2019 Predictions: What Is to Come and How to Prepare
I’m Charline Shan, Vice President, Access Experience Team. Welcome back to All Access, Precision for Value’s bimonthly newsletter sharing the latest payer insights brought to you by our team of former access decision-makers.
Last year brought a flurry of unexpected changes. Depending on the stakeholder, some were good and some not so good. In this edition we encapsulate some of the most important changes on the horizon for 2019 and have asked our advisors to offer their predictions and impact for market access leaders. Jeremy Schafer reviews the growing number of gene therapies and how payers are in the midst of creating innovative and/or alternative payment methods to address the high cost of these therapies; Dominic Galante indicates payer and health system consolidation will continue to increase; Todd Edgar examines the proposed rule by HHS to amend the safe harbor regulations; Andy Cournoyer tackles two visions of Medicare policy changes and ICER’s growing influence; and Elizabeth Oyekan delivers an in-depth playbook of strategies that payers and health systems might employ to manage drug costs.
I think you’ll find the insights in All Access to be thought provoking and helpful in navigating the payer landscape. As always, please feel free to drop me a note and let me know if you have a topic suggestion for the Access Experience Team to address, and we’ll do our best to cover it in a future edition.
Regards,
Charline Shan
Charline Shan, RPh, MPH
Vice President, Access
Experience Team
EMAIL CHARLINE
All Access is a bimonthly newsletter that features key insights from our team of former payers, intended specifically for market access leaders. It is published by Precision for Value.
Guest Editor
Charline Shan
Executive Editor
Louis Landon
Contributors
Joe Honcz
Todd Edgar
Ami Gopalan
Andrew Cournoyer
Elizabeth Oyekan
Dominic Galante
Jeremy Schafer
Louis Landon
Less Drug Inflation—More Payer Innovation
Manufacturer drug pricing has been and will continue to be a key focal point on political agendas. But as proposed legislation is blocked or stymied, will there be any room for advancement? Andy Cournoyer discusses potential roadblocks, opportunities for innovation, and what they mean for payers in 2020.
2020: What’s the Next Move by Regional Health Plans?
The current healthcare market is dominated by partnerships, mergers, and healthcare giants. Dan Danielson explores 2 examples of how smaller, regional health plans can stay in the mix and competitive with the big kids on the block.
Medicare Advantage Plans: 2020 Focus on Social Determinants of Health
Elizabeth Oyekan examines the increasingly influential role health plans play in the Medicare program, and their shift to focus on social determinants of health. What will new policy and structural changes mean to the plan benefits and offerings in the ever-changing healthcare landscape?
PBMs in 2020: What Is Changing and What Stays the Same
From the potential withdrawal of the rebate safe harbor, to the myriad state laws targeting various PBM practices, 2019 was a year of tumult for drug manufacturers and PBMs. Jeremy Schafer takes a look at how 2020 will stack up in comparison.