Five Categories that Key Account Managers Need to be Skilled in

1. Best in ClassAccountManagement ©2018 the brooks group

2. The Best in Class Account Manager Assumption:Approach to account management must evolve to address the realities of a market environment in transition. The Imperative:Many Account Managers have been consistently ranked in the top tier by HIRC (Health Industries Research Companies) as assessed by customers. Leadership should recognize that reaching the firm’s strategic objectives requires them to be recognized as “Best in Class” & able to deliver on a value proposition validated by customers. Source: HIRC, 2017

3. In-Person Contact Between Key Customers & Account Managers is Limited Optimizing Time with Key Customers Through Exemplary Account Managers is Critical. Managed Markets Customers: N=232

4. What are the factors driving systemic market change & shaping customers’ challenges? Traditional healthcare business models & flow of the dollars are changing • Merger & acquisition activity is resulting in enhanced capabilities of current customers through vertical integration (i.e. CVS/Aetna) & decision makers with a broader set of healthcare opportunities & challenges • New potential customers (i.e. Amazon) could disrupt the current wholesale, PBM, & / or pharmacy landscape • Health plans are moving to control costs & improve care through bundled payments & value-based benefit design, both of which provide financial incentives so that physicians’ & patients’ actions are aligned with those of the delivery & payment systems • Growing out-of-pocket costs for patients & benefit design changes are resulting in new solutions to addressing the patient burden • Growth in 340B drugsis resulting in pressure on pharma margins • Disruption in D.C.is resulting in uncertainty in many key aspects of healthcare policy • Pharmacy giant CVS Health has agreed to buy Aetna in a $69 billion blockbuster acquisition that could rein in healthcare costs & transform its 9,700 pharmacy storefronts into community medical hubs for primary care based procedures Source: https://www.washingtonpost.com/news/wonk/wp/2017/12/03/cvs-agrees-to-buy-aetna-in-69-billion-deal-that-could-shake-up-health-care-industry/?utm_term=.62f31797696e

5. Implications for Account Managers Factors Affecting Market Approach Implications for Payers Implications for AMs Having Best in Class Account Managers will ensure that you are best positioned to react to the changing healthcare environment.

6. Best in Class Account Management Capabilities innovate | implement | impact

7. Best in Class Account Management Capabilities Our research with key healthcare stakeholders breaks down the perceptions of Best in Class Account Managers into5 overall categories ProfessionalEthos 1 5 Best in Class Account Manager Ethos 4 Resiliency & Adaptability Professional Credibility 2 3 Personable & Engaging

8. 1 Best in Class Account Manager Ethos Exceptional Business Acumen • Understands national healthcare policy & industry trends & their potential impact on your business • Knowledgeable about government programs (e.g., Medicaid, Medicare) • Is skilled at producing financial analyses that facilitate internal decision making • Effectively works with you to find mutually beneficial contract positions/agreements • Demonstrates & applies knowledge of market trends & market dynamics to manage your account effectively • Knowledgeable about working relationships among MCOs, hospital systems, medical groups, & other constituents (e.g., patients, payers, advocacy groups) in the healthcare system

9. 1 Best in Class Account Manager Ethos Exceptional Business Acumen “ What does it mean to have exceptional business acumen? Follow the dollar Understand the incentives Financial perspective Understand customer’s business What it is like to operate like a payer Understand the web of influencers “Account Managers need a focus on business acumen & really understanding the challenges that our customers have…so they can really engage & have a meaningful conversation…being able to really understand their internal drivers so we can better understand what levers to pull, where to press… it is a give & take relationship.”

