Emerging Health Care Trends: Implications for Pharmacy Education

 
Top Ten Emerging Health Care
Trends: 
Implications for Patients,
Providers, and Educators
 
Ahead of the Curve
 
A project of the AMCP Foundation and
distributed in partnership with the American
Association of Colleges of Pharmacy
 
Introduction
 
20 years ago: 
The American Association of Colleges
of Pharmacy (AACP) issues the Janus Commission
Report, restating colleges of pharmacy’s
responsibility to navigate changes on the horizon
Today: 
The pace of change is accelerating, and it
will be critically important for pharmacy educators:
To comprehend today’s trends and their far-reaching
implications
To assume leadership roles in moving the pharmacy
profession
To prepare students for the challenges and opportunities
ahead
 
2
 
Introduction 
(cont’d)
 
This module helps delineate today’s most critical
changes, identify trends that are inter-related, and
identify opportunities for pharmacy leaders,
including educators, to reshape their organizations
to meet today’s and tomorrow’s challenges.
Ahead of the Curve 
presents the results of a survey
that identifies and links these changes, and
suggests ways pharmacy educators can prepare
the leaders of tomorrow.
 
Outline
 
4
 
Study Background and Objectives
Top Ten Emerging Health Care Trends
Implications for Pharmacy Educators
 
Study Background
 
The US health care system is in
a constant state of change
The Patient Protection and
Affordable Care Act (ACA)
placed the “Triple Aim” of
health care center stage
 
5
 
The Education of Pharmacy Students Must Reflect
Today’s Changes and Emerging Trends
 
Health care stakeholders are increasingly asked to
do more with less
Costs of medicines escalating in parallel with growing
requirements for improved patient outcomes
Migration from volume to value in the health care
marketplace
Current need to identify and assess the impact of
the rapidly changing dynamics in the US health
care system to proactively prepare for expected
changes
 
Goals of the Research Initiative
 
7
 
RESEARCH GOAL:
Identify the top ten emerging health care trends expected to have a
significant impact on managed care pharmacy organizations in the next five
years
ADDITIONAL STUDY OBJECTIVES:
Provide real-world insights on key health policy priorities relevant to a set of
broader health care stakeholders
Develop a comprehensive reference resource for managed care provider
organizations, health care payers, policy makers, and other stakeholders
 
Advisory Panel for “Ahead of the Curve”
 
8
 
Outline
 
9
 
Study Background and Objectives
Top Ten Emerging Health Care Trends
Implications of Emerging Trends for Pharmacy
Educators
 
Top 10 Trends Countdown
 
10
 
Health Care Everywhere
 
11
Current Trends:
Current Trends:
Health Care Everywhere
Health Care Everywhere
CHANGING THE PLACE
OF CARE
 
REDEFINING PATIENT
OUTREACH
 
MEDICALIZATION OF
CONSUMER DEVICES
12
Looking Ahead:
Looking Ahead:
Health Care Everywhere
Health Care Everywhere
Expanded role for retail pharmacies
Technologies and devices to enable physician extenders
New roles in the health care workforce
Opportunities Ahead
13
 
Top 10 Trends Countdown
Top 10 Trends Countdown
 
14
 
 
Increasing Patient Cost Sharing
Increasing Patient Cost Sharing
 
15
Current Trends:
Current Trends:
 
 
Increasing Patient Cost Sharing
Increasing Patient Cost Sharing
COST SHARING FOR
PHARMACEUTICALS IS RISING
 
 
PATIENT ENGAGEMENT
IS IMPORTANT
 
 
 
BENEFIT DESIGNS ARE INCREASING
PATIENT FINANCIAL RISK
 
 
 
IMPACT OF COST SHARING ON
CARE SEEKING BEHAVIORS
16
1.
 Magellan Pharmacy Solutions 2012; 
2.
 CVS Caremark 2013; 
3.
 PwC Health Research Institute 2013b; 
4.
Blumenthal 2013;
Looking Ahead:
Looking Ahead:
Increasing Patient Cost Sharing
Increasing Patient Cost Sharing
Promoting the use of high value services
Increasing patient ownership over disease management
Opportunities Ahead
17
 
