DDP 2010: Utilize Outcomes Based Contracting in Payment Reform for Improved Health and Reimbursement Rates in More Costly Delivery Products

Moderator: Cyndy Nayer, President and Chief Executive Officer, Center for Health Value Innovation
Thom Stambaug, VP and Chief Clinical Officer, Pharmacy Management, CIGNA
Peter F. Hayes, President Healthcare Solutions, Hannaford Brothers and Chair, Maine Business Coalition
Kevin O’Brien, Chief Executive Officer, Partners in Care

Value based design. Getting people engaged in the appropriate care to manage chronic condition that costs employer lots of money.

Three principles:
-Can we influence waste reduction?
-Can we get ahead of future risk?
-How can we link health to wealth and performance? How does this influence community health?

Potential partners for adherence and persistence
Virtual care networks

Patients: what is individual responsibility to the health?
-Accountability, good choice, health based status. How do we get the patients engaged to start taking care of themselves. If they’re not, should they be paying more into the system? A day will come when employers think about what therapies will be included on plans. What can we afford? Retail pharmacies, employers, and the global market place will probably change pricing structure.

Questions: What is new now?
Why didn’t we do public healthcare ten years ago? When we look back, how do we purchase drugs? On rebates. How do rebates work? Cereals put on racks based on pricing. This is an equation for how drugs work. Can we get more performance and productivity out of every dollar that we spend? Health outcomes and productivity have to be looked at together. When we encourage patients to be compliant, the price of their care goes dramatically down because their care is better. Generics is encouraging the industry to look at this again. How can we present value for new products?

Incentives in system encourage sick care instead of healthcare.
Q: How long will it be before the consumer actually knows how much the drug is costing?
When you go to the doctor, you pay $30, however, it actually costs the healthcare company $200. The panelist believes that the consumer will be seeing how much different things cost via different avenues within the next 12-18 months. The market place should also provide the value of the care. Value and cost of treatment will soon be available to the customer. Total cost must be known by the consumer, as healthcare knowledge should know price and value.

Huge trend in smaller employers to a co-insurance instead of a co-pay. People are realizing what it costs. Electronic medical records will show gaps in care. The doctors own electronic medical records. So what about the individuals? They don’t own them.

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Web Seminar: Leveraging Health: Improving Health Status and Bending the Financial Trend through Value-Based Designs

Title: Leveraging Health: improving health status and bending the financial trend through value-based designs.
Date: Thursday, September 24, 2009
Time: 12:00 PM - 1:00 PM EDT

Reserve your Webinar seat now at:
https://www1.gotomeeting.com/register/478763376

About the web seminar:
Health cost inflation and the economic downturn are unique challenges, but they are also the unique opportunities. The tension that exists in managing health care costs at this time is exactly the spotlight that was needed to change the dialogue on health care. In fact, even the questions we’ve been asking should be changed.

Instead of asking “How much will this cost?” the road to real, sustainable change lies in the question, “How much health will this dollar buy?” Value-based designs have consistently shown the results in improved health status and reduced financial strain. This seminar showcases the learnings, the levers, and the dividends that accrue when a total health management approach is used to create sustainable results through aligned risks and rewards.

You will learn:
- The definition and process of a value-based design, including the categories for improvement
- The metrics of success and the time to achieve them
- The data required to begin the shift to investing in value
- The case studies of others who have implemented over 100 levers to drive change and improved health and economic outcomes

About the presenters:
Cyndy Nayer, MA
Cyndy Nayer is the President and Chief Executive Officer of the Center for Health Value Innovation, a community of employers and payers building evidence, tools and competency in value-based design for improved health and reduced cost trends . She is on of the five equal founders of the Center; Jack Mahoney MD, Global Health Strategy consultant for Pitney Bowes, is another of the founders, and he serves as Chief Medical Officer for the Center.

John J. (Jack) Mahoney, M.D.
John J. (Jack) Mahoney, M.D., is a founder of the Center for Health Value Innovation and serves as its Chief Medical Officer. In 2008, Dr. Mahoney was named as a Fellow of the Center, along with other prominent health benefits executives and thought leaders who are committed to advancing value-based health design.

Jan Berger, M.D., M.J.
Jan Berger works closely with Jack Mahoney, M.D. and Cyndy Nayer as member of the Board of Strategic Advisors for the Center for Health Value Innovation. Her depth and breadth of knowledge in value-based design and provider engagement serve as the foundation for for her role in the Center.

This Web Seminar is brought to you by:

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What is value driven pharma?

Pharmaceutical companies must proactively respond to the changing economics of drug “value” metrics to remain competitive. IIR’s Value Driven Pharma event brings together stakeholders across the healthcare value chain to address the urgent need to develop drugs that deliver true value throughout the healthcare value chain.

In Washington, DC on October 15th the industry convenes for an unprecedented multi-stakeholder event focused on how to improve market share and deliver the right drug to the right patient at the right time in an era a value-based benefit design. As an active audience participant you will have the opportunity to meet with an industry cross section of those adopting a value driven approach from the point of drug discovery through commercialization.

Find out more about the event here.

If you are interested in joining a group of professionals focusing on Value Driven Pharma, follow us on Twitter or join our LinkedIn group.

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