The Capital Compass

By VizientBusiness Medicine Health & Fitness Investing

The Capital Compass episodes

August 12Strategic capital planning: Balancing financial pressure, equipment needs & long-term growth
00:04 — Introduction & Episode Overview
Host Susan Edwards introduces the challenge facing healthcare executives: how to continue investing in critical equipment, infrastructure, and technology while operating margins remain under pressure.
Healthcare organizations are balancing:
Aging equipment
Demand for advanced technology
Workforce challenges
Changing patient expectations
Financial and operational constraints
Guests:
Danny Cisneros, Associate Principal, Capital Equipment Solutions, Vizient
Jon Nickvis, Senior Vice President, Kaufman Hall
The conversation explores how organizations can prioritize investments, evaluate funding models, and build sustainable capital strategies.
01:44 — Today’s Financial Environment
Every dollar matters as health systems operate under continued financial pressure.
Major facilities and strategic investments traditionally receive significant financial scrutiny, while equipment spending can be more reactionary.
Treating equipment financing as a strategic decision can help organizations:
Preserve cash
Improve capital efficiency
Maintain financial flexibility.
02:26 — Bringing Discipline to Capital Equipment Planning
Strong organizations establish clear ownership of the equipment planning and financing process.
Without accountability, organizations risk:
Evergreen lease extensions
Keeping equipment longer than intended
Difficult end-of-term requirements
Unplanned financial decisions
Ownership needs to begin upfront, not when a contract or lease is about to expire.
03:17 — Post-COVID Capital Decisions & Embedded Leases
Accounting changes have influenced how organizations evaluate equipment leases.
Health systems may turn to placement agreements that bundle:
Equipment
Services
Software
Disposables
Reagents
These arrangements can unintentionally circumvent strategic capital decision-making and create accounting complexity.
04:02 — The “Spiderweb” of Placement Agreements
Large organizations may lack a consistent process for auditing placement agreements.
Ownership may shift between individuals and departments over time.
Agreements can include right-of-use assets that may need to be treated as equipment leases.
Poor visibility creates:
Equipment risk
Strategic risk
Accounting risk
Audit risk.
05:02 — The Need for Specialized Expertise
Real estate and capital equipment may both affect the balance sheet, but require very different expertise.
Legacy ownership structures can leave responsibility with individuals who were never intended to manage an expanding equipment portfolio.
As organizations grow, processes need to mature rather than continuing to rely on institutional knowledge alone.
06:25 — Capital Equipment as a Growing Strategic Priority
Equipment planning is receiving greater attention as organizations recognize its connection to:
Clinical outcomes
Patient care
Operational performance
Cybersecurity
Aging technology can introduce new risks, making it increasingly difficult to rely on reactive replacement strategies.
08:01 — Balancing Immediate Needs With Long-Term Strategy
Organizations should avoid using placement agreements simply to circumvent capital approval.
Instead, leaders should develop a forward-looking capital plan that evaluates:
What equipment is needed
Why and when it is needed
How it should be financed
Options may include:
Cash
Finance leases
Fair-market-value operating leases
Placement agreements
Finance should be involved earlier in the process.
09:28 — The Visibility Problem
Equipment does not suddenly become outdated when a quote reaches sourcing.
Waiting until procurement begins means many cost decisions may already be effectively determined.
Service, IT, implementation, and other expenses also need consideration.
The larger challenge may be less about access to capital and more about visibility into future equipment needs.
10:09 — CapEx, OpEx & Hidden Equipment Costs
Organizations may lack clarity around what should be treated as capital expense versus operating expense.
Vendors should not be relied upon to make accounting decisions for health systems.
A right to use equipment may represent an embedded lease requiring balance-sheet treatment.
Earlier finance and treasury involvement can reduce total cost and accounting risk.
11:57 — When Keeping Aging Equipment Costs More Than Replacing It
Deferred equipment replacement can create costs far beyond maintenance.
Equipment downtime can:
Shut down operating rooms
Delay or reschedule procedures
Increase administrative work
Reduce revenue
Affect surgeon relationships
Push patients and procedures to competing sites.
13:07 — Cybersecurity, Maintenance & Operational Risk
Aging equipment may require greater:
HTM labor
Parts expense
Service support
Older operating systems can create cybersecurity vulnerabilities.
Inconsistent equipment across departments can also increase training and change-management burden.