Top 10 Trends Countdown
Top 10 Trends Countdown
 
18
 
Role of Technology
Role of Technology
in Patient Engagement
in Patient Engagement
 
19
8
Current Trends:
Current Trends:
 
 
Role of Technology
Role of Technology
in Patient Engagement
in Patient Engagement
PATIENTS WILL DRIVE
TECHNOLOGY USE
 
TECHNOLOGY IN DISEASE
MANAGEMENT
 
TECHNOLOGY IN
MEDICATION
MANAGEMENT
 
 
DEMOGRAPHICS IMPACT
USAGE
20
8
Looking Ahead:
Looking Ahead:
Role of Technology in Patient Engagement
Role of Technology in Patient Engagement
Improved patient health care decision-making
Patient ownership over disease management
Opportunities Ahead
21
8
 
Top 10 Trends Countdown
Top 10 Trends Countdown
 
22
 
Growth and Performance of ACOs
Growth and Performance of ACOs
 
23
7
8
 
Current Trends:
Current Trends:
Growth and Performance of ACOs
Growth and Performance of ACOs
PUBLIC & PRIVATE ACOS ARE ON
THE RISE
 
 
 
 
APPEAL OF THE ACO MODEL
 
 
 
 
 
PIONEER ACOS 
MIXED RESULTS
24
1.
 Muhlestein 2013a; 
2.
 Gold 2014; 
3.
 Ignagni 2013; 
4. 
Sanofi 2013; 
5. 
Petersen 2013; 
6. 
Muhlestein 2013b; 
7.
CMS 2013; 
8.  
Gold 2014
7
8
Looking Ahead:
Looking Ahead:
Growth and Performance of ACOs
Growth and Performance of ACOs
Dual focus on cost and quality
Data-driven insights
For Educators
Challenges Ahead
Opportunities Ahead
 
Reduced provider autonomy
Sharing revenue
Fragmented health system
 
ACO and shared-savings models offer opportunities for pharmacy
Shared savings through better adherence and persistence?
University-based health systems and ACOs: an opportunity for
student experience?
25
7
8
 
Top 10 Trends Countdown
Top 10 Trends Countdown
 
26
 
Migration to Value-Oriented
Migration to Value-Oriented
Health Care Marketplace
Health Care Marketplace
 
27
6
7
8
Current Trends:
Current Trends:
 
 
Migration to Value-Oriented
Migration to Value-Oriented
Health Care Marketplace
Health Care Marketplace
DRIVING VALUE THROUGH
INCENTIVES
 
CHALLENGES IN
PAYING FOR VALUE
28
 
FINANCIAL INCENTIVES
ALONE MAY NOT DRIVE
VALUE
6
7
8
Looking Ahead:
Looking Ahead:
 
 
Migration to Value-Oriented
Migration to Value-Oriented
Health Care Marketplace
Health Care Marketplace
Era of value-based marketplace
Paying for value instead of services
Opportunities Ahead
29
6
7
8
 
Top 10 Trends Countdown
Top 10 Trends Countdown
 
30
 
Medicaid Expansion
Medicaid Expansion
due to Health Care Reform
due to Health Care Reform
 
31
5
6
7
8
Current Trends:
Current Trends:
 
 
Medicaid Expansion
Medicaid Expansion
due to Health Care Reform
due to Health Care Reform
MEDICAID ENROLLMENT WILL
RISE
 
 
STATE RESPONSES WILL VARY
 
 
MEDICAID EXPENDITURES
WILL RISE
 
 
EXPANSION WILL HARNESS NEW
CARE DELIVERY MODELS
32
1.
 Sanofi 2013; 
2. 
Cannon
 
2012;
 3.
 KFF 2014; 
4.
 The Advisory Board Company 2014; 
5.
 Rudowitz 2014; 
6.
Kocot 2013
Looking Ahead:
Looking Ahead:
 
