Challenge

Our client was developing a long term growth strategy and required an understanding of the policies impacting specialty drug marketing over the next three years in particular the role of Accountable Care Organizations (ACO).


Solution
Triage conducted a review of the current and future status of the healthcare market and the potential policy drivers for changing healthcare post accountable care act (ACA) focusing on the role of provider organizations, Payer management and the changing role of consumers as Payers.  The outcomes from this review were used for comprehensive interactive discussions with Payers, providers and provider groups (e.g. ACOs, hospitals, clinics, etc.) 


Results and Impact
Triage provided a detailed report on the future healthcare market delivery system impacting how specialty drugs will be managed and paid.  This report detailed the key changes in beneficiary healthcare policy designs and a move to alternative payment models giving our client a conceptual framework to prioritize future development and growth.


  • Market trends driving changes in plan benefit design 
  • Challenges facing manufacturers in providing value 
  • Impact of the ACA on payment and delivery
  • Potential changes in bundled payment design 
  • Market dynamics driving changes as healthcare moves to value based care model


Our strategic recommendation was to revise their approach to Payers, providers and Triage identified a model for monitoring policy issues and further research.
 

Healthcare Policy

Managing Specialty Drugs

A specialty pharmaceutical company needed to understand the direction of healthcare policy in the US and the potential impact of future price and access models