Remember those commercials for Hair Club for Men where the spokesperson says, I'm not just the President; I'm also a client, At the ExL Pharma Partnering with ACOs conference in Philly recently, I had the privilege of being both a presenter and an attendee. And in a single sentence, I can give you the key conference takeaway: Customize your strategy by drug/device, by stakeholder and by market.
Here's a little color around that last point: ACO implications for pharma and device makers shift with each geographic market. For example, while ACOs abound in Southern California, the birthplace of HMO capitation, they've been slower to form in traditionally innovative markets like Rochester. In Boston, another big market, dominant payer Blue Cross Blue Shield of Massachusetts is driving at least 27 ACOs. But even in Omaha, where pre-ACO partnerships don't yet involve payers, two rival health systems have teamed to win price concessions from device makers.
For ACO answers, start with the right questions.
We all know why this is happening: fee-for-service is unsustainable and the Affordable Care Act is now the law of the land. Reimbursement 2.0 is calling for Pharma/Device 2.0, challenging companies to re-tool themselves by:
- Training/Deploying a next-gen sales force and re-structuring key account management. We're all being called to be healthcare reform experts now. Knowing how your drug/device fits into that picture for each market and its power players is an important step.
- Engaging with new customers, Physicians are no longer the be-all, end-all. Payers and hospitals are two of your new targets. Even after the conference's carb-heavy lunch, attendees were perking up at the list of new stakeholders. And it's not the hospital CEO; speakers emphasized CFOs, CMOs and Quality Directors.
A market-based strategy is key to both. I lost track of all the speakers (present company included) who emphasized the end of a one-size-fits-all approach.
So how do you make the shift? The good news is you don't have to have all the answers. But you do need to ask the right questions. Who is driving a market's ACO formation, And why?
How many ACOs are in the market. Who are the payers? What's the takeaway? Start with these if you want to go 15 rounds with Apollo Creed, Clubber Lang or Ivan Drago. Since the conference was in Philly, figured I should end with a Rocky analogy.
Follow Laura Beerman on Twitter @LauraBeermanHLI