 
Medicaid Expansion
Medicaid Expansion
due to Health Care Reform
due to Health Care Reform
A “hot bed” of innovation
New roles
For Educators
Challenges Ahead
Opportunities Ahead
 
Potential trickle-down effect of financial risk
Difficult processes for treating and paying for the uninsured
 
Greater opportunities for pharmacy to play new roles in primary
care and on the care team
More need than ever for pharmacy students to deeply understand
the evolving health system and grasp new innovations and their
effect on traditional provider roles
33
 
Top 10 Trends Countdown
Top 10 Trends Countdown
 
34
 
Spending and Utilization
Spending and Utilization
for Specialty Pharmaceuticals
for Specialty Pharmaceuticals
 
35
Current Trends:
Current Trends:
 
 
Spending and Utilization
Spending and Utilization
for Specialty Pharmaceuticals
for Specialty Pharmaceuticals
SPECIALTY BOOM WILL
CONTINUE
 
BIOSIMILARS BRING
MARKET OPPORTUNITY
 
HEALTH PLAN RESPONSES
TO
SPECIALTY SPENDING RISE
36
Looking Ahead:
Looking Ahead:
 
 
Spending and Utilization
Spending and Utilization
for Specialty Pharmaceuticals
for Specialty Pharmaceuticals
37
“Personalized” or “precision” medicine
Improved patient outcomes
Opportunities Ahead
 
Final regulatory framework for biosimilars
Over-specialization of care
 
Prepare new pharmacists with focused education on specialty and
biosimilars, including the challenges for bioequivalence, safety,
and efficacy
Differentiate the nuances of the pharmacy vs. medical benefit in
pharmacy practice in teaching/experiential learning
Challenges Ahead
For Educators
 
Top 10 Trends Countdown
Top 10 Trends Countdown
 
38
 
Widespread Use of Data
Widespread Use of Data
and Analytics in Patient Care
and Analytics in Patient Care
 
39
Current Trends:
Current Trends:
 
 
Widespread Use of Data and
Widespread Use of Data and
Analytics in Patient Care
Analytics in Patient Care
EXPANDED USE OF ELECTRONIC
HEALTH RECORDS
 
 
MULTIPLE SOURCES OF
DATA WILL ARISE
 
 
LACK OF RELEVANT AND
MEASURABLE PATIENT OUTCOMES
PRESENT BARRIERS
 
 
NEW DATASETS WITH NEW
PURPOSES
40
1.
 Hsiao 2014; 
2.
 Charles 2013; 
3.
 ASCO 2014
Looking Ahead: 
Looking Ahead: 
Widespread Use of Data
Widespread Use of Data
and Analytics  in Patient Care
and Analytics  in Patient Care
Data driven insights
Transparency in the care provision process
For Educators
Challenges Ahead
Opportunities Ahead
 
Fragmented patient data
Reluctance of many clinicians
Availability of meaningful patient metrics
 
Introduce to students the concepts of EHR and HIT in general, and
the contributions/roles of pharmacy in collecting data
Discuss with pharmacy students the benefits and challenges in
using analytics to track patient care
41
 
Top 10 Trends Countdown
Top 10 Trends Countdown
 
42
 
Consolidation of Health Care Stakeholders
Consolidation of Health Care Stakeholders
 
43
2
Current Trends:
Current Trends:
Consolidation of Health Care Stakeholders
Consolidation of Health Care Stakeholders
HOSPITAL MERGERS ON THE RISE
 
INCREASED HORIZONTAL
INTEGRATION
 
REACTIVE CONSOLIDATION
 
COORDINATED
DECISION-MAKING
44
1.
 Enders 2014; 
2. 
Brooks 2012; 
3. 
Genentech 2012; 
4. 
Hernandez 2013
Looking Ahead:
Looking Ahead:
 
 
Consolidation of
Consolidation of
Health Care Stakeholders
Health Care Stakeholders
45
Increased use of data and technology
Increased care efficiency
More negotiating power
Opportunities Ahead
 
Gaps in data on longitudinal patient outcomes and the health care
supply chain
Shifts in the conventional provider role
 
