A New Breed of Buyer: The Population Health Manager

Pharmaceutical marketers understand the profound changes that are reshaping the U.S. healthcare system. As they seek ways to adapt to the new consumer-driven environment, they should look to hospitals, healthcare systems and physician groups that now make population health management (PHM) a key focal point.

Appointed to lower costs and improve outcomes, PHM managers represent a new breed of buyer—and they are taking a hard look at therapeutics. To survive this scrutiny, and thrive in an increasingly complex healthcare system, pharmaceutical companies should consider forging partnerships with healthcare providers, payers and employer groups that emphasize quality patient outcomes.

Modeled after a retail shopping experience, including cash reward and financial incentive tools, the healthcare-consumer model empowers patients to make informed, cost-conscious healthcare choices, without sacrificing quality of care. For pharma companies, this means making a shift away from a volume-centric approach toward funneling resources into a pay-for-service approach.

Making Good on the Pay-for-Service Promise

By partnering with key stakeholders, health systems gain the ability to more readily identify health risks and manage consumer health through an ongoing outreach strategy. To be successful, business and healthcare leaders, including pharma, must work together to determine the best way to allocate resources and make a real difference in overcoming PHM challenges:

  • Data management: Data enables a full analysis of risk among patient populations. Automatically aggregating and consolidating data from a variety of disparate systems and sources, including inpatient, ambulatory and home sites, has been shown to improve continuity of patient care and efficiency.
  • Educating patients: It’s important to elevate patient understanding of the healthcare industry so that all stakeholders are moving in the same direction.
  • Organization: Health systems and their partners must organize in a way that allows them to be truly effective.
  • Cultural shift: Every component of the healthcare system must be shifting toward a value-based care model.
  • Personalized medicine: Simple genetic swab testing has become readily available. It enables physicians to know whether certain medications will be appropriately metabolized by a patient, among other valuable information points.

With PHM, the objective is to minimize costly, yet often unnecessary or redundant interventions, such as emergency department visits or inappropriate hospitalizations.1 To be effective, healthcare systems must not only focus on high-risk patients, but also connect data silos and enhance transparency. This means using the most effective strategies available to meet the needs of every patient.2

In working with PHM partners to improve patient outcomes, pharma companies can offer a wealth of knowledge, as well as data on patient behaviors, and play a key role in ensuring that patients receive the best possible care.

Healthcare management organizations can help pharma companies in this process, positioning them to reach the patient more effectively, improve efficiency and reduce costs. Ultimately, the goal is to find new ways to empower patients through data analytics, personal health records and value networks that foster more informed decision-making in a patient-centric world.

References:

1. Institute for Health Technology Transformation; Population Health Management; 2012; http://ihealthtran.com/pdf/PHMReport.pdf; accessed February 24, 2015.

2. Institute for Health Technology Transformation, 2012.

  • Joseph Berardo, Jr.

    Joseph Berardo, Jr. is CEO of MagnaCare, an administrator of self-insured health plans for employers in New York and New Jersey. Joseph started his career in healthcare with U.S. Healthcare in 1990. He currently serves as Chairmen of Board of Directors of the Make-A-Wish foundation of NJ and Vice Chairman of the Board of the Ocean Medical Center Foundation.

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