Risk Sharing Between Pharmaceutical, Biotechnology, and Medical Device Manufacturers and Accountable Care Organizations Has Become a Reality

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New research from HRA shows that accountable care organizations (ACOs) are looking for their relationship with manufacturers to evolve from just selling products to sharing risk for positive patient outcomes.

Pharmaceutical and biotechnology companies should prepare themselves to meet the risk sharing demands from the increasing number of ACOs in the coming years, according to new research from HRA – Healthcare Research & Analytics. In the company’s most recent study, Accountable Care Organizations: Partnering for the Future, ACOs are increasingly looking for risk sharing to become part of standard contracting agreements with manufacturers in the near future.

According to input from 100 accountable care organizations, 8% of Medicare ACOs and 4% of Commercial ACOs already have active risk-sharing programs with manufacturers. The risk-sharing models vary across ACOs, but the message is clear that the organizations expect manufacturers to have a stake in patient outcomes.

“We need you to come to the table and say – ‘we want to partner with you and the providers to share risk’,” says Edward D. Shanshala, CEO at Ammonoosuc Community Health Services, a key opinion leader (KOL) interviewed as part of the study.

Payers take manufacturer responsibility a step further, citing a strong need for pharma to become more involved in patient adherence for chronic conditions. A managed care pharmacy director says, “If manufacturers own adherence, then shared risk is possible in the future.”

HRA’s newest syndicated study, Accountable Care Organizations: Partnering for the Future, clarifies the once blurred image of ACOs and presents comprehensive guidance on how to interact and collaborate with ACOs moving forward. Readers will walk away with an understanding of who holds the power in each type of an ACO, what influences these decision makers, and methods to develop partnerships with them. Methodologically, the study pairs extensive desk research with primary qualitative and quantitative research among providers and administrators within ACOs, integrated delivery networks (IDNs), group purchasing organizations (GPOs), commercial payers (MCOs), pharmacy benefit managers (PBMs), and across retail, hospital, and specialty pharmacy. It also includes perspectives from key opinion leaders (KOLs) who serve as experts in the issues surrounding the accountable care organizations and the healthcare market at large. The research covers a variety of topics including an analysis of decision-making pathways within ACOs, the level of payer influence within these organizations, the differences between Medicare and Commercial ACOs, the impact of Centers for Medicare and Medicaid Services (CMS) quality measures, and the relationship between ACOs and manufacturers and opportunities that may exist to strengthen those ties. HRA’s report also provides profiles of 10 key accountable care organizations included in the study which provide a blueprint for interacting with these ACOs.

“With the surprising prevalence of the so-called “commercial” ACOs, it is clear that the concept of accountable care is here to stay,” said Kevin M. Kelly, Executive Vice President & General Manager of HRA. “It is incumbent upon manufacturers to understand the unique needs of these organizations to create a true partnership in improving quality of care.”

To learn more about HRA and read additional insights into the relationship between manufacturers and ACOs provided by Accountable Care Organizations: Partnering for the Future, visit http://www.hraresearch.com.

About Healthcare Research & Analytics
HRA – Healthcare Research & Analytics is a consultative healthcare market research practice leveraging a flexible spectrum of solutions to support decision-making and strategy development across healthcare channels with expertise in health systems. HRA’s team of highly-experienced market researchers combines deep domain expertise in healthcare, science, business, and statistics with a passion for uncovering insights. HRA’s portfolio of offerings encompasses quantitative and qualitative, custom and syndicated market research services to support the business needs of the pharmaceutical, biotech, and medical device markets. HRA’s people and its products provide the healthcare market with actionable intelligence – facilitating better business decisions. HRA is a subsidiary of Michael J. Hennessy & Associates, an organization that maintains a unique reach into nearly every sector of healthcare professionals. MJH & Associates combines the power of an established network of publications and websites with the customer service focus and customization capabilities of a boutique firm.

Contact: Kevin M. Kelly, Executive Vice President & General Manager, kkelly(at)hraresearch(dot)com, 973-240-1200

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