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  4. > Pharma and the Changing US Payer Environment: Meeting the demands of Accountable Care Organizations (ACOs)




There’s a revolution happening...and it’s going to change the way pharma thinks.

As the accountable care movement gains traction in the United States and physicians eye a possible $1 trillion in saved healthcare costs, ACOs are emerging quickly. There is no question that knitting together improved quality of care, real world data and quality measures will result in lower healthcare expenditures. But how will that affect pharma?

The answer lies in being a first-mover, understanding what it takes to be a successful ACO and most of all, adjusting traditional marketing and development practices in response. To be agile in the face of revolution, pharma must first understand the complete scope of the change now underway.

In Pharma and the Changing US Payer Environment: Meeting the demands of Accountable Care Organizations (ACOs), FirstWord explores the rapidly changing landscape of the accountable care movement and how it is poised to impact pharma. The report examines the types of ACOs, the critical pathway to their success and why it’s so important for pharma to switch marketing and development practices to meet their needs. As an overview of a movement that changes minute-by-minute, the report is an urgently needed snapshot of an industry in transition.







Key Report Features of Pharma and the Changing US Payer Environment: Meeting the demands of Accountable Care Organizations (ACOs) include:


Up-to-date overview of the accountable care movement, ACO types and keys to their success
Analysis of why pharma must review marketing and development practices to meet ACO needs
Discussion of how accountable care varies from managed care
Examination of the relationship between quality measures and savings
Analysis of gaps facing ACOs, with particular attention to where pharma can direct their efforts






Key Benefits


Because accountable care is still evolving, there is an urgent need to stay up to date with changes as they happen. Amongst the many benefits in Pharma and the Changing US Payer Environment: Meeting the demands of Accountable Care Organizations (ACOs), this report will help you to:


Understand the scope and nature of the changes being wrought
Learn which ACO data requirements can be fulfilled by pharma
Understand the parameters of guidelines governing ACOs
Develop key knowledge in how to redirect efforts in the chronic disease market to be more patient-centric


Pharma and the Changing US Payer Environment: Meeting the demands of Accountable Care Organizations (ACOs) answers key questions:


What do pharma companies need to do to market their products to ACOs?
What data do ACOs require?
Are there functional gaps facing ACOs?
How can pharma better support patients?
What should pharma do to get into the conversation about improving population management?









Key facts

Americans spend $2.8 trillion on healthcare—enough to buy the ten most valuable companies in the US, host three Olympic Games and still have more money than Warren Buffet. Possible savings from ACOs may reach $1 trillion of that.
Since its inception, the ACO movement has attracted considerable interest from federally funded and private sector insurers.
There are more than double the number of ACOs today than there were in June 2012.



Content Highlights


The accountable care movement is emerging rapidly. In this report, you will discover:

How ACOs and pharma will need to work together in the future
The technical hurdles facing ACOs
The true scope of quality measures required of ACOs and how pharma may play a role







Table Of Contents

Pharma and the Changing US Payer Environment: Meeting the demands of Accountable Care Organizations (ACOs)
1.Executive summary
2.Introduction
2.1.Constraining costs
2.2.Creating the conditions for assessing value
2.3.PPACA impact on pharma
3.The ACO movement
3.1.Accelerating factors
3.1.1.Enormous potential savings
3.1.2.High cost differentials
3.2.Linking data
3.2.1.Rapid pace of change
3.3.Working with real world data
4.Different kinds of ACO
4.1.Pharmacists enter the fray
4.2.Diversification
4.3.Medicare Shared Savings Programme
4.4.Quality measures
4.4.1.Who can take part in an ACO?
4.4.2.Governance arrangements
4.5.Catering for differences
4.6.Commercial ACOs
4.6.1.Choice of risk-sharing deals
5.ACO implications for pharma
5.1.So many variables
5.2.Learning from the pioneers
5.2.1.Getting real
5.2.2.Other key learnings
5.2.3.Early lessons from the private sector
5.3.Broader dialogue becomes imperative
5.4.New ways of thinking
6.A transitional phase
6.1.Filling the ACO capability gaps
6.2.Coordinated care
6.3.How can drugs reduce overall costs?
6.4.Information to educate patients
6.5.Optimising medication therapy
6.6.The role of pharmacists in ACOs
6.7.New stakeholders
6.7.1.extenders
6.7.2.Developing a patient focus
6.7.3.Physicians require help
6.8.Patient-centred disease management
6.8.1.Data mining
6.9.Population health management
6.9.1.Pharma collaborations
6.9.2.Care4Today
7.Learning from the new NHS
7.1.Global trends
8.Issues of trust
9.A marriage of health outcomes and profits
10.Gearing up for change

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