Highlights of the report:
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As the health care market continues to shift from volume to value, integrated delivery networks (IDNs) are implementing a number of quality and clinical initiatives that can impact pharmaceutical market access. HIRC's report, Integrated Delivery Networks: Quality Objectives and Activities to Improve Patient Outcomes and Reduce Costs, reviews IDN quality goals, examines population health management capabilities, and reports IDNs' activities in prescription medication management. The report addresses the following questions:
- Which measures and metric systems are IDNs utilizing to benchmark quality of care?
- What do IDNs report as their primary quality objectives across 30+ common chronic diseases, specialty conditions, and cancer types? What challenges remain?
- Which population health management capabilities do IDNs deploy to assist them in meeting their quality goals?
- What is the status of IDN pharmacy services, including the prevalence of IDN-owned specialty pharmacies?
- What mechanisms do IDNs utilize to influence physician prescribing behavior? What is the landscape of IDN physician decision support systems across 30+ common chronic diseases, specialty conditions, and cancer types?
Key Finding: As the health care environment shifts further towards value-based reimbursement, IDNs will continue to invest in activities that enable them to deliver cost-effective, evidence-based care across the continuum.
Reducing the Total Cost of Care is a Top IDN Quality Objective Across Disease State Categories. IDN decision-makers were asked to indicate their quality objectives across a listing of several common chronic, specialty, and oncological disease states. While quality objectives vary by disease state, reducing the total cost of care is among IDNs' top quality objectives across nearly all disease areas. In coronary artery disease, for example, 57% of IDNs report actively seeking to reduce the total cost of care, followed by improving disease-specific measures (55%) and reducing hospital readmissions (54%).
Over Half of IDNs Report Having Adopted an Internal Specialty Pharmacy. Fifty-four percent of IDNs now report having an internal IDN-owned specialty pharmacy in-place, up from 39% of IDNs in 2016. As IDNs take on more risk and accountability for health care costs through alternative payment models, they are more likely to invest in their own specialty pharmacy to better manage costs.
The full report explores additional IDN activities to assist them in achieving quality and cost objectives, such population health management capabilities, IDNs' use of data and analytics, and the landscape of standardized physician decision support systems.
Research Methodology and Report Availability. In December and January, HIRC surveyed 56 IDN senior leaders and pharmacy and medical directors. Online surveys and follow-up telephone interviews were used to gather information. The full report, Integrated Delivery Networks: Quality Objectives and Activities to Improve Patient Outcomes and Reduce Costs is part of the Organized Providers Service, and is now available to subscribers at www.hirc.com.