10. 2 Best in Class Account Manager Ethos Professional Credibility • Handles difficult or sensitive issues in a knowledgeable, professional, & respectful manner • Under pressure, he/she comes across as a poised presenter • Communications are concise, clear, & relevant • Attentive & effective listener • Acts with the highest standards of ethics & integrity – you trust him/her to do the right thing • Demonstrates that he/she is a true advocate for your patient’s needs

11. Best in Class Account Managers recognize that they are central to a manufacturers value chain for customers A credible single point of contact adept in problem solving 2 Best in Class Account Manager Ethos Professional Credibility “ “I really just want one point of contact. One point of contact who can speak on behalf of the organization. I know organizations are complex. I'm complex. But you still have one pharmacy director for the entire commercial, Medicare, Medicaid exchange business. I think that's what they have to get to. It goes back to simplification.” “What we really demand from companies is that there's a single point of presence when it comes to account management for their companies. So even though their business may be organized slightly differently, we want that account manager for that company to really be the quarterback, so to speak, for that company so there's a single point of contact, that accountability. They actually bring their experts in at times, but we don't want six people from your company running around creating havoc because they don't really understand our company. So one of the things that we really advocate & in some degree try to enforce is this notion that you have a single relatively powerful account manager who can call on all the internal resources, but understands our business end, & is that strong quarterback who can really pull it together knowing what's a priority for the pharma company but also the priority for our particular company.”

12. 2 Best in Class Account Manager Ethos Professional Credibility “ Caveats Regarding Credibility: CREDIBILITY is not a core competency – it is not a skill you can improve nor competitive advantage to develop CREDIBILITY can’t be marketed – it must be earned Having a trusting relationship with your customers does not ensure they will remain loyal “It starts with trust. You have to trust them. Have to really want to work with your Account Manager. You have to respect them. Technically you don't have to like them but you have to respect them. You have to feel like your Account Manager understands your goals & objectives, is able to adequately communicate that internally to their own company, that they are an advocate for what our needs are with their own company even though they might be not exactly in alignment, but they'll work through that.”

13. 3 Best in Class Account Manager Ethos Personable & Engaging • Provides a consultative approach to the account & is seen as providing strong value • Always available when you need him/her • Helps keep you up to date with new products & emerging marketplace changes/trends • Proactively informs you of potential issues or challenges unique to your organization or geographic area • Demonstrates an ability to build long-term relationships • Develops effective working relationships beyond pharmacy & medical, which include sales/marketing, network management, quality initiatives, IT, & senior executives

14. 3 To be “best in class” you have to be “trusted” A customer’s confidence in the AM is developed one engagement at a time Data suggests that maintaining & being viewed as a trustworthy AM requires demonstrating (1) Fairness, (2) Honesty, (3) Reliability & (4) Technical Expertise Best in Class Account Manager Ethos Personable & Engaging “ Focused on building the long-term relationship & provides a best in class service “First, they are about the long-term relationship & I don't feel like every time that we're meeting they're trying to sell me something. They're balanced & they'll tell us not just the pros & where they're better, but also where they may not be the best solution for us or for the patient. And so by doing so they create some degree of trust . . . They're more willing to think out of the box, to understand our programs & ask how can they get involved in them & align their pricing models or offerings or incentives with the type of outcomes based thing we're doing.” “ A very polished individual who comes across as someone who is motivated to assist me in providing a superior level of service to my patients. [He/she] doesn't come across as pushy but does manage to convey all resources that [Company] has available to enhance patient care. I feel like I have access to information, patient assistance or the ability to be directed to the right source for my needs.”

15. 4 Best in Class Account Manager Ethos Resiliency & Adaptability • Deliver on what the account truly needs – “our advocate within the manufacturer” • Responsible & tracks all discussions & activity pertaining to the account • A high degree of responsiveness & quick turnaround • Bringing new or useful information that customers can use, & sharing new insights that may have been overlooked or not well known • Situational Awareness – able to operationalize knowledge & understanding into actionable insights • Perseverance to accomplish long-term or higher-order goals in the face of challenges & setbacks

16. 4 Best in Class Account Manager Ethos Resiliency & Adaptability “ Understands the current economic environment as well as the changes in technology & health care reform. Good listener who understands what the customer needs & works with [his/her] company to see that these needs are met. Cognitive of time constraints & the policies of our organization.