Aging technology may slow procedures and create workarounds that reduce efficiency.
14:55 — The Long-Term Cost of Deferring Capital Decisions
Lease extensions can become surprisingly expensive.
Equipment intended for a three-year lease may cost significantly more when repeatedly extended.
Jon explains that organizations need to align:
Useful equipment life
Lease term
End-of-term flexibility
Otherwise, seemingly easy short-term extensions can substantially increase long-term costs.
16:26 — Connecting Capital Investment to Patient Care
Equipment strategy should ultimately support the health needs of the community.
Access to innovative technology can help clinicians:
Diagnose patients sooner
Perform procedures efficiently
Improve clinical outcomes
Support post-procedure care
Capital equipment is an important component of delivering high-quality care.
18:08 — Creative Equipment Funding Models
New models include:
Pay-per-use
Pay-per-click
Cloud agreements
Managed equipment services
Other bundled arrangements
These structures are not inherently bad, but organizations should compare them against traditional alternatives such as cash purchases and leases.
Contract terms can determine whether an organization retains flexibility to upgrade technology later.
20:44 — Avoiding Pressure-Driven Capital Decisions
Urgent equipment needs can put finance teams in a difficult position.
Time-limited supplier offers may encourage organizations to make decisions before contracts receive adequate review.
Short-term convenience can create longer-term financial and contractual constraints.
21:12 — Hidden Financial & Strategic Risk
Alternative financing arrangements may appear to reduce short-term financial pressure while increasing long-term risk.
Potential exposures include:
Technology risk
Legal risk
Audit risk
Accounting risk
Rating agency risk
Individually small agreements can become significant when aggregated across a large health system.
22:38 — Turning Equipment Into a Strategic Asset
Capital equipment should align with an organization's mission and strategic priorities, rather than being replaced simply because it is old.
Leaders may need to prioritize high-impact technology over lower-priority replacements.
Greater visibility allows organizations to allocate limited capital toward equipment that best supports service-line and organizational goals.
24:30 — Capital Planning as a Competitive Advantage
Capital planning can help organizations support:
Service-line growth
Margin improvement
Clinical recruitment
Technology modernization
Finance, treasury, supply chain, procurement, and clinical stakeholders should collaborate earlier.
Contracts should provide enough flexibility to respond as technology and strategic priorities evolve.
26:08 — Best-in-Class Care Requires Best-in-Class Tools
Modern equipment can be part of an organization's competitive positioning.
Clinicians recognize differences in the technology available to them.
Organizations positioning themselves as leaders and innovators need equipment capable of supporting that strategy.
26:57 — Capital Planning Trends Over the Next 3–5 Years
Capital equipment is becoming a more visible strategic priority.
Health systems are increasingly turning to subject matter experts to help:
Improve processes
Increase visibility
Manage financial pressures
Avoid adding unnecessary staffing simply to support inefficient workflows
More organizations are recognizing that equipment planning requires dedicated expertise.
28:52 — Moving Capital Equipment From Afterthought to Strategy
Capital equipment historically received less strategic attention than real estate, M&A, and other major investments.
That is beginning to change.
Organizations that successfully align:
Capital acquisition planning
Cash vs. financing decisions
Contract structures
Rapid technology change
may position themselves ahead of peers.
30:01 — Final Advice: Start With Visibility
Danny’s takeaway:
Understand what equipment and assets you currently have.
Greater fleet visibility is the first step toward effective long-term planning.
Organizations must become comfortable with:
Process change
New technology
Improving capital-management maturity.
30:38 — Take Ownership of Capital Decisions
Jon’s takeaway:
Ask: “Was this our decision, or was this our supplier’s decision?”
Health systems should own decisions about:
What equipment to acquire
How to pay for it
Which financing structure creates the greatest value
Suppliers can be important partners, but the health system must retain strategic ownership.
31:03 — Closing
Susan summarizes the central message: healthcare organizations do not necessarily have to choose between fiscal responsibility and strategic investment.
Successful capital strategies align investment decisions with organizational priorities, evaluate funding options thoughtfully, and direct resources toward areas with the greatest potential impact.
Listeners are encouraged to explore additional capital planning and equipment strategy resources and subscribe to Capital Compass.

