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Market Access
Strategically Managing ACO and IDN Customers to
Increase Revenue and Market Share
1
Presenters
• Anthony Slonim, MD, CEO, Renown Health
• David McCombs, VP, Bon Secours Health System
• LeAnn Born, VP, Fairview Health Services
• Michelle O’Connor, President and CEO, CMR
Institute
2
Our objective:
Understand how the evolving healthcare landscape is
changing market access strategies and the
knowledge, skills and tools that are needed to
successfully partner with health systems.
Market Access: How the
Landscape and Our Work
are Changing
Anthony D. Slonim, MD, DrPH
President and CEO
Renown Health
Clinical Professor,
Internal Medicine and Pediatrics
University of Nevada
School of Medicine
I’m going to Share a Story About the World of Healthcare
• A Few Years Ago….the World was Normal
• Normal was Disrupted by the Affordable Care Act
• Today, we realize we still have a problem…
• Hang on, the world needs to change
• Here’s what YOU can do to help me manage through it
The “Normal World”
5
HOSPITAL
DOCTOR
Industry
Account Execs
I’m going to Share a Story About the World of Healthcare
• A Few Years Ago….the World was Normal
• Normal was Disrupted by the Affordable Care Act
• Today, we realize we still have a problem…
• Hang on, the world needs to change
• Here’s what YOU can do to help me manage through it
• Health care legislation enacted March 23, 2010
• Goals:
–To increase health care access
–Affordable health insurance coverage to most Americans
–To improve cost-effectiveness of US health care
Patient Protection and Affordable Care Act (PPACA)
Value Proposition
Value = Quality/Total Costs of Care
Increased Value → Improve Quality or Lower Costs
Decreased Value → Reduce Quality or Increase Costs
• Networks of clinicians and hospitals who share responsibility
for clinical and financial outcomes
• Focus on total patient
–Including acute, chronic, preventative, wellness,
maintenance, rehabilitative needs
• Promotes:
–Evidence-based medicine
–Patient engagement
–Coordination across providers
Accountable Care Organization
• Decreased access to providers
• Changing decision makers
• Shift towards advanced payment models (e.g. MACRA,
bundled payments)
• Need for more clinical evidence in purchasing decisions
How the World is Changing
I’m going to Share a Story About the World of Healthcare
• A Few Years Ago….the World was Normal
• Normal was Disrupted by the Affordable Care Act
• Today, we realize we still have a problem…
• Hang on, the world needs to change
• Here’s what YOU can do to help me manage through it
The Problem - Misaligned Goals
Health Systems
Physicians
Industry
I’m going to Share a Story About the World of Healthcare
• A Few Years Ago….the World was Normal
• Normal was Disrupted by the Affordable Care Act
• Today, we realize we still have a problem…
• Hang on, the world needs to change
• Here’s what YOU can do to help me manage through it
Patient Lifecycle
Health and Illness Trajectory
PreventionAmbulatory
Diagnostics Acute
Care
Post
Acute
Care
Prevention
WellnessConvalescence
Rehabilitation
Home Care
Hospice
ASCs
Observation
Lab
Rad
ED
Inpatient
Operative
Destination
Hospital
Ambulatory
Surgery
Centers
Home
Care
Pharmacy
Networks
Radiology
Networks
Hospice
and
Palliative
Care
SpecialistsPrimary
Care
Physicians
Referring
Hospital
Slonim AD, Marcin JP, and Pollack MM. Outcomes in Critical
Care Medicine: Implications for Health Services Research and Patient
Care. In: Fuhrman B and Zimmerman J. Pediatric Critical Care 4th
Adopt a Different Lens of Healthcare
The Patient and Family’s View
LifeHospitalization
(3.5 Days)
Hospitalization
(3.5 Days)
Understand the Health System’s Role in “Life”
Emphasis Changes To:
Health, Wellness and Prevention
Coordinating Care Across a Continuum
Addressing Behavioral Health
Care for All
Social Determinants of Disease
Engaging and Educating Consumers
Aligning with Physicians
Technology, Technology, Technology
Isolated Campus…Being in and of the Community
Don’t do Everything…Do What’s Right
Standardization of Care
• Implement protocols and interventions that:
– Evidence-based
– Improve care
– Reduce costs
• Minimize complications
– Ventilator associated pneumonia
– Central-line associated infections
– Healthcare Associated Complications (HACs)
• Develop methods for benchmarking
– Data may be used to determine eligibility for shared savings
I’m going to Share a Story About the World of Healthcare
• A Few Years Ago….the World was Normal
• Normal was Disrupted by the Affordable Care Act
• Today, we realize we still have a problem…
• Hang on, the world needs to change
• Here’s what YOU can do to help me manage through it
Future State – Aligned Goals and New Types of Partnerships
19
Patient
Outcomes
What We Can Do Together
• Assure quality healthcare for the patients we have in common
• Assure care across transitions and accept our roles for being
accountable
• Help our team make better decisions
• Know our teammates and their roles
• Work together on acceptable cost strategies
• Embrace technology for care delivery
Implications for Strategy
• Sales
– Call on the right people
– Provide relevant information
• Marketing
– Think about Educating
• Total Costs of Care
• Outcomes
• Training
– Ensure your sales teams understand the changing healthcare landscape
– Engage your ‘A’ Team and ensure training and application for all roles
23
Helpful Tools for Market Access
On your tables:
Aligning Account Management Strategies with Customers’ Goals
Health Systems Partnering Strategies – Registration form (FREE)
On tables in back of room and in the app:
Top Tips for Engaging with Health Systems
ACO/IDN Assessment Tool CMRinstitute.org
24
INVITATION
Please join us to continue the application discussion
When: Tuesday at noon
Location: McArthur 1 and 2
Panelists:
• David Harlow, PharmD, AVP for Professional Services, Martin Health System
• Tony Slonim, MD, CEO, Renown Health
• Clara Anne Spencer, Director of Pharmacy Contracting, Carilion Clinic
25
Market Access
Strategically Managing ACO and IDN Customers to
Increase Revenue and Market Share
26
Contact Us
800.328.2615
CMRinstitiute.org
www.cmrinstitute.org/blog
www.linkedin.com/company/cmr-institute
@CMRINSTITUTE