17. 5 Best in Class Account Manager Ethos Keen Intellect & Superb Powers of Observation • Understands the structure of your organization & the constraints under which you work • Focuses on matters of strategic importance to your business • Demonstrates the ability to professionally handle customer objections • Engages in joint problem solving with customers • Knows well the business indicators your organization uses to assess its market performance • Assists you in addressing your real business issues (e.g., increase market share, reduce costs, enhance patient satisfaction)

18. 5 Best in Class Account Manager Ethos Keen Intellect & Superb Powers of Observation “ What does it mean to have keen intellect & superb powers of observation? Customer business knowledge: Application to the customer Relevant to the customer The entire business of healthcare (not just pharmacy) “They need to have a realistic & deep understanding of environmental pressures … a deeper understanding of how each customer operates…& the way they run their business.” “I think the need for our product knowledge is going to be called on more.” “We’ve got to increase our exposure to what others are doing… our ability to learn from past experiences can give us a competitive advantage in both wins & losses…”

19. Best in Class Account Management Capabilities Best in Class Account Managers demonstrate capabilities across the five categories & each of the tangential skills comprise the broader capabilities. Problem Solving Financial Acumen Situational Assessment Negotiation Leadership & Organizational Effectiveness Creative Thinking Knowledge of Payers Conflict Resolution Knowledge of Health Systems & IDNs Project Management Knowledge of Regional Market Dynamics Goal Setting Responsiveness & Listening Knowledge of Products Impression Management Interpersonal Communication

20. What “Great” Looks Like… <Company> is a leading national provider of infusion & home care management solutions. They collaborate with the full spectrum of healthcare professionals & have been able to demonstrate real world outcomes across 30 different categories that represent hospital systems, patient population, & the bulk of their medical & pharmacy spend. Since CMS launched the Bundled Payments for Care Improvement in 2011, <Company> has demonstrated expertise in post-acute value-based payment models & has been part of many demonstration projects to improve cost efficiencies & patient outcomes. Recently, they worked in conjunction with a health system on a Total Joint Replacement initiative that resulted in annual savings of $1.36M by decreasing skilled nursing facility (SNF) utilization, average length of stay (ALOS) & avoidable readmissions. This pilot was with a subset of 48 patients, that can now be scaled to other systems of care that will have significant cost savings. Source: Brooks Group Customer Market Research

21. What “Great” Looks Like… <Company> has a team of Strategic Account Managers (SAMs) working with Multiple Sclerosis (MS) Centers of Excellence (COE). The number of MS products, coupled with the price, & treatment protocols were increasing the complexity of this therapeutic space. The cost to keep patients on medications has driven down the adherence rates. The SAMs needed to differentiate their product & show that their co-pay patient assistance program was having a positive impact on patient care. The SAM asked HQ & the patient hub to generate analytics in preparation for a business review that illustrates 1) number of patients on product; 2) number of patients on co-pay assistance &; 3) total savings provided by the manufacturer to that specific Center of Excellence. This process was approved to be utilized for all SAMs. To date, this company remains the only manufacturer in the space that is compliantly providing this information to their COE’s & each practicing Neurologist can also be given a report by the SAM indicating the amount of savings they are providing to their MS patients. It’s been a differentiator for the manufacturer & has put the company as a trusted partner with the MS COEs. Source: Brooks Group Customer Market Research

22. Health Plans & PBM’s Future Expectations of Account Managers Additional external research validates the perception of the strong value of account managers. Overall, managed markets customers have a positive future outlook of the account management role. Specifically, panelists would like account managers evolving to become (1) more focused on potential partnership opportunities, & (2) more focused on customers’ strategic priorities. Q: How do you see the future of account manager engagement with your organization evolving? 2017 n=94 Future Outlook: Positive Evolution of AM Customer Engagement Future Outlook: Diminishing Need for AM Presence HRC: 2017 Managed Markets n=94