It’s the prices
Demonstrating value is critical
Healthcare providers, drug companies and payers should develop plans to address the ongoing and intensifying focus on prices from consumers, lawmakers and the media. This could mean developing more affordable options, embracing true price transparency or demonstrating the provided service’s value.
- Providers: To remain competitive, providers need to demonstrate value by delivering consistent outcomes at predictable prices and offering easy access to services in the right care setting.
- Pharmaceutical and life sciences: Consider differentiating using clinical decision making tools and other value-added services such as companion diagnostics to offer personalized treatments to patients.
- Payers and employers: Consider offering a value plan option with a limited network focusing on quality and customer satisfaction along with pricing transparency tools to demonstrate savings and value.
Make room for advocates
Consumers and employers want their own representation
Employers are adding health advocacy to health and wellness benefits to help employees get the most out of their benefits. Health advocates help consumers make medically appropriate, financially sound decisions.
- Providers: Health advocates can help improve patient outcomes by supporting care coordination efforts for patients across specialties and services.
- Pharmaceutical and life sciences: As care advocates become more common, demand may rise for outcomes-based pricing and may increase price pressures. Advocates will guide patients to the most cost-effective treatment options.
- Payers and employers: Health advocates may enhance existing disease management and care management programs, particularly for populations with chronic conditions.
Consolidation is not enough
A better customer experience will be essential
Consolidation has changed the healthcare landscape. Health systems are getting larger. And yet, consolidating to protect and increase market share and negotiating power won’t guarantee success. Understanding consumers’ points of view is critical. Organizations armed with knowledge about the populations they serve can target investments strategically.
- Providers: Post-merger, providers should consider strategies to improve customer experience, quality and convenience of care. This demonstrates the additional value gained from any price increases.
- Pharmaceutical and life sciences: As provider consolidation continues, consider refocusing sales tactics from conversations with individual prescribing providers to presentations showing efficacy and cost effectiveness to a formulary committee.
- Payers and employers: Consider proactively renegotiating contracts to manage potential rate increases in a post-acquisition market.