This strategy report focuses Accountable Care Organizations and what impact they will have on pharma including an evaluation of ACOs’ structures, sizes, cultures, and risks.
Datamonitor’s independent research and analysis provides extensive coverage of major disease areas, companies and strategic issues, giving you the perspective to identify opportunities and threats arising from shifting market dynamics and the insights to respond with faster, more effective decision-making. This strategy report focuses Accountable Care Organizations and what impact they will have on pharma including an evaluation of ACOs’ structures, sizes, cultures, and risks.
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Disease group covered:
Gastroenterology (non inflammatory bowel disease)
Rheumatology (non autoimmune)
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
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
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
42 ACO RESULTS SO FAR
42 Savings are modest
44 Case study analysis: ACO success stories
50 About the author
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
Figure 2: Alternative payment models pyramid
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