1 / 52

Top Ten Emerging Health Care Trends: Implications for Patients, Providers, and Educators

A project of the AMCP Foundation and distributed in partnership with the American Association of Colleges of Pharmacy. Top Ten Emerging Health Care Trends: Implications for Patients, Providers, and Educators Ahead of the Curve. Introduction.

williamskeith
Download Presentation

Top Ten Emerging Health Care Trends: Implications for Patients, Providers, and Educators

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. A project of the AMCP Foundation and distributed in partnership with the American Association of Colleges of Pharmacy Top Ten Emerging Health Care Trends: Implications for Patients, Providers, and Educators Ahead of the Curve

  2. Introduction • 20 years ago: The American Association of Colleges of Pharmacy (AACP) issues the Janus Commission Report, restating colleges of pharmacy’s responsibility to navigate changes on the horizon • Today: The pace of change is accelerating, and it will be critically important for pharmacy educators: • To comprehend today’s trends and their far-reaching implications • To assume leadership roles in moving the pharmacy profession • To prepare students for the challenges and opportunities ahead

  3. Introduction (cont’d) • This module helps delineate today’s most critical changes, identify trends that are inter-related, and identify opportunities for pharmacy leaders, including educators, to reshape their organizations to meet today’s and tomorrow’s challenges. • Ahead of the Curve presents the results of a survey that identifies and links these changes, and suggests ways pharmacy educators can prepare the leaders of tomorrow.

  4. Outline • Study Background and Objectives • Top Ten Emerging Health Care Trends • Implications for Pharmacy Educators 4

  5. Study Background • The US health care system is in a constant state of change • The Patient Protection and Affordable Care Act (ACA) placed the “Triple Aim” of health care center stage Improving Population Health Improving Affordability of Care Improving Pt Satisfaction and Care Quality 5

  6. The Education of Pharmacy Students Must Reflect Today’s Changes and Emerging Trends • Health care stakeholders are increasingly asked to do more with less • Costs of medicines escalating in parallel with growing requirements for improved patient outcomes • Migration from volume to value in the health care marketplace • Current need to identify and assess the impact of the rapidly changing dynamics in the US health care system to proactively prepare for expected changes

  7. Goals of the Research Initiative 10 5 emerging trends in US health care impacting managed care pharmacy in the next Top years RESEARCH GOAL: • Identify the top ten emerging health care trends expected to have a significant impact on managed care pharmacy organizations in the next five years • ADDITIONAL STUDY OBJECTIVES: • Provide real-world insights on key health policy priorities relevant to a set of broader health care stakeholders • Develop a comprehensive reference resource for managed care provider organizations, health care payers, policy makers, and other stakeholders 7

  8. Advisory Panel for “Ahead of the Curve” 8

  9. Outline • Study Background and Objectives • Top Ten Emerging Health Care Trends • Implications of Emerging Trends for Pharmacy Educators 9

  10. Top 10 Trends Countdown

  11. Health Care Everywhere 10 11

  12. Current Trends:Health Care Everywhere 10 Changing the place of care Redefining Patient Outreach Medicalization of Consumer Devices 12

  13. Opportunities Ahead Looking Ahead:Health Care Everywhere 10 • Expanded role for retail pharmacies • Technologies and devices to enable physician extenders • New roles in the health care workforce Challenges Ahead For Educators • Care coordination and continuity of care • Data portability and technology integration • Focusing on coordination-of-care training • Expansion of pharmacy practice areas: patient care and outreach • Offering experiential training in innovative settings 13

  14. Top 10 Trends Countdown

  15. Increasing Patient Cost Sharing 9 15

  16. Current Trends:Increasing Patient Cost Sharing 9 Patient engagement is important Cost Sharing for Pharmaceuticals is rising impact of cost sharing on care seeking behaviors BENEFIT Designs are increasing patient financial risk 1. Magellan Pharmacy Solutions 2012; 2. CVS Caremark 2013; 3. PwC Health Research Institute 2013b; 4. Blumenthal 2013; 16

  17. Opportunities Ahead Looking Ahead:Increasing Patient Cost Sharing 9 • Promoting the use of high value services • Increasing patient ownership over disease management Challenges Ahead For Educators • Balanced risk sharing models are needed • Changes in provider payment and health system delivery • Raise awareness that greater patient cost sharing has the potential to limit adherence with therapies, without appropriate balances • Understand that methods to optimize patient decision making will require novel consumer-focused technologies 17

  18. Top 10 Trends Countdown

  19. Role of Technology in Patient Engagement 8 8 19

  20. Current Trends:Role of Technology in Patient Engagement 8 8 Patients WILL DRIVE technology use Technology in Disease management Technology in Medication Management Demographics impact usage 20

  21. Opportunities Ahead Looking Ahead:Role of Technology in Patient Engagement 8 8 Challenges Ahead • Improved patient health care decision-making • Patient ownership over disease management • Patient education including health literacy and e-literacy • Coordination of technologies • The digital divide For Educators • Technology will play several roles in connecting to patients regarding their pharmaceutical care and cost sharing 21

  22. Top 10 Trends Countdown

  23. Growth and Performance of ACOs 7 7 8 23

  24. Current Trends:Growth and Performance of ACOs 7 7 8 Pioneer ACOs mixed results Public & private ACOs are on the rise Appeal of the ACO model 1. Muhlestein 2013a; 2. Gold 2014; 3. Ignagni 2013; 4. Sanofi 2013; 5. Petersen 2013; 6. Muhlestein 2013b; 7. CMS 2013; 8. Gold 2014 24

