowed to talk directly to them, she said. In one case, a contingent nurse was improperly blamed with a problem and a no-contact rule made the situation difficult to resolve.

Another concern was a lack of payment to staffing firms, in some cases, if the host facility recruits a temporary worker directly, Mills said. It’s also a concern that an MSP may have an opportunity to fill positions itself before going to other suppliers in the program.

However, there were VMS/MSP success stories among staffing firms as well

Pankaj Jindal spoke from an information technology staffing perspective, where VMS and MSP is already firmly in place. Jindal at one time built up a $50 million IT staffing firm that did all its business through VMS/MSP.

VMS is a good value proposition for buyers, Jindal told healthcare staffing attendees during a panel at the conference. “We figured out this was a model that was going to catch fire.”

Although his firm didn’t start by solely servicing VMS/MSP, he tailored it to serving them in terms of recruitment strategy and incentives for internal workers. Jindal is now chief operating officer of Akraya Inc.

Equal chance. A benefit of a good MSP is that it can level the playing field, giving smaller firms the same shot at filling openings as larger players, he said. MSPs can have program fees of about 1 percent to 2.8 percent, but that is somewhat offset by lesser investment in sales and account management as well as better payment terms. In one case, Jindal said a client reduced its payment terms to 17 days from 67 after it adopted the MSP.

MSPs can also provide a certain amount of volume, although there can be volume discounts, Jindal said.

Stakeholder support. Leanne Oatman, executive vice president of MSP-provider RightSourcing Inc., said in a conference session on working with MSPs that a concern when implementing such a system is getting everybody on board.

“The biggest challenge in the beginning is getting all the key stakeholder from both the suppliers and the client on the same page,” Oatman said. “So it’s understanding what’s in it for them? Where’s the value? What’s driving the change? And then communicating that out to the hiring managers and suppliers so that everybody’s on board in terms of change management and they’re award of again what’s in it for them.”

Several at the conference argued that efficiency will win out in the end.

The National Healthcare Staffing Alliance’s Mills said her organization is working on possible solutions to difficulties presented by the VMS/MSP relationship. However, she also said that hospitals — large buyers of contingent healthcare staffing — are in a tough spot.

“Hospitals are working in a very rigid, a very unfavorable climate and they have great challenges,” she said.

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James Waite 11/11/2013 5:23 am

The challenges here with VMS/MSP faced by the Healthcare Industry are no different than challenges faced by other industries. Oatman is spot on with her diagnosis; alignment on talent equilibrium strategy and objectives is critical to the success of any sourcing program. Rates & payment terms can only be seen in the context of the aggregate labor market and how a client wants to position themselves within their own sector. MSPS and VMS providers do need to be more transparent and not hide behind a "reactive" sourcing model and spend more time developing innovative supply incentivization models.


Gary Campbell 06/11/2013 3:42 pm

Since coming into this side of healthcare a few years back, I have a much better understanding of the slower adoption (remember, this is the group that until only recently relied on all paper charting). This is where the rest of the industry was over 10 years back. The key to success here, as anywhere, is to fully know what you want from the MSP/VMS engagement. You also need a program champion at the top within the hospital/healthcare system so there is no misunderstanding of direction here. Finally, the MSP needs to have a solid track record of successfully delivering results in this area. No MSP will be successful when the internal client isn't completely bought in at the start.


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