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Tips for successfully navigating the shift in healthcare from volume to value

Life sciences leaders have two options to address the evidence-based medicine movement: disrupt, or be disrupted.

So much is changing in the life sciences industry. Companies are moving from volume-based to value-based business models. Digital technology offers a granular view of patients and their treatments, and enables care at a lower cost. There are new incentives for reimbursement and specialized therapeutics. Life sciences leaders have a choice amid all of these changes: disrupt, or be disrupted.

Shaking up the status quo
Current operating models must change to accommodate new outcome-based programs that have a set of services directed to provider systems, physicians and patients. In the move from volume to value, life sciences players are upping their game in these areas:

  • Patient engagement. It is now standard procedure to have patient engagement and patient services entities that can provide critical reminders and support for the patient while on a therapy or therapies. Mobile apps provide disease and therapy-specific tools, and create care linkages between patient and provider.

  • Patient services. Digital is helping to bridge the void between patient, provider and life sciences companies. Mobile apps and provider-facing tools enhance the ability to identify high-responder patients and collect patient outcomes in a real-world data registry.

  • Patient care management. Companies are beginning to partner with a provider system or systems to advance the status of a population and individual patients within the population, usually as part of a service-based revenue model.

Life sciences leaders are using more real-world data, advanced analytics and focused sets of services as the basis for their contracting. They are not required to do so—they simply have a higher likelihood of receiving fair reimbursement for their novel therapies and devices where they are linked to value creation. This approach will increase in popularity as reimbursement is more value-based, medicine more digital, and go to market models involve patient- and provider-facing services.

Value innovators: the new definition of leadership
The definition of ‘preferred partner’ will evolve and create a greater separation between those that lead and those that follow.

Future leaders will be the ones that disrupt traditional modes of care, embracing digital and analytic-driven insights and putting improved patient and economic outcomes front and center of their business models, operating models and cultures. Cycles will no longer be tied only to patent expiry or new indications. Instead, services and value-based contracting models will deliver new value to patients and the health systems at an accelerating pace.

In the coming months, highly targeted solutions and new business models will move from pilot stage to full deployment. Those that lead will be true value innovators and accelerate investment to fully evolve their operating models from volume-based to value-based, creating previously unseen partnerships that form a new wave of disruption that will ultimately benefit the patient first and foremost.