Insights from Big data and partnerships among medtech companies, insurers and health systems will drive the success of value-based care.
That was the message from industry executives gathered at the annual conference of the medtech industry — AdvaMed 2016 — in Minneapolis that concluded Wednesday.
Those partnerships are already leading to better clinical outcomes, said Dr. Richard Migliori, chief medical officer of UnitedHealthcare. Medtronic became the preferred provider of insulin pumps for UnitedHealth Group’s commercial and Medicaid patients in July in an initiative to reduce hypoglycemia incidents that frequently send patients to the emergency room.
“It’s just a great way of linking back from a desired outcome to a delivery system that’s focused on that outcome,” Migliori said.
Migliori and executives from Medtronic, Mayo Clinic, and IBM Watson Health agreed that the move toward value-based care will continue, despite the impending change in U.S. political administrations.
“The move to value-based payment is pretty important but it’s also undefined at the moment,” said Dr. John Noseworthy, CEO of Mayo Clinic.
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.
Mayo is focused on understanding the value that its system provides by quickly getting the answers to helping patients with complex conditions, and bringing in technology early in the process to advance that effort, Noseworthy said. Mayo is looking for strategic partners to help in those efforts, he added.
Those partners for hospitals and medtech companies needn’t be as large as a Medtronic to get new technology to market, according to Noseworthy and Medtronic CEO Omar Ishrak. Smaller medtech companies can move more quickly to develop products because they don’t have to contend with the layers of bureaucracy that exist at a large corporation, Ishrak explained. If the healthcare industry values outcomes over products, whoever finds an effective solution to a healthcare problem will get credit for that, he said.
Stifling the creativity of small companies would be a “huge mistake,” added Noseworthy. “There are some advantages in being small. You don’t have to ask for permission. You just ask for forgiveness later on.”
The rapid evolution of artificial intelligence is also expected to help drive health systems as well as medtech companies to improve patient outcomes and value-based care. Experts said AI resembles the Internet of the mid 1990s and will expand into a variety of products and services, according to a report in the New York Times.
Applying cognitive value to data from a variety of sources will help lead to the best patient outcomes for the best value, said Deborah DiSanzo, general manager of IBM Watson Health. IBM Watson Health is working with Mayo by funneling clinical trial information directly to oncologists so they may determine which patients might be eligible to participate, she said.
The U.S. healthcare system would be wise to look toward the Netherlands and some of the Scandinavian countries for leadership in executing value-based models, Medtronic’s Ishrak noted. Those countries have good healthcare data and have worked in different conditions to execute value-based models, although they haven’t been scaled across any one particular country yet, he said. The Netherlands instituted a bundled-payment model for diabetes in 2007, in which insurers pay a care delivery group to cover diabetes care services for one year, according to a report in Harvard Business Review.
“One thing is for certain,” Ishrak declared. “The move is going to happen and everybody is going to have to change. I can’t change my business model without everybody here changing their business model.”
Photo: Bigstock