Ensure pharmacy students are prepared to work in an environment
characterized by changing payment models and IDNs and can
critically analyze the pharmaceutical purchasing/supply chain
For Educators
Challenges Ahead
 
Top 10 Trends Countdown
Top 10 Trends Countdown
 
46
 
Migration from FFS to
Migration from FFS to
New Provider Payment Models
New Provider Payment Models
 
47
Current Trends:
Current Trends:
 
 
Migration from FFS to
Migration from FFS to
New Provider Payment Models
New Provider Payment Models
BUNDLED PAYMENTS IN
ONCOLOGY
1.
 Magellan Pharmacy Solutions 2012; 
2.
 Zellmer 2013; 
3.
 RWJF 2013
 
BUNDLED PAYMENTS IN
HOSPITALS
 
 
BUNDLED PAYMENTS ARE
SUCCESSFUL
 
 
COLLABORATION IS KEY IN
DESIGNING NEW MODELS
48
Looking Ahead:
Looking Ahead:
 
 
Migration from FFS to New
Migration from FFS to New
Provider Payment Models
Provider Payment Models
High-quality patient outcomes
Reduced costs for government and commercial
New approaches for care delivery
For Educators
Challenges Ahead
Opportunities Ahead
 
Lack of long-term data on performance
Potential abandonment/reduction of care for certain high-cost
chronic diseases
Ability of providers to identify and reduce waste
 
Payment reform will need to be an evolving process
Illustrate opportunities for pharmacists to provide value in such systems
49
 
Top Ten Emerging Health Care Trends
Top Ten Emerging Health Care Trends
 
50
 
Outline
Outline
 
51
 
Study Background and Objectives
Top Ten Emerging Health Care Trends
Implications of Emerging Trends for Pharmacy
Educators
 
 
Implications For Pharmacy Educators
Implications For Pharmacy Educators
 
The role of pharmacy will continue to expand
Pharmacists will be more integrated on patient care teams
Utilization of health information and patient technologies by
pharmacists
Improving value through improved medication adherence and
persistence
Opportunities Ahead
 
Continuing to demonstrate pharmacy value in evolving systems,
especially in coordination of care
Managing specialty pharmaceutical trends
Understanding the complexities of payment reform and risk sharing
Challenges Ahead
 
52
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The evolving landscape of healthcare demands that pharmacy educators understand and adapt to current trends. This report, a collaborative effort by AMCP Foundation and American Association of Colleges of Pharmacy, delves into crucial changes impacting patients, providers, and educators. It emphasizes the need for leadership in preparing pharmacy students for future challenges and opportunities. The study identifies top emerging trends and offers insights for educators to reshape their curriculum and organizations effectively.

  • Health Care Trends
  • Pharmacy Education
  • Healthcare System
  • Pharmacy Leaders
  • Student Preparation

Uploaded on Jul 29, 2024 | 0 Views


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  1. Top Ten Emerging Health Care Trends: Implications for Patients, Providers, and Educators Ahead of the Curve A project of the AMCP Foundation and distributed in partnership with the American Association of Colleges of Pharmacy

  2. Introduction 20 years ago: The American Association of Colleges of Pharmacy (AACP) issues the Janus Commission Report, restating colleges of pharmacy s responsibility to navigate changes on the horizon Today: The pace of change is accelerating, and it will be critically important for pharmacy educators: To comprehend today s trends and their far-reaching implications To assume leadership roles in moving the pharmacy profession To prepare students for the challenges and opportunities ahead 2

  3. Introduction (contd) This module helps delineate today s most critical changes, identify trends that are inter-related, and identify opportunities for pharmacy leaders, including educators, to reshape their organizations to meet today s and tomorrow s challenges. Ahead of the Curve presents the results of a survey that identifies and links these changes, and suggests ways pharmacy educators can prepare the leaders of tomorrow.

