Inside five Vizient member systems, hospitals with the same case mix spend up to twice as much per discharge.
Non-salary costs, from 2023 Medicare cost reports. Each gap is a ready-made first site for the solutions Vizient previewed in September.
Every system has a matched pair at least 22% apart. In California, the gap is nearly 2×.
Non-salary operating expense per adjusted discharge, divided by Medicare case mix index. One dot per hospital, 96 hospitals with 50 or more beds. Joined dots are two hospitals in the same system and state whose case mix is within 0.1.1
Higher-cost hospitalIts matched twinOther hospitalsSystem median
The pairs share a state, a size band and a case mix, so the gap needs an explanation the cost report can't give.
Dollars per case-mix-adjusted discharge, fiscal 2023. Hospitals are named as on their cost reports, shortened.2
System
Higher-cost hospital
Per discharge
Matched twin
Per discharge
Gap
Sutter Health
Alta Bates315 beds · case mix 1.80
$12,642
Sutter Roseville343 beds · case mix 1.79
$6,389
1.98×
Providence
St. Joseph Eureka131 beds · case mix 1.92
$8,207
St. Mary Apple Valley214 beds · case mix 1.86
$4,387
1.87×
AdventHealth
Heart of Florida202 beds · case mix 1.69
$4,930
Sebring204 beds · case mix 1.72
$3,400
1.45×
SSM Health
St. Mary’s Jefferson City140 beds · case mix 1.71
$3,028
St. Clare Fenton180 beds · case mix 1.64
$2,479
1.22×
Intermountain Health
Alta View57 beds · case mix 1.45
$4,479
Riverton87 beds · case mix 1.45
$3,682
1.22×
How I've tackled spend that doesn't buy outcomes
At Bayer I led the annual budget reset that took a 100+ person AI startup from $50M to $30M in burn, while the customer base and release pace both grew. The method was the one on this page: compare like units, then ask why the costly one costs more.
Each of the three new solutions gets a pilot where the gap is widest for what it fixes.
Solutions as described in Vizient's September 22, 2026 preview.3
P2P Price Assurance
Sutter Health · Alta Bates and Sutter Roseville
Check whether the 1.98× hospital pays more for the same items
Price Assurance matches invoices to contract terms. Two hospitals with the same case mix inside one system should pay the same contract price, so any invoice gap between them is a direct finding.
First move. Run both hospitals' last 90 days of invoices against contract and compare price variance in their 20 largest categories.
Agentic Sourcing
Providence · St. Joseph Eureka and St. Mary Apple Valley
Let the agent rank where Eureka spends more per case
Agentic Sourcing is built to find and rank savings in fragmented supplier spend. A 131-bed hospital at 1.87× its twin is a fair first test.
First move. Point it at both hospitals' supplier files and count how many of its top 10 ranked savings hold up after a sourcing lead's review.
Clinically Integrated Supply Chain
AdventHealth · Heart of Florida and Sebring
Find the service line behind a 1.45× gap between two 200-bed hospitals
AdventHealth expanded its access to Vizient's Clinical Data Base in January, so the supply cost per case by service line is already in Vizient's hands.4
First move. Pull supply cost per case for the five highest-volume service lines at both hospitals and take the widest one to its physician lead.
Next step: a 90-day Price Assurance pilot at Alta Bates and Sutter Roseville, measured in invoice dollars recovered against contract.
The pair is the control. If Alta Bates' price variance closes toward Roseville's in 90 days, Price Assurance has a case study with a matched comparison behind it, which is the evidence a member CFO asks for first.
I'd be glad to walk through the data in 20 minutes.