  25. Opportunities Ahead Looking Ahead:Growth and Performance of ACOs 7 7 8 Challenges Ahead • Dual focus on cost and quality • Data-driven insights • Reduced provider autonomy • Sharing revenue • Fragmented health system For Educators • ACO and shared-savings models offer opportunities for pharmacy • Shared savings through better adherence and persistence? • University-based health systems and ACOs: an opportunity for student experience? 25

  26. Top 10 Trends Countdown

  27. Migration to Value-Oriented Health Care Marketplace 6 6 7 8 27

  28. Current Trends:Migration to Value-Oriented Health Care Marketplace 6 6 7 8 Driving value through incentives CHALLENGES in paying for value Financial incentives alone may not drive value 28

  29. Opportunities Ahead Looking Ahead:Migration to Value-Oriented Health Care Marketplace 6 6 7 8 • Era of value-based marketplace • Paying for value instead of services Challenges Ahead For Educators • Lack of consistent definition of “value” • Lack of available data • Ensure pharmacy students grasp the concept of value in health care treatment (from both the patient’s and system’s perspective) • Champion a dialogue on standard benchmarks for value • Establish procedures to iteratively evolve the definition of value 29

  30. Top 10 Trends Countdown

  31. Medicaid Expansion due to Health Care Reform 5 5 6 7 8 31

  32. Current Trends:Medicaid Expansion due to Health Care Reform 5 State responses will vary Medicaid enrollment will rise Medicaid expenditures will rise Expansion will harness NEW care delivery models 1. Sanofi 2013; 2. Cannon2012; 3. KFF 2014; 4. The Advisory Board Company 2014; 5. Rudowitz 2014; 6. Kocot 2013 32

  33. Opportunities Ahead Looking Ahead:Medicaid Expansion due to Health Care Reform 5 Challenges Ahead • A “hot bed” of innovation • New roles For Educators • Potential trickle-down effect of financial risk • Difficult processes for treating and paying for the uninsured • Greater opportunities for pharmacy to play new roles in primary care and on the care team • More need than ever for pharmacy students to deeply understand the evolving health system and grasp new innovations and their effect on traditional provider roles 33

  34. Top 10 Trends Countdown

  35. Spending and Utilization for Specialty Pharmaceuticals 4 35

  36. Current Trends:Spending and Utilization for Specialty Pharmaceuticals 4 SPECIALTY BOOM WILL CONTINUE Health Plan Responses to Specialty Spending Rise Biosimilars bring market opportunity 36

  37. Opportunities Ahead Looking Ahead:Spending and Utilization for Specialty Pharmaceuticals 4 Challenges Ahead • “Personalized” or “precision” medicine • Improved patient outcomes • Final regulatory framework for biosimilars • Over-specialization of care For Educators • Prepare new pharmacists with focused education on specialty and biosimilars, including the challenges for bioequivalence, safety, and efficacy • Differentiate the nuances of the pharmacy vs. medical benefit in pharmacy practice in teaching/experiential learning 37

  38. Top 10 Trends Countdown

  39. Widespread Use of Data and Analytics in Patient Care 3 39

  40. Current Trends:Widespread Use of Data and Analytics in Patient Care 3 EXPANDED USE OF ELECTRONIC HEALTH RECORDS Multiple sources of data will arise Lack of relevant and measurable patient outcomes present barriers NEW DATASETS WITH NEW PURPOSES 1. Hsiao 2014; 2. Charles 2013; 3. ASCO 2014 40

  41. Opportunities Ahead LookingAhead: Widespread Use of Data and Analytics in Patient Care 3 Challenges Ahead • Data driven insights • Transparency in the care provision process • Fragmented patient data • Reluctance of many clinicians • Availability of meaningful patient metrics For Educators • Introduce to students the concepts of EHR and HIT in general, and the contributions/roles of pharmacy in collecting data • Discuss with pharmacy students the benefits and challenges in using analytics to track patient care 41

  42. Top 10 Trends Countdown

  43. Consolidation of Health Care Stakeholders 2 43

  44. Current Trends:Consolidation of Health Care Stakeholders 2 INCREASED HORIZONTAL INTEGRATION Hospital MERGERS ON THE RISE REACTIVE CONSOLIDATION COORDINATED DECISION-MAKING 1. Enders 2014; 2. Brooks 2012; 3. Genentech 2012; 4. Hernandez 2013 44

  45. Opportunities Ahead Looking Ahead:Consolidation of Health Care Stakeholders 2 • Increased use of data and technology • Increased care efficiency • More negotiating power Challenges Ahead For Educators • Gaps in data on longitudinal patient outcomes and the health care supply chain • Shifts in the conventional provider role • Ensure pharmacy students are prepared to work in an environment characterized by changing payment models and IDNs and can critically analyze the pharmaceutical purchasing/supply chain 45

  46. Top 10 Trends Countdown

  47. Migration from FFS to New Provider Payment Models 1 47

  48. Current Trends:Migration from FFS to New Provider Payment Models 1 Bundled payments in oncology Bundled payments in hospitals bundled payments are successful Collaboration IS KEY IN DESIGNING NEW MODELS 1. Magellan Pharmacy Solutions 2012; 2. Zellmer 2013; 3. RWJF 2013 48

  49. Opportunities Ahead Looking Ahead:Migration from FFS to New Provider Payment Models 1 • High-quality patient outcomes • Reduced costs for government and commercial • New approaches for care delivery Challenges Ahead • Lack of long-term data on performance • Potential abandonment/reduction of care for certain high-cost chronic diseases • Ability of providers to identify and reduce waste For Educators • Payment reform will need to be an evolving process • Illustrate opportunities for pharmacists to provide value in such systems 49

  50. Top Ten Emerging Health Care Trends 50

More Related