  4. Outline Study Background and Objectives Top Ten Emerging Health Care Trends Implications for Pharmacy Educators 4

  5. Study Background The US health care system is in a constant state of change The Patient Protection and Affordable Care Act (ACA) placed the Triple Aim of health care center stage Improving Pt Satisfaction and Care Quality 5

  6. The Education of Pharmacy Students Must Reflect Today s Changes and Emerging Trends Health care stakeholders are increasingly asked to do more with less Costs of medicines escalating in parallel with growing requirements for improved patient outcomes Migration from volume to value in the health care marketplace Current need to identify and assess the impact of the rapidly changing dynamics in the US health care system to proactively prepare for expected changes

  7. Goals of the Research Initiative Top 10 care pharmacy in the next5years emerging trends in US health care impacting managed RESEARCH GOAL: Identify the top ten emerging health care trends expected to have a significant impact on managed care pharmacy organizations in the next five years ADDITIONAL STUDY OBJECTIVES: Provide real-world insights on key health policy priorities relevant to a set of broader health care stakeholders Develop a comprehensive reference resource for managed care provider organizations, health care payers, policy makers, and other stakeholders 7

  8. Advisory Panel for Ahead of the Curve THOUGHT LEADER PROFESSIONAL AFFILIATION Research Associate Professor & Associate Director, PORC at the University of Utah College of Pharmacy Joseph Biskupiak, PhD, MBA Former Health Care Policy Advisor, the White House (National Economic Council) Chris Dawe Jeffrey Dunn, PharmD, MBA Senior Vice President, VRx Pharmacy Services Medical Director, Northeast Business Group on Health (NEBGH); Executive Director, NEBGH Solutions Center Jeremy Nobel, MD, MPH Sandy Robinson, BA, MPA Senior Vice President, Avalere Health Executive Vice President and CEO of the National Alliance of State Pharmacy Associations Rebecca Snead, RPh Mark Snyder, MD Specialist Leader, Deloitte Consulting Research Professor and Project Director, Center on Health Insurance Reforms at Georgetown University Health Policy Institute JoAnn Volk, MA Director of Medicare Pharmacy Clinical Programs at Coventry Health Care, Inc./Aetna Mitzi Wasik, PharmD, BCPS Jed Weissberg, MD Senior Fellow, the Institute for Clinical and Economic Review 8

  9. Outline Study Background and Objectives Top Ten Emerging Health Care Trends Implications of Emerging Trends for Pharmacy Educators 9

  10. Top 10 Trends Countdown 1 2 3 4 5 6 7 8 9 10 Health care everywhere 10

  11. 10 Health Care Everywhere The Location of Care is Shifting Beyond Health Care Facilities Non-Physician Care Roles are Expanding Innovations in Technology are Fueling Enhanced Patient Engagement A New Generation of Health Care Roles Will Emerge New Care Settings Bring New Challenges in Coordination 11

  12. Current Trends: 10 Health Care Everywhere CHANGING THE PLACE OF CARE REDEFINING PATIENT OUTREACH MEDICALIZATION OF CONSUMER DEVICES 12

  13. Looking Ahead: Health Care Everywhere 10 Opportunities Ahead Expanded role for retail pharmacies Technologies and devices to enable physician extenders New roles in the health care workforce Challenges Ahead Care coordination and continuity of care Data portability and technology integration For Educators Focusing on coordination-of-care training Expansion of pharmacy practice areas: patient care and outreach Offering experiential training in innovative settings 13

  14. Top 10 Trends Countdown 1 2 3 4 5 6 7 8 9 10 Increasing patient cost sharing Health care everywhere 14

  15. 9 Increasing Patient Cost Sharing Patient Cost Sharing is Increasing New Provider Payment Models May Increase Patient Financial Risk Non-financial Approaches are Needed to Effectively Engage Patients 15

  16. Current Trends: 9 Increasing Patient Cost Sharing COST SHARING FOR PHARMACEUTICALS IS RISING PATIENT ENGAGEMENT IS IMPORTANT IMPACT OF COST SHARING ON CARE SEEKING BEHAVIORS BENEFIT DESIGNS ARE INCREASING PATIENT FINANCIAL RISK 1. Magellan Pharmacy Solutions 2012; 2. CVS Caremark 2013; 3. PwC Health Research Institute 2013b; 4. Blumenthal 2013; 16