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32 min
August 05 Recovering lost value in capital procurement
Healthcare organizations often negotiate strong pricing, incentives and contract terms for capital equipment, but the full value of those agreements can be lost as projects move into execution. In this episode, we examine where value leakage occurs, why it can be difficult to detect and how Vizient’s Capital Procurement Recovery program helps healthcare organizations validate pricing, activate contract benefits and recover missed value while protecting every capital dollar invested.

Guests:
Vizient Capital Procurement Recovery subject matter experts
Capital Equipment Solutions and Contract Services
Vizient

Moderator:
Susan Edwards
Product Marketing Manager
Vizient

Show Notes:
[00:52 – 02:25] Why is protecting negotiated capital value increasingly important for healthcare organizations?
[02:25 – 04:35] How fragmented project teams and stakeholder handoffs create blind spots during capital procurement.
[04:35 – 06:30] The operational, clinical and financial effects of value leakage.
[06:30 – 08:40] Why margin pressure makes recovering every available capital dollar more important.
[08:40 – 10:40] The client challenge that led to the development of Capital Procurement Recovery.
[10:40 – 12:45] How missed pricing tiers, rebates and incentives can reduce the value of a negotiated agreement.
[12:45 – 14:50] The discovery process: validating purchases, contract terms and supplier commitments.
[14:50 – 16:55] The difference between a traditional vendor and a strategic capital procurement partner.
[16:55 – 18:55] How Vizient’s GPO relationships, contract knowledge and market perspective support recovery efforts.
[18:55 – 20:45] What the Capital Procurement Recovery review looks like in practice.
[20:45 – 22:35] The performance-based model and how it aligns success with measurable value delivered.
[22:35 – 24:20] Why active validation matters throughout the capital procurement lifecycle.
[24:20 – 26:08] Key takeaways: do not assume negotiated terms will be realized automatically, and use recovered value to support patient care, infrastructure and future growth.

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27 min
May 04 Holding the line: Capital strategy for rural and independent community hospitals
Today we're going to explore the current state of rural hospitals and independent community hospitals, many of which are navigating razor thin margins and rising capital costs. We'll talk about emerging policy support and how this may impact capital investment decisions.

Guests:
Russell Hall
VP, Independent Community Market
Vizient

Rebecca Gayden
Sr Principal, Capital Equipment Solutions
Vizient

Host:
Susan Edwards
Product Marketing Manager
Vizient

Show Notes:
[01:40 – 3:27] State of the union when it comes to rural hospitals
[03:27 – 04:09] The pressures being faced by rural and community hospitals and how that affects capital spend
[04:09 – 04:46] The tradeoffs being made
[04:46 – 6:27] How an independent hospital needs to prioritize
[6:27 – 8:22] Rural health transformation funds
[8:22 – 9:08] Following the money
[9:08 – 13:41] Determining eligibility and other options
[13:42 – 15:55] How we bridge the gap between strategy and action
[15:55 – 17:57] The most effective use of dollars
[17:57 – 19:10] Maximizing capital dollars
[19:10 – 20:47] Additional levers and Group buys
[20:47 – 24:11] What's ahead
[24:11 – 25:42] Wrap up and suggestions

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27 min
January 09 The Capital Commit Program
Haphazard plans aren't really plans at all and when you are dealing with capital commitments that can range from thousands to hundreds of thousands of dollars In expense, the work you do BEFORE you spend Is as Important as the spend Itself. That's where Capital Commit comes In.

Guests:
Mahogany Laur
Program Services Manager
Vizient

Tammi Pegues
Program Services Director
Vizient

Host:
Susan Edwards
Product Marketing Manager
Vizient

Show Notes:
[00:45 – 05:08] What Is the capital commit program? What Is the history of It?
[05:08 – 08:04] The power of aggregation and the Ideal client.
[08:04 – 09:20] Utilizing leverage and commitment.
[09:20 – 12:10] Group buys and how commit Is different.
[12:10 – 14:52] How does the program support the suppliers? The power of Data.
[14:52 – 15:46] Price paid transparency.
[15:46 – 20:32] What Is the future of Capital Commit?
[20:32 – 22:37] Wrap up and suggestions

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23 min
December 08, 2025 Unlocking value
Where is the true value in capital equipment procurements? Capital purchases are often high-stakes decisions that require coordination between clinical, financial and operational teams. Listen In as we unlock the secrets to finding value within your capital expenditures.

