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Why Payers, Providers and Life Science/Pharma Must Join Forces to Achieve True Value-Based Care

Is value-based care (VBC) the path to reducing the 18% of GDP that is spent on healthcare? It just may be, but all parties must play their part. Iya Khalil, chief commercial officer & co-founder at GNS Healthcare argues that in order for VBC to reach peak levels of performance and adoption, there must be a convergence of understanding between three key players: payers, providers and the life science industry.

These three parties have developed lifesaving innovations, tech-enabled new procedures, and advanced medical training that have all contributed over the last half century to push the US economy to spend an unsustainable amount on healthcare. Data and analytics are key to fixing this problem and are transforming the way that healthcare is delivered, however, VBC implementation remains complex. In this webinar Iya and Elia Stupka, SVP and general manager, life sciences business at Health Catalyst discuss how the healthcare industry reached this tipping point, why the move to VBC is so important, and how these parties can jointly work together to make healthcare sustainable.

View the webinar and learn:
- How you can make the move to VBC
- The importance of AI and data to drive VBC

VBC will happen and presents an unprecedented moment for payers, providers and life science groups to work together.

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Why Payers, Providers and Life Science/Pharma Must Join Forces to Achieve True Value-Based Care

  1. 1. Why Payers, Providers and Life Science/Pharma Must Join Forces in Leveraging Real-World Data to Achieve True Value-Based Care Elia Stupka SVP & General Manager, Life Sciences Business Health Catalyst Iya Khalil Chief Commercial Officer & Co-Founder GNS Healthcare
  2. 2. © 2018 Health Catalyst 2 Payers Providers Life Sciences & Pharma
  3. 3. © 2018 Health Catalyst Which industry do you work in? • Payer — 12% • Provider — 53% • Life Sciences/Pharma — 35% Poll Question #1 3
  4. 4. © 2018 Health Catalyst Healthcare’s Matching Problem 4 Asthma Rx 40% Arthritis Rx 50% Cancer Rx 75% No benefit Benefit
  5. 5. © 2018 Health Catalyst Healthcare’s Increasing Costs 5 13.3% GDP 18.2% GDP 2000 2018 9/10 drug candidates FAIL to win FDA approval Today $2.6 billion per approved drug and average 10 years 1976 $179 million to develop drugs
  6. 6. © 2018 Health Catalyst If you are a provider, what percent of your total costs are pharmaceuticals/drugs? • 1-25% — 40% • 26-50% — 46% • 51-75% — 11% • 76-100% — 3% Poll Question #2 6
  7. 7. © 2018 Health Catalyst The History of Value-Based Care 7 Medicare Improvements for Patients and Providers Act (MIPPA) Affordable Care Act (ACA) Medicare Access and CHIP Reauthorization Act (MACRA) 2008 2010 2015 ??? 2019 and beyond Over 10 years have passed, but what progress has been made?
  8. 8. © 2018 Health Catalyst How much is VBC a reality in your organization today? • We are using it right now. — 55% • We are gearing up to be ready in the next year. — 13% • It’s a year or more out. — 32% Poll Question #3 8
  9. 9. © 2018 Health Catalyst From Theory to Practice: Data & Analytics? 9
  10. 10. © 2018 Health Catalyst What impediments are you facing in implementing VBC? • Tech: Lack of data and analytics to truly implement VBC model. — 28% • Bureaucracy: Lengthy cycles of claims processing and reimbursement. — 26% • Operations/Implementation: Willing to move to VBC, but lacking an operational strategy to implement it. — 22% • Culture: Training our care providers at scale. — 24% Poll Question #4 10
  11. 11. © 2018 Health Catalyst The Perfect Opportunity 11 Intervention Innovation Data AI & Machine Learning
  12. 12. © 2018 Health Catalyst Each Patient Has an Optimal Intervention 12
  13. 13. © 2018 Health Catalyst 13 Invest in deep and meaningful data. Increase data access and interoperability. Engage and learn from patients. “The most important feedback loop.” Insights utilized across the healthcare ecosystem.
  14. 14. © 2018 Health Catalyst All Diseases are Becoming Rare Diseases 14
  15. 15. © 2018 Health Catalyst 15 Hope
  16. 16. Q & A
  17. 17. Thank You!

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