Now that the dust has settled, and more than a few wrap-ups have already been published, I submit for your consideration the top three things absent from last week’s J.P. Morgan 2016 Healthcare Conference in San Francisco, arguably the largest business of healthcare conference in the world.
Medcity News covered many of the hot topics in earnest. You can find “Some closing thoughts on the J.P. Morgan Healthcare Conference” by Meghana Keshavan here. Still, every iteration of the venerable, and expensive, gathering leaves me thinking most about the missed opportunities. Here are three that have bubbled to the top.
1. What is most needed that we didn’t find? The answer is still in the EMR.
Express Scripts CEO, Tim Wentworth, said the PBM is seeking to expand its data services. This is certainly timely, but all the data in the world is meaningless unless it’s brought to bear to directly improve patient outcomes. Data analytics might enhance the risk stratification process for a large PBM, but the impacts on clinical utility and patient outcomes still need robust, direct patient contact.
Synchronization of, and access to, clinical data, including lab results, is what is most needed to improve healthcare alignment. Every day our team of pharmacists and MTM experts claws for critical patient lab data that currently resides with providers in order to evaluate the medication therapies we manage. It is a process that needs an elegant solution or product to come to market quickly.
Athena Health is tackling this from the administrative side. Healthcare needs this from the clinical side, and quickly. When asked if Athena will expand its offering from administrative to clinical, CEO Jonathan Bush told me, “Absolutely.” As long as you’re not planning to return to your days as an EMT, please bring that along quickly, sir.
2. Value & pharma’s day at-risk: mostly crickets.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Pharma’s “at-risk” day arrived last November with the announcement of the Harvard Pilgrim deal with Amgen for the PCSK9 inhibitor Repatha. This is a big deal. As Tracy Staton reported in FiercePharma, Amgen “negotiated a pay-for-performance deal with the health plan Harvard Pilgrim, gaining an exclusive spot on the payer’s formulary in return for an upfront discount and future rebates if Repatha doesn’t perform as outlined.”
Just this week, Ms. Staton also reported on pay-for-performance cancer drugs in Italy, where the country’s “medicine regulator had full-refund deals on more than 90 drugs” [at the end of 2014].
Yet at J.P. Morgan 2016, there were no announcements of new, similar deals. We heard about value, though without great definition. Exactly how does one define “value?” We define it as outcomes divided by costs.
We definitely heard about the denominator in that equation: wringing out more costs from the system, mostly in prescription medication costs, naturally. (Thanks, Martin.) And while mutually beneficial alignment among pharma manufacturers and payers is not only possible, but a good thing in the new world of “at-risk” deals, I wish we had heard more about this and the continued alignment of healthcare stakeholders.
But how do (or will) healthcare service providers get paid for value? How do we impact the numerator of the value quotient – patient outcomes? Those are questions that should be addressed in any discussion of value-based healthcare. Those questions and answers were largely absent at J.P. Morgan 2016.
- As usual, the patient was largely absent. Or were they? One opportunity the organizers should create for 2017.
Because J.P. Morgan is a business of healthcare event, not a business of improving patient access or outcomes event, the absence of the patient is not really surprising. Yet everyone took notice when the aforementioned Jonathan Bush resuscitated a man he found incapacitated on the sidewalk while a crowd gathered and did nothing. In a somewhat related, though less emergent event, my colleague Patrick Dunham, CEO of Curant Health, left the conference to assist a family member who was transitioning out of a San Francisco hospital that day. It was terribly difficult for Patrick to help his family member in coordinating the services he would need upon his leaving the hospital. “Everyone is talking about how good they are with transitional care but I’ve got first hand experience again that it’s all up to the patient,” said Patrick.
Sometimes it takes an incapacitated human on the sidewalk to bring a dose of patient focus into J.P. Morgan Healthcare. If it hadn’t been for the aforementioned Mr. Bush’s CPR training and effort in resuscitating him, things may not have turned out well for the unconscious man. As reported by Medcity’s Stephanie Baum, Bush said of the incident, “It was a lot like the healthcare industry: a lot of people were standing around tweeting about it but no one was trying to do anything about this guy lying in the street.”
I think many of the J.P. Morgan conference attendees (and even analysts) may like to see more anecdotal proof of the impact the various healthcare companies, and their products and services, have on the improvement of patient outcomes in addition to their financial improvement. We are all stakeholders in healthcare and we should be able to achieve both. Give more innovators visibility into what is most needed to improve outcomes. How about next year we have a patient journey panel? It would be great for everyone to focus on the improvement in health outcomes in addition to the improvement in the “business of healthcare.”
Marc O’Connor is Chief Operating Officer for Curant Health. Curant Health treats patients nationwide through its medication management protocols, including medication reconciliation and establishment of personalized medication regimens, and supports its provider partners and care coordination with its award-winning EHR, MedPlan™.
Photo: Free Digital Photos
