DGOS – Procurement
The French General Directorate for Healthcare (DGOS – Direction générale de l’offre de soins), which is related to the French Solidarities & Health Ministry, has launched the procurement transformation program « PHARE » in 2011 in order to generate « smart savings » and, in the meantime, ensure the quality of care.
Standard levers such as « massification » and rationalisation have been strongly activated since 2011. These actions highly contributed to improve GHTs’ procurement maturity during the previous years. Today, the ambition of the DGOS is to go one step further and support GHT towards more advanced procurement mechanisms initiatives and a strategic use of procurement, i.e. take « les achats complexes » to the next level.
A first consultation jointly organised with the lifescience industry, hospital federation and hospitals reveals that complex procurement levers initiatives « les achats complexes » could be applied within three kinds of areas: patient pathway optimisation, medicotechnological equipment harmonisation, and the make-or-buy decision.
« Le marché global de performance » (overall performance market) is a specific type of contract/tender provided by French public market law which represents an asset to unlock « les achats complexes ».
EU4HS Consultancy
Consultancy was provided to the EUROGROUP Consulting, who were commissioned by DGOS in France to optimise the public procurement process.
« Les Achats Complexes » will help to create value at three different levels and thus contribute to patient care pathway optimisation and outcomes.
Direct economic value
à All the financial benefits/gains related to the purchasing of a specific product and/or service (incl. cost of disposables material, frequency of use of product, related complications, price, human & institutional cost of resources used, training, maintenance, leasing cost, outsourcing, disposing, storage…).
Indirect economic value
à All the benefits/gains (financial excl.) related to a purchase which impact the overall economic value and therefore contribute to the creation of financial value.
Non-economic value
à All the improvements/optimisations generated by the change of procurement practices across the whole healthcare ecosystem: patients, caregivers, hospitals, society.
Contractual terms will further help to regulate and guarantee value creation over the long term thanks to service provider payment/rewarding income models based on objectives and KPI achievement (bonus/malus).
The application foreseen in 3 areas
Patient pathway optimization
This first area of application includes all type of procurement which includes mix medical devices and related services (« solutions »). It aims to optimise the patient care pathway at every step and relies on specific « overall performance market contracts » and Value-Based Procurement principles.
It could concern all purchase linked to the patient care pathway optimisation: prevention, diagnosis, preparation, medical intervention, medical recovery, patient follow up,…
Initially a focus on innovative solutions related to hospital covered services liabilities and then will launch initiatives related to ambulatory and primary care services.
Medico-Technological Innovation Equipment
This second area consist to activate optimisation levers by combining the purchase of medicothechnological equipment/device and the services related to the equipment/device cycle life and use: maintenance, training, end life cycle management, funding, energy consumption, clinical efficient use.
Considering a supportive tools: overall performance market contracts, full cost-pricing and total cost of ownership (TCO) / technical, financial, legal level and partnership agreements,
Make are Buy
The make-or-buy decision is the act of making a strategic choice between producing an item or manage a services internally (in-house) or buying it externally (from an outside supplier).
Comparative analysis between internalizing vs outsourcing will concern non-core business items only in this case and will help to set up performance targets and capture additional value.
A non-core item is a function considered to be outside of all medical business activities such as facility management.
In addition to an overall educational support on the application of a value based approach to obtain economic most advantegous tender, a deep dive was support in technologies as minimally invasive soft tissue robotic surgery.
A guiding principle for the Strategic use of procurement :