Guest:
Adam Fairbourn
Sr. Director, Contract Services
Vizient

Joni Swartz
Sr. Director, Contract Services
Vizient

Host:
Susan Edwards
Product Marketing Manager
Vizient

Show Notes:
[01:24 – 03:05] What makes capital equipment procurement unique?
[03:05 – 05:30] Vizient's bid process explained.
[05:30 – 07:13] How important is the total cost of ownership?
[07:13 – 9:58] What value can be unlocked In the GPO national agreements.
[9:58 – 12:17] Examples of how the framework Is put together.
[12:17 – 13:39] What Is the value of unlocking a GPO?
[13:39 – 14:58] How can smaller clients unlock the same value?
[14:58 – 16:18] Are group buys available?
[16:18 – 19:10] Unlocking value on a large scale.
[19:10 – 21:45] Are there quick wins to be found?
[21:45 – 23:05] Wrap up and suggestions

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24 min
November 14, 2025 Precision equipment planning boosted by Vizient’s GPO
What makes medical equipment planning such a crucial part of the construction, expansion and renovation equation? When you think of construction costs, you can't limit yourself to thinking of bricks and drywall. There's way more to It. In this episode, we explore the costs associated with medical equipment and medical equipment planning so that you're better Informed when It comes time to renovate or build that new medical space.

Guest:
Patrick Melone
Associate Principal, Capital Equipment Solutions
Vizient

Host:
Susan Edwards
Product Marketing Manager
Vizient

Show Notes:
[00:52 – 02:21] What's the big picture? Why Is medical equipment planning Important?
[02:30 – 03:30] The hidden pitfalls of construction and expansion projects.
[03:31 – 04:50] How do you now need to approach equipment planning with new developments in technology?
[04:51 – 7:27] How does cyber security play into planning?
[7:28 – 9:10] Where can cost overruns happen?
[9:20 –10:45] The lifecycle of equipment. The total cost of ownership.
[10:47 – 11:29] The Importance of terms and conditions.
[11:27 – 12:24] Is sustainability a key decision-making element?
[12:24 – 14:17] The Vizient difference. The value of the GPO.
[14:17 – 16:34] How do we get a project to the finish line?
[16:34 – 18:02] Budget management.
[18:02 – 19:09] The role of medical equipment planning during the construction process.
[19:09 – 19:56] The owner contractor architect meeting.
[19:56 – 21:17] Key takeaways and things to think about.
[21:17 – 22:15] Wrap up and suggestions

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23 min
October 08, 2025 Total cost of ownership
What is the true cost of ownership when it comes to medical equipment? When you think of capital spending, ownership costs can become very configurable from the standpoint that everyone has different systems, tools and methods to arrive at a base value. That's why Vizient has put tools in place that allow for a certain amount of standardization and consistency, essentially leveling the field when it comes to ownership costs and strategies.

Guest:
Danny Cisneros
Sr. Consulting Director
Vizient

Host:
Susan Edwards
Product Marketing Manager
Vizient

Show Notes:
[00:46 – 03:15] What Is total cost of ownership? What Is Its history?
[03:15 – 04:13] The science behind "unbundling" of equipment costs
[04:13 – 08:20] How does the cost of ownership Impact expansion?
[08:20 – 10:22] The approach to consolidating people and resources
[10:22 – 12:28] Unbundling and the lifecycle of equipment
[12:28 – 13:44] Finding the hidden costs and working over time
[13:44 – 15:27] Assets advice for organizations
[15:27 – 16:22] Balancing needs and outcomes for the ASC's
[16:22 – 19:07] Real life examples and how to respond
[19:07 – 21:15] Does everyone face the same challenges and what Is It about capital equipment that adds to the complexity of the Issue?
[21:15 – 22:12] Terminology
[22:12 – 23:44] Wrap up and suggestions

Links | Resources:
CES Case Studies

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25 min
September 04, 2025Capital spend insights: Data that deliver smarter procurement decisions
Whether you're navigating decentralized purchasing, benchmarking spend, or trying to align capital budget system wide, the Capital Spend Insights tool was built to transform how your organization approaches capital planning. Mike Kolp, associate principal from Vizient's Capital Equipment Solutions team joins host Susan Edwards to share how health systems are using Capital Spend Insights to unlock smarter, faster and more strategic decisions.

