Turning Challenges into Opportunities: Mike Alkire

“Leadership is the art of getting someone else to do something you want done because he wants to do it.”

— Dwight D. Eisenhower

HEALTHCARE REFORM IS one of those hot-button topics best avoided at office water coolers and company dinner parties. But within the confines of the Premier healthcare alliance, it’s far more than a politically charged headline or topic for debate; it’s a driving force behind various initiatives that have become industry recognized models for reducing healthcare costs and raising standards of care.

Adept at turning challenges into opportunities, Mike Alkire, president of Premier Purchasing Partners Inc., believes one of the goals of healthcare reform must be to demolish the barriers that exist between clinicians, hospital staff, providers and payers. As the purchasing division of Premier, a healthcare performance improvement alliance of 2,400 not-for-profit hospitals, Premier Purchasing Partners is one of the largest healthcare group purchasing organizations in the United States, offering comprehensive supply chain services to hospitals across the country. Under Alkire’s leadership, Premier provides members with innovative programs and services that foster supply chain improvement, promote cost savings and facilitate shared best practices.

“One of our primary functions is to help hospitals accelerate performance for both clinical outcomes and supply chain costs,” says Alkire. “We’re creating a standard for the sharing of information that can be easily applied and implemented. I really believe that we have to be the ones to drive change — if the stakeholders don’t establish the standards, the standards will be chosen for us.”

A Model for National Healthcare Reform

In recent years, Premier has led several successful initiatives that have garnered national attention, including the 2003 HospitalQuality Incentive Demonstration (HQID), a pioneering value-based purchasing project with Medicare. More than 250 hospitals with varied demographics participated in the sixyear program, which studied quality process measures and outcome statistics. Specific studies examined admission procedures, such as whether cardiac patients were offered aspirin upon arrival, while others analyzed mortality and infection rates. Initially, topperforming hospitals were rewarded while underperforming participants were penalized; midway through the project, performance incentives evolved to include bonuses for various benchmarks and improvements. The program is significant because its results were later used as a model for national healthcare reform.

“Having anticipated the need for reform nearly a decade ago, we’ve worked proactively with our members to introduce offerings that would help hospitals reduce readmissions, expand evidence-based care delivery, improve patient safety and eliminate excess costs,” explains Alkire. “HQID is one example; another is our acquisition of an automated surveillance system to help hospitals reduce risk and harm.”

In fact, Premier houses the nation’s largest detailed clinical and financial database, containing patient level data from more than 600 hospitals, 45 million records and 309 million hospital visits. Web-based tools allow hospitals to compare their performance in specific areas to peers and best performers, find opportunities for improvement, and track the results of their efforts. This data warehouse is used by the Food and Drug Administration for drug surveillance and by the Centers for Medicare and Medicaid Services to evaluate nextgeneration payment models.

“The value of this platform is in that it allows our hospital members to take a critical look at things like evidence-based outcomes, geographical variations and resource utilization,” Alkire says. “Our board of directors has a fundamental belief that the wide variation in how medicine is practiced and how products are used are at the root of the industry’s problems. We are focused on tightening up the variations by sharing vital data that can create increased evidence-based outcomes, improved collaboration and more predictable outcomes.”

Premier’s other recent accomplishments include the “QUEST” collaborative, referred to within the company as “an insurance policy for reform.” QUEST helps participating hospitals avoid payment penalties by enhancing quality, reducing readmissions, expanding evidence-based care delivery, improving patient safety, preventing harm and eliminating excess costs. Alkire says in the first 18 months of the project, participants are estimated to have saved more than 14,000 lives and more than $1 billion.

Another alliance effort Alkire is especially proud of is Premier’s new Accountable Care Organization (ACO) collaboratives. ACOs connect groups of providers who share the common goal of improving the health status, efficiency and care for specific populations.

“Healthcare is a very fragmented system, and we are actively working to change that,” says Alkire. “We are in a unique position because we have 2,400 member hospitals; this allows us to leverage our influence and share best practices in a timely fashion, and the timely sharing of information leads to innovation. We also have a voice and a measure of influence at the federal level, especially when it comes to how certain reform programs are rolled out and implemented. Our members recognize the inherent value in that.”

Identifying the Big Picture Challenges

In looking at some of the big picture challenges within the healthcare industry, Alkire identifies two major issues: the lack of shared interests within U.S. hospitals and the overall cost of healthcare currently weighing on the federal budget. “I think everyone understands that we cannot continue to pay at the same levels — we have to create a different delivery system,” he says. “There is a keyhole we have to squeeze through before we successfully make that transition, and some stakeholders will have to temporarily defer their own personal profit for the greater good.”

A hands-on leadership style drives Alkire to spend a majority of his time on the road interfacing with Premier’s members and business partners in an effort to better understand their issues and gather valuable input. When he’s not traveling, Alkire motivates his leadership team by continually sharing and modeling the company vision and purpose “to improve the health of communities.” In terms of company culture, Alkire says he strives to create an atmosphere where opinions and ideas are welcomed and implemented. “We recognize innovation, while also placing a high value on performance and execution,” he says. “I have a passion for communicating ideas in a way that is not dictatorial, but rather inspires action.”