  17. Looking Ahead: 9 Increasing Patient Cost Sharing Opportunities Ahead Promoting the use of high value services Increasing patient ownership over disease management Challenges Ahead Balanced risk sharing models are needed Changes in provider payment and health system delivery For Educators Raise awareness that greater patient cost sharing has the potential to limit adherence with therapies, without appropriate balances Understand that methods to optimize patient decision making will require novel consumer-focused technologies 17

  18. Top 10 Trends Countdown 1 2 3 4 5 6 7 8 9 10 Role of technology in patient engagement Increasing patient cost sharing Health care everywhere 18

  19. Role of Technology in Patient Engagement 8 8 The Rise of Health Care Technologies is Empowering Patients Technology Tools Support Communication and Decision-Making Patients are Becoming Consumers Patient Education and Technology Coordination are Keys to Success The Digital Divide is a Risk for Some 19

  20. Current Trends: Role of Technology in Patient Engagement 8 8 PATIENTS WILL DRIVE TECHNOLOGY USE TECHNOLOGY IN DISEASE MANAGEMENT TECHNOLOGY IN MEDICATION MANAGEMENT DEMOGRAPHICS IMPACT USAGE 20

  21. Looking Ahead: 8 8 Role of Technology in Patient Engagement Opportunities Ahead Improved patient health care decision-making Patient ownership over disease management Challenges Ahead Patient education including health literacy and e-literacy Coordination of technologies The digital divide For Educators Technology will play several roles in connecting to patients regarding their pharmaceutical care and cost sharing 21

  22. Top 10 Trends Countdown 1 2 3 4 5 6 7 8 9 10 Growth and performance of accountable care organizations Role of technology in patient engagement Increasing patient cost sharing Health care everywhere 22

  23. 7 8 7 Growth and Performance of ACOs ACOs are Expanding Early Data on ACOs are Promising ACO-Type Thinking is a Necessary Transitional Step Data and Analytics Will be Key for ACOs A Broader Culture Shift is Needed to Bend the Cost Curve 23

  24. Current Trends: 7 8 7 Growth and Performance of ACOs PUBLIC & PRIVATE ACOS ARE ON THE RISE PIONEER ACOS MIXED RESULTS APPEAL OF THE ACO MODEL 1. Muhlestein 2013a; 2. Gold 2014; 3. Ignagni 2013; 4. Sanofi 2013; 5. Petersen 2013; 6. Muhlestein 2013b; 7. CMS 2013; 8. Gold 2014 24

  25. Looking Ahead: 7 8 7 Growth and Performance of ACOs Opportunities Ahead Dual focus on cost and quality Data-driven insights Challenges Ahead Reduced provider autonomy Sharing revenue Fragmented health system For Educators ACO and shared-savings models offer opportunities for pharmacy Shared savings through better adherence and persistence? University-based health systems and ACOs: an opportunity for student experience? 25

  26. Top 10 Trends Countdown 1 2 3 4 5 6 7 8 9 10 Migration to value-oriented health care marketplace Growth and performance of accountable care organizations Role of technology in patient engagement Increasing patient cost sharing Health care everywhere 26

  27. Migration to Value-Oriented Health Care Marketplace 6 7 8 6 Migration to Value-Oriented Marketplace is Occurring Defining Value Will be Necessary Meaningful, Measurable Patient Outcomes Must be Defined and Tracked Multi-faceted Approaches Will be Needed 27

  28. Current Trends: Migration to Value-Oriented Health Care Marketplace 6 7 8 6 DRIVING VALUE THROUGH INCENTIVES CHALLENGES IN PAYING FOR VALUE FINANCIAL INCENTIVES ALONE MAY NOT DRIVE VALUE 28

  29. Looking Ahead: Migration to Value-Oriented Health Care Marketplace 6 7 8 6 Opportunities Ahead Era of value-based marketplace Paying for value instead of services Challenges Ahead Lack of consistent definition of value Lack of available data For Educators Ensure pharmacy students grasp the concept of value in health care treatment (from both the patient s and system s perspective) Champion a dialogue on standard benchmarks for value Establish procedures to iteratively evolve the definition of value 29

