Health systems are budgeting for supply chain inflation between 2.4% and 2.8% through mid-2027, Vizient's Winter 2026 outlook raised the forecast to 2.78%, with tariffs, freight, imported products, capital equipment, and surgical supplies named among the drivers. The number most systems are not budgeting for is the one hiding inside it: how much of the "inflation" they are asked to absorb is unaudited pass-through and recoverable leakage.
Tariff pass-through is a claim, not a fact. When a supplier raises prices citing tariffs, that increase embeds assumptions: the HTS classification, the declared valuation, the country of origin, the duty program eligibility. Each of those is testable. Misclassification repeats on every entry; first-sale valuation and duty recovery programs routinely offset a meaningful share of claimed tariff cost. A health system negotiating a pass-through without auditing these is accepting the supplier's homework unchecked.
Inflation is uncontrollable. Leakage is not. While procurement fights for basis points on price, whole percentage points leak through channels: gray-market product entering at "discount" prices that void warranty and rebate integrity, rebate claims exceeding actual purchases, shrinkage and dwell in distribution. In one engagement, a global health and medical manufacturer's channel data showed unauthorized product at 12% of direct purchases and rebate over-claims of roughly $200,000 a year, $5.5 million of diversion quantified across three years. That money doesn't show up in an inflation forecast. It shows up when movement is reconciled against reported sales.
Working capital is the third lever. For a med-surg distributor, removing six days of border dwell freed $1.8 million in trapped cash and produced $1.26 million in recurring annual benefit, an 8.4× return on the custody program that produced it. Cash cycle is a supply chain property, not a treasury one.
The discipline: score it before you budget it. The SIMS Integrity Index measures a supply chain across five weighted dimensions, Channel, Revenue, Trace, Trade, Custody, and converts the gaps into a dollar exposure. For a health system, that turns the budget conversation from "how do we absorb 2.78%?" into "what is our recoverable number?" One is a cost of doing business. The other is a project with an ROI.
Find your recoverable number, the free Integrity Snapshot™, hospital/health-system preset included.
Score your supply chain →
Sources: Vizient Winter 2026 Spend Management Outlook (2.78% forecast, July 2026-June 2027); industry reporting on health-system supply chain inflation baselines. Engagement figures from anonymized SIMS client work.
← All Insights