By Michelle Gustafson, Director of Spend Optimization
I’ll admit it. When I was in high school, my friends and I spent a lot of time at the mall. And one of my guilty pleasures was browsing the racks at The Gap. I had it all. The jeans, the sweaters, the whole thing.
One time, a salesgirl talked me into buying jeans that were a size too big. I loved the style so much I couldn’t say no. She told me to cinch it with a belt, so I went home and did exactly that. I was swimming in Denim. If you didn’t know any better, you’d say I looked like one of the cast members of Friends.
The visibility-to-action gap, though, is an entirely different gap altogether. And it has kept me up at night a lot more than those jeans ever did.
Here’s a little context on why I care so much about this.
I started my career as an X-ray tech. I spent nearly two decades in the cath lab and interventional radiology, watching care teams make split-second decisions with whatever information was in front of them. Good data meant better decisions. Bad data, or no data, meant risk. That lesson never left me.
When I eventually moved into supply chain consulting, first at Vizient, then leading strategic sourcing teams at Marshfield Clinic Health System, Duke Health, and Jefferson Health, I kept running into a version of the same problem. Just on the financial side of the house instead of the clinical side.
Health systems have data. Lots of it. What they don’t have is a clear line from that data to a decision they can actually act on.
I was sitting in on a conversation recently with the VP of Supply Chain at a 500-plus-bed safety-net hospital in the western United States. Sharp guy. Lean background. He knew his spend inside and out. And he said something that I’ve heard in one form or another from nearly every supply chain leader I’ve ever worked with.
He said he wasn’t short on data. He had dashboards, portals, and benchmarking reports. What he was short on was a force-ranked list of what to do next, prioritized by what he could actually do something about right now.
He described one situation as “inactionable.” A real savings opportunity sitting on a contract that doesn’t expire until 2031. He could see it clearly. He just couldn’t touch it. And being handed that information, he said, felt less like help and more like being shown a window you can’t open. I reminded him that we do mid-cycle negotiations all the time and that in the world of healthcare as it exists today, nothing can be “inactionable”.
That’s the visibility-to-action gap.
Most organizations can see their spend. Few can effectively determine where value is actually being lost; which opportunities are real versus theoretical; which ones are actionable given current contract terms and organizational bandwidth, which to prioritize first; and how to convert any of it into measurable financial results.
The gap between visibility and action is where the money stays lost. Not because supply chain leaders aren’t paying attention. They absolutely are. But because most of the tools they rely on were built to show them data, not to tell them what to do with it.
I’ve sat on the other side of that table. I know what it feels like to have a board-level savings target, a lean team, hundreds of active contracts, and a portal full of benchmarking data that points you toward opportunities you can’t get to. It is a specific kind of frustration.
What closes the gap isn’t more reporting. It’s working at the invoice and contract level, with people who understand both the numbers and the operational reality of actually implementing change inside a health system. It’s knowing which surcharges aren’t permitted under your contract terms or should be negotiated out of your contracts. Which vendors have been quietly billing above your negotiated rates. Which mid-cycle conversations are worth having right now, without waiting for renewal.
That’s the work. And after more than 30 years in healthcare, from the cath lab to the boardroom, it’s the work I find most meaningful.
If any of this sounds familiar, I’d love to hear from you.
And as my friend Ross always used to say… 🎵 I’ll be therrrre for youuuu. 🎵