  30. Top 10 Trends Countdown 1 2 3 4 5 6 7 8 9 10 Medicaid expansion due to health care reform Migration to value-oriented health care marketplace Growth and performance of accountable care organizations Role of technology in patient engagement Increasing patient cost sharing Health care everywhere 30

  31. Medicaid Expansion due to Health Care Reform 5 6 7 8 5 Medicaid Enrollment is Increasing States Hold the Power to Drive Expansion Cost Reduction and Care Efficiency Will be Key Medicaid Expansion Will be a Hot Bed of Innovation for Change Improved Outcomes With Lower Reimbursements Will be Necessary 31

  32. Current Trends: Medicaid Expansion due to Health Care Reform 5 MEDICAID ENROLLMENT WILL RISE STATE RESPONSES WILL VARY MEDICAID EXPENDITURES WILL RISE EXPANSION WILL HARNESS NEW CARE DELIVERY MODELS 1. Sanofi 2013; 2. Cannon2012; 3. KFF 2014; 4. The Advisory Board Company 2014; 5. Rudowitz 2014; 6. Kocot 2013 32

  33. Looking Ahead: Medicaid Expansion due to Health Care Reform 5 Opportunities Ahead A hot bed of innovation New roles Challenges Ahead Potential trickle-down effect of financial risk Difficult processes for treating and paying for the uninsured For Educators Greater opportunities for pharmacy to play new roles in primary care and on the care team More need than ever for pharmacy students to deeply understand the evolving health system and grasp new innovations and their effect on traditional provider roles 33

  34. Top 10 Trends Countdown 1 2 3 4 5 6 7 8 9 10 Spending and utilization for specialty pharmaceuticals Medicaid expansion due to health care reform Migration to value-oriented health care marketplace Growth and performance of accountable care organizations Role of technology in patient engagement Increasing patient cost sharing Health care everywhere 34

  35. Spending and Utilization for Specialty Pharmaceuticals 4 Specialty Medicine Spending and Utilization Will Continue to Grow Biosimilars Have the Potential to Shift the Cost Curve Scientific Advances Can Help Get the Right Treatments to the Right Patients Promoting Optimal Use of Specialty Medications Requires New Approaches 35

  36. Current Trends: Spending and Utilization for Specialty Pharmaceuticals 4 SPECIALTY BOOM WILL CONTINUE HEALTH PLAN RESPONSES TO SPECIALTY SPENDING RISE BIOSIMILARS BRING MARKET OPPORTUNITY 36

  37. Looking Ahead: Spending and Utilization for Specialty Pharmaceuticals 4 Opportunities Ahead Personalized or precision medicine Improved patient outcomes Challenges Ahead Final regulatory framework for biosimilars Over-specialization of care For Educators Prepare new pharmacists with focused education on specialty and biosimilars, including the challenges for bioequivalence, safety, and efficacy Differentiate the nuances of the pharmacy vs. medical benefit in pharmacy practice in teaching/experiential learning 37

  38. Top 10 Trends Countdown 1 2 3 4 5 6 7 8 9 10 Widespread use of data and analytics in patient care Spending and utilization for specialty pharmaceuticals Medicaid expansion due to health care reform Migration to value-oriented health care marketplace Growth and performance of accountable care organizations Role of technology in patient engagement Increasing patient cost sharing Health care everywhere 38

  39. Widespread Use of Data and Analytics in Patient Care 3 Patient Data Assets are Multiplying Data and Analytics-Based Insights Will Drive Care Efficiency Collecting the Right Data is Increasingly Important Integrated Systems are Primed to Lead the Way Organizational and Operational Barriers Must be Addressed 39

  40. Current Trends: Widespread Use of Data and Analytics in Patient Care 3 EXPANDED USE OF ELECTRONIC HEALTH RECORDS MULTIPLE SOURCES OF DATA WILL ARISE LACK OF RELEVANT AND MEASURABLE PATIENT OUTCOMES PRESENT BARRIERS NEW DATASETS WITH NEW PURPOSES 1. Hsiao 2014; 2. Charles 2013; 3. ASCO 2014 40

