January 23, 2017 - Curant Health COO, Marc O'Connor, in Managed Healthcare Executive - Despite news breaking on the first steps toward the repeal of the Affordable Care Act (ACA) and President-elect Trump’s comments on pharmaceutical manufacturers and pricing, not all was doom and gloom at the J.P. Morgan 35th Annual Healthcare Conference 2017, January 9-12, in San Francisco. Here are a few to-dos and reasons for optimism for managed care executives that we learned during our time at one of the most significant healthcare business event of the year.
The drive to value is accelerating
However slowly in some spaces, nearly every session I attended featured a focus on value-based care. No longer a dull hum in the background, I sensed a vibrancy in discussions and initiatives designed to accelerate the drive to value-based care at J.P. Morgan 2017 that had not existing in previous years.
In its simplest terms, we define value as outcomes divided by cost. Winning organizations improve outcomes while reducing costs at the same time. And they should be prepared to prove it.
Express Scripts launched its Diabetes Care Value Program last year, the fifth in a series including hepatitis, inflammatory conditions, cholesterol and oncology care. According the PBM, “The Diabetes Care Value Program is projected to boost the average medication adherence rate for enrolled patients by 5%, reducing downstream health complications and healthcare costs. Currently, $4,690 per diabetes patient is spent each year on medical expenses that could have been avoided if patients had taken their diabetes medications as prescribed.”
The efficacy of the program in real-world conditions will take time to measure, but it is a step in the right direction. We know well the importance of medication adherence to the value equation. In October, preliminary results of a Curant Health study with Johns Hopkins indicated enhanced medication therapy management improves adherence by 30% over the standard of care for patients with inflammatory bowel disease (IBD). Multiple colleagues with whom we met reacted with near amazement when we shared this data with them.
What to do while we wait and see
We heard many more questions than answers within the healthcare industry at J.P. Morgan 2017. There were fewer big announcements at the show compared to any year in recent memory. The M&A guys were on the hunt for deals and not finding many at J.P. Morgan 2017. One notable exception was WellCare’s acquisition of Universal American. That aside, an uncertain tack on legislation and the pending status of the Aetna-Humana and Anthem-Cigna deals has most healthcare executives playing the wait and see game. This might be prudent with respect to big moves, but executives should not be lulled into complacence when there are immediately actionable, value-based to-dos.
1. Find your value-based partners. If you can find partners that improve value, your cost profile, HEDIS responsiveness, reduces readmission rates or improve adherence especially to specialty medications, wait and see does not apply. Find them. Engage them. Insist on value-based success in real-world situations, not just clinical trials. Real-world efficacy is going to become the gold standard in care, especially for pharmaceutical manufacturers.
To read Marc’s full article, visit Managed Healthcare Executive.
To learn more about Curant Health, contact Kristin Lindsey, Senior Marketing Director, at firstname.lastname@example.org.