Table of Contents

5 EXECUTIVE SUMMARY
5 Affordable care, accountable care: should pharma care?
5 ACOs come in many shapes and sizes
5 ACOs, pharma, and medication management
6 ACO results so far
8 AFFORDABLE CARE, ACCOUNTABLE CARE: SHOULD PHARMA CARE?
8 Payment reform: from volume to value
8 Maturing, multiplying ACOs matter to pharma
10 Key terms and players in value-based care
12 Bibliography
16 ACOS COME IN MANY SHAPES AND SIZES
16 ACOs vary in structure, size, culture, and risk
24 Variations on the ACO theme
25 Winners and losers in a shifting, consolidating provider landscape
26 Physician-led ACOs considered best for care, with health plan support
26 Bibliography
30 ACOS, PHARMA, AND MEDICATION MANAGEMENT
30 Medication management is not a priority for most ACOs
30 Some Medicare ACOs may be using more drugs
31 Commercial ACOs’ focus on short-term savings means drug cost caps
32 Changing roles and incentives for physicians
33 More formulary power to providers
34 ACO-pharma contracting? Not yet, but soon
34 Pharmacists as the new physicians?
36 Barriers to promoting pharmacists
36 Pharma can help ACOs in other ways: data, education, and patient support
38 Bibliography
42 ACO RESULTS SO FAR
42 Savings are modest
44 Case study analysis: ACO success stories
47 Bibliography
50 APPENDIX
50 About the author
50 Scope
50 Methodology

List of tables and figures

6 Figure 1: ACOs and pharma

9 Figure 2: Alternative payment models pyramid
37 Figure 3: Tips for successful pharma-ACO relationships
43 Figure 4: ACO success factors and challenges
17 Table 1: Types of public ACOs
22 Table 2: Types of commercial ACOs
30 Table 3: MSSP ACO metrics: a summary