Whether it is data collection in the electronic patient record, information in the claims data base or monitoring of patient biometrics, data analysis and interpretation will be the lifeblood of healthcare organizations.
That lifeblood represents two critical elements 1) treatment delivered to the patient based on best practices and 2) quality care that supports value-based payment.
Simply put, for money to change hands in the future, you will need to show you’ve earned it using data. With public attention on drug costs, particularly after the Turing Pharmaceutical debacle where it took the price of a a toxoplasmosis drug from $13.50 to $750 a pill, biopharmaceuticals are under just as much pressure as anyone else to prove they are worth the price.
Novartis has stepped out in front of this parade by cutting outcomes-based pricing deals with Cigna and Aetna. The industry has been having discussion about outcomes-based pricing for a long time, but it is notoriously hard to determine exactly what to measure, and under what circumstances, to prove your - case. With better data and patient monitoring, pharma believes it has the tools – or soon will - to begin making these deals real.
The title of an article in mobihealthnews last week toplines the terms: Norvartis signs Aetna, Cigna for pay-for-performance drug deal, but not remote monitoring yet.
According to mobihealthnews.com, last fall when Novartis first mentioned how the deal would be structured, it told the Wall Street Journal that is was looking into remote monitoring and other digital health monitoring avenues to measure the drug’s performance, including possibly bundling devices with the drug, to support pricing. For now, it appears that part of the plan is on hold.
But the fact that the plan was well developed means that patient data – not just data in the patient record but biometric monitoring – is going to be part of pay-for-performance initiatives in the future.
So, if you think that exchanging digital information among patients, providers and payers, and the resultant data collection and tracking, is just nice to have for the cutting-edginess of it, do think again. The day is closer than it appears in your mirror when a mix of the digital assets available to healthcare will figure prominently in payment and reimbursement of all sorts.
Got value? Prove it.
Peggy Salvatore MBA is a healthcare writer and trainer specializing in pharmaceutical managed markets sales training and health IT. She also has authored books and training programs on leadership and working with subject matter experts. You can read her blogs at www.healthsystemed.com and www.workingwithsmes.com