From Siloed Spreadsheets to Strategic Visibility

As ambulatory surgery centers (ASCs) and physician practices face mounting reimbursement pressure, rising supply costs, and increasing operational complexity, many organizations are discovering that their biggest challenge is not simply controlling spend, but seeing it clearly in the first place.

That was the reality facing Century Vision Global, an ophthalmology and ambulatory surgery organization operating 13 locations and two surgery centers, before implementing Trivalence’s centralized procure-to-pay (P2P) platform.

According to Lonna Carter, CEO and General Counsel for Century Vision Global, the organization inherited a highly manual purchasing and invoice management process spread across multiple sites.

“We started doing Excel spreadsheets and saving everything on a consolidated shared drive,” Carter said. “It was a very manual analysis to figure out our spend. We had different people ordering things; it was an antiquated system that we inherited.”

That challenge is increasingly common across non-acute healthcare environments.

Will Byington, CEO of Trivalence, notes many ambulatory providers still rely on fragmented purchasing processes, spreadsheets, emails, vendor portals, and manual workflows that create blind spots around procurement, inventory, and accounts payable.

The growing operational pressure on ASCs

ASCs are under increasing pressure to operate more like sophisticated health systems while maintaining the lean staffing and fast-paced workflows that define outpatient care. As more procedures continue shifting from inpatient hospitals to outpatient environments, supply chain and spend management are becoming critical operational and financial differentiators.

Byington says that outpatient services now account for nearly half of total hospital system revenue, while ambulatory care spending in the U.S. exceeds $1 trillion annually. Yet many ASCs still lack centralized supply chain oversight and continue managing purchasing through disconnected tools and manual processes.

The pressures facing ASCs today extend well beyond supply ordering. Reimbursement cuts, payer scrutiny, geopolitical disruptions, labor costs, and ongoing supply chain instability are forcing organizations to rethink operational efficiency.

“The operational pressure has been outstanding,” Carter said. “Medicare cuts, insurance payers reducing reimbursements, and increasing denial rates are all contributing.”

At the same time, supply disruptions continue to ripple through healthcare.

“We were advised by one vendor that we have supplies stuck in a container ship in the Strait of Hormuz,” she said. “There’s always going to be a supply chain issue.”

For many ASCs, these operational pressures expose longstanding weaknesses in decentralized purchasing and inventory management. Multi-site ambulatory organizations often operate with:

• Different staff members ordering from different vendors.
• No centralized item master.
• Limited standardization of products.
• Inconsistent invoice workflows.
• Minimal inventory visibility.
• Off-contract purchasing activity.

The result can be higher supply costs, excess inventory, stockouts, delayed reimbursements, and limited visibility into true supply utilization across locations.

Moving beyond “the way we’ve always done it”

For Carter, one of the biggest shifts was moving the organization away from siloed workflows toward centralized visibility.

“A lot of folks are just doing it the way that they’ve always done it,” she said. “You don’t see the bigger picture. You’re siloed.”

That lack of visibility often limits organizations’ ability to compare purchasing behaviors, identify utilization trends, or negotiate better pricing across locations.

“When we start being able to compare locations and other processes, that’s when we start having those ‘aha’ moments about operational improvements. We have meaningful data to potentially renegotiate contracts and get better pricing,” Carter explained.

Byington emphasizes this same concept of “clarity plus control,” arguing that most health systems and ambulatory networks have significant unmanaged non-labor spend due to fragmented processes and inconsistent data.

The company says its platform is designed to unify procurement, inventory visibility, AP automation, and payments into a single system that improves operational clarity and financial control.

Why spend management has become strategic for ASCs

Spend management is no longer viewed as simply a finance or purchasing function. Increasingly, ASC leaders are treating it as an enterprise-wide operational strategy.

One of the biggest pain points for many organizations is the disconnect between procurement and accounts payable. In many ASC environments:

• POs are inconsistently created.
• Invoices arrive through multiple channels.
• Invoice reconciliation is manual.
• GL coding varies across locations.
• Finance teams spend excessive time matching purchases and invoices.

This creates additional administrative burden while limiting real-time financial visibility.

Trivalence positions its platform around closing those operational gaps through automated purchasing workflows, PO-to-invoice matching, inventory tracking, payment automation, and real-time analytics.

Inventory management is another growing challenge. Smaller ambulatory sites frequently operate with lean staffing models and limited supply chain infrastructure, making it difficult to track inventory levels, expiration dates, or usage trends consistently across locations.

Trivalence says its platform helps organizations improve visibility into stock levels, expiration tracking, and inventory utilization to reduce waste and improve purchasing accuracy.

Building a more data-driven ASC environment

Carter said one of the biggest advantages has been gaining faster access to actionable operational data.

“Now we have the data to say this location overutilizes,” she said. “And compare that to another location using less product easily. This leads to process improvements, cost savings, opportunities for us to reflect on possible compliance issues and improve our compliance improvements.”

The organization also sees opportunities to improve vendor negotiations and purchasing strategies using broader visibility into spend patterns and utilization trends.

“We have better insight into how to improve our negotiations,” Carter said, “and, just get that data faster because it is less manual now.”

Byington estimates organizations can reduce non-labor supply spend by up to 10%, cut purchasing errors by 70%, and reduce inventory waste through centralized visibility and automation.

The platform also reflects a broader shift happening across outpatient healthcare: moving from reactive purchasing toward proactive operational intelligence. Increasingly, ASCs are looking for systems that not only automate workflows, but also generate actionable insights around utilization, physician preference variation, supplier performance, and contract compliance.

AI, benchmarking, and predictive visibility

Like many healthcare technology vendors, Trivalence is also exploring AI-enabled capabilities. Byington describes future applications ranging from supplier performance analytics and predictive automation to spend forecasting and intelligent workflow optimization.

Carter believes the future of non-acute supply chain management will increasingly revolve around peer benchmarking and predictive analytics or AI.

“Within three to five years, a platform like this will have access to even more information from our peers,” she said. “They’ll be able to de-identify it and say, ‘Your team is spending $100,000 on XYZ over six months. Your peers are spending $80,000. There might be an opportunity here for you.’”

For ASC leaders navigating tightening margins and growing operational complexity, that kind of visibility may become increasingly valuable.

“The more data, the better,” Carter said. “That’s going to give us more information so we can make more informed decisions faster.”