  41. Looking Ahead: Widespread Use of Data and Analytics in Patient Care 3 Opportunities Ahead Data driven insights Transparency in the care provision process Challenges Ahead Fragmented patient data Reluctance of many clinicians Availability of meaningful patient metrics For Educators Introduce to students the concepts of EHR and HIT in general, and the contributions/roles of pharmacy in collecting data Discuss with pharmacy students the benefits and challenges in using analytics to track patient care 41

  42. Top 10 Trends Countdown 1 2 3 4 5 6 7 8 9 10 Consolidation of health care stakeholders Widespread use of data and analytics in patient care Spending and utilization for specialty pharmaceuticals Medicaid expansion due to health care reform Migration to value-oriented health care marketplace Growth and performance of accountable care organizations Role of technology in patient engagement Increasing patient cost sharing Health care everywhere 42

  43. 2 Consolidation of Health Care Stakeholders Consolidation of Health Care Stakeholders is on the Rise Decision-Making Will Become Centralized and Standardized The Balance of Market Power Will Shift Consolidation Creates New Opportunities in Health Information Technology 43

  44. Current Trends: 2 Consolidation of Health Care Stakeholders INCREASED HORIZONTAL INTEGRATION HOSPITAL MERGERS ON THE RISE REACTIVE CONSOLIDATION COORDINATED DECISION-MAKING 1. Enders 2014; 2. Brooks 2012; 3. Genentech 2012; 4. Hernandez 2013 44

  45. Looking Ahead: Consolidation of Health Care Stakeholders 2 Opportunities Ahead Increased use of data and technology Increased care efficiency More negotiating power Challenges Ahead Gaps in data on longitudinal patient outcomes and the health care supply chain Shifts in the conventional provider role For Educators Ensure pharmacy students are prepared to work in an environment characterized by changing payment models and IDNs and can critically analyze the pharmaceutical purchasing/supply chain 45

  46. Top 10 Trends Countdown 1 2 3 4 5 6 7 8 9 10 Migration from fee-for-service to new provider payment models Consolidation of health care stakeholders Widespread use of data and analytics in patient care Spending and utilization for specialty pharmaceuticals Medicaid expansion due to health care reform Migration to value-oriented health care marketplace Growth and performance of accountable care organizations Role of technology in patient engagement Increasing patient cost sharing Health care everywhere 46

  47. Migration from FFS to New Provider Payment Models 1 Focus on Paying for Accountability Stakeholders are Employing a Variety of New Models Payers Hold the Responsibility for Designing Balanced Models Payment Changes are Shifting Care Delivery Practices 47

  48. Current Trends: Migration from FFS to New Provider Payment Models 1 BUNDLED PAYMENTS IN ONCOLOGY BUNDLED PAYMENTS IN HOSPITALS COLLABORATION IS KEY IN DESIGNING NEW MODELS BUNDLED PAYMENTS ARE SUCCESSFUL 1. Magellan Pharmacy Solutions 2012; 2. Zellmer 2013; 3. RWJF 2013 48

  49. Looking Ahead: Migration from FFS to New Provider Payment Models 1 Opportunities Ahead High-quality patient outcomes Reduced costs for government and commercial New approaches for care delivery Challenges Ahead Lack of long-term data on performance Potential abandonment/reduction of care for certain high-cost chronic diseases Ability of providers to identify and reduce waste For Educators Payment reform will need to be an evolving process Illustrate opportunities for pharmacists to provide value in such systems 49

  50. Top Ten Emerging Health Care Trends 1 2 3 4 5 6 7 8 9 10 Migration from fee-for-service to new provider payment models Consolidation of health care stakeholders Widespread use of data and analytics in patient care Spending and utilization for specialty pharmaceuticals Medicaid expansion due to health care reform Migration to value-oriented health care marketplace Growth and performance of accountable care organizations Role of technology in patient engagement Increasing patient cost sharing Health care everywhere 50

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