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IDNsExplained

Whatdoyougetwhenyoucrossapayerwithaprovider?Somehavecoinedthisunionas“payviders”.1 Otherscallthemintegrated

deliverynetworksorIDNs.Everyoneistalkingaboutthem.Specifically,anIDNisa formalsystemofprovidersandsitesofcarethatprovidesbothhealthcareservicesandahealthinsuranceplan

topatientsinaparticulargeographicarea.

ThegoalforIDNsaretocometogetherformoreefficientuseofresources,providebetterqualityofpatientcareandachievehomogeneityinguidelinesandformularieswithinthenetworkofphysicians.Thiscoordinatedcareistoensurethatpatientsandpopulationsgettherightcare,attherighttimeandwithoutharm,whileavoidingcarethathasnoprovenbenefitorrepresentsanunnecessaryduplicationofservices.Thismaysoundfamiliar,likeanACO,right?IDNscanbepartofanACO.

INTEGRATEDDELIVERY NETWORKPROVIDERS & PATIENTS

IDNSPAYERS

WhyShouldICare?

• ProvidersarealigningwithIDNstocapturepatientvolume,adjusttodecreasingpayerreimbursement,optimizerevenue,andreducefinancialrisk

• IDNsareimpactingpatientcare,andthedataandevidencerequiredforuptakewithinthesesystems

CENTRALIZINGCAREMANAGEMENT

• Treatmentdecisionsmovingtoadministratorsandnon-prescribers

• IDNmechanismsforutilizationmanagementcanimpactphysicianprescribingdecisions,e.g.,centralizedphysicianorderentry(CPOE),centralizeddrugformulariesandpathwaystodirectoncologiststowardpreferredtherapies

LEVERAGINGSIZE TONEGOTIATEPRICE

• IDNsaretakingonriskintheformofbundledpaymentsandpopulationhealthmanagement,alsocoordinatingwithcommercialpayersanddevelopingmodelsforspecificpopulationsandsub-populations

• Focusonnovelreimbursementishighlydisruptivetotraditionalfee-for-servicereimbursementmodels

INCREASINGPATIENTINVOLVEMENT

• Patientaffordabilityissuesareattheforefrontintreatmentdecisions,withIDNphysiciansoftenlookingtolesscostlydrugalternatives

AreYouReady?

JupiterCanHelpYouDevelopanActionableIDNStrategy

PAYERSEGMENTATIONKnowyourcustomer,Identifywhichintegratedhealthsystemsareimportantandwhichindividualstoapproachwithinthem

COMMUNCIATIONSTRATEGY

Delivertherightmessagewiththerightevidence,shapevalueandevidencetopositionforpopulationhealthgoals

ALTERNATIVEPRICINGOPTIONS

Evaluaterisk-basedalternativeapproaches,focusingonpricing,contractingandmarketaccessrelativetopatientpopulationsgoals

STRATEGICCHOICES Developscenariosandexecutionplanforyourproductandportfolio

SOURCES:1. http://managedhealthcareexecutive.modernmedicine.com/managed-healthcare-executive/news/top-managed-care-trends-watch-

2017?page=0%2C5

INTEGRATEDDELIVERYNETWORKSBLURRINGTHELINESBETWEENPAYERS&PROVIDERS

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