Guests:
Mike Kolp,
Associate Principal, Vizient Capital Equipment Solutions
Vizient

Moderator:
Susan Edwards
Marketing Communications Manager

Show Notes:
[01:09 – 02:04] The why behind Capital Spin Insights
[02:05 – 03:15] Industry overarching trends needing solutions for capital provurement
[03:16 – 03:59] How capital spend insights tool changes visibility traditionally exposed in the capital procurement process
[04:00 – 05:11] How Capital Spend Insights make the quote review process better
[05:12 – 07:37] Comparing Capital Spend Insights to what's available in the marketplace from other competitors
[07:38 – 10:22] How Capital Spend Insights works alongside or in tandem with the other Vizient data solutions
[10:45 – 11:36] How full fledged subscribers are they using the tool most effectively in their organizations today
[11:37 – 13:00] Common types of projects that got clients interested in using this tool
[13:01 – 17:09] The tool’s GPO compliance component and the pull through of budget alignments
[17:10 – 19:03] New improvements and enhancements for the solution
[19:04 – 20:41] Comparing Capital Spend Insights to key Competitors
[20:42 – 23:25] Key Takaways
[23:26 – 24:19] Next steps for people interested in the tool
[24:20 – 25:08] Mike will be talking about the tool at the Vizient Summit

Links | Resources:
Link to Capital Equipment Solutions webpage: Click here
Link to Capital Spend Insights video: Click here
Capital Spend Insights fact sheet: Click here

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26 min
August 12, 2025 Theranostics: A new weapon against cancer – part 2
Theranostics is a groundbreaking topic that's reshaping how we diagnose and treat cancer. It's a cutting-edge approach in cancer care, combining diagnosing and treating cancer using the same molecular tools. Theranostics has the spotlight because it's delivering on a promise we've been chasing for years in cancer care, truly personalized targeted treatment with fewer side effects than traditional options.

Guests:
Lindsay Williams, MBA, CNMT, R.T.(N)(CT)(ARRT)
Pharmacy Sourcing Portfolio Executive
Vizient

Setu Shah, MPH
Sr. Associate, Intelligence
Sg2

Janna Laton, MBA, CNMT, NMTCB(CT), R.T.(R)(N)(MR)(ARRT)
Independent Contributor and SME

Host:
Adam Fairbourn, MBA, CNMT
Senior Director, Contract Services
Vizient, Capital Equipment Solutions

Show Notes:
[00:48 – 01:55] What it takes for a healthcare organization to implement Theranostics
[01:56 – 04:04] Success stories solving for some of the access and workflow issues
[04:05 – 05:11] Education and training programs needed to support demand for nuclear medicine specialists and technologists
[05:12 – 07:54] What's driving that growth in the field
[07:55 – 09:34] What’s most exciting about theranostics over the next five to 10 years
[09:34– 10:08] Will Theranostics become the standard of care for more types of cancer than we see today
[10:09 – 11:30] The future of cancer care and Theranostics
[11:30– 12:03] What Vizient is doing on the Theranostics front

Links | Resources:
Vizient article - https://www.vizientinc.com/insights/diagnostic-imaging
Sg2 Perspectives Podcast: Transforming Cancer Care Delivery
Sg2 Perspectives Podcast: Cell and Gene Therapy in Practice

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13 min
July 29, 2025 Theranostics: A new weapon against cancer – part 1
Theranostics is a groundbreaking topic that's reshaping how we diagnose and treat cancer. It's a cutting-edge approach in cancer care, combining diagnosing and treating cancer using the same molecular tools. Theranostics has the spotlight because it's delivering on a promise we've been chasing for years in cancer care, truly personalized targeted treatment with fewer side effects than traditional options.

Guests:
Lindsay Williams, MBA, CNMT, R.T.(N)(CT)(ARRT)
Pharmacy Sourcing Portfolio Executive
Vizient

Setu Shah, MPH
Sr. Associate, Intelligence
Sg2

Janna Laton, MBA, CNMT, NMTCB(CT), R.T.(R)(N)(MR)(ARRT)
Independent Contributor and SME

Host:
Adam Fairbourn, MBA, CNMT
Senior Director, Contract Services
Vizient, Capital Equipment Solutions

Show Notes:
[00:45] Defining Theranostics and why it’s getting attention
[02:10] “See what you treat and treat what you see” captures the power of Theranostics
[03:10] Why neuroendocrine tumors and prostate cancer are particularly well suited for this approach
[03:50] Prostate specific membrane antigen or PSMA targeted imaging and treatment work and results
[05:28] How Theranostics compares with more traditional cancer treatments in terms of precision and side effects

Links | Resources:
Vizient article - https://www.vizientinc.com/insights/diagnostic-imaging
Sg2 Perspectives Podcast: Transforming Cancer Care Delivery
Sg2 Perspectives Podcast: Cell and Gene Therapy in Practice

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12 min

About The Capital Compass

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Chart your course with The Capital Compass, an exciting new podcast to help you navigate your journey to value. On The Capital Compass, we explore today’s most dynamic areas in capital spend strategy.…

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