This workshop will provide attendees insight on to best design a commercial approach for engaging with new provider models. Through shared-savings incentives, the Affordable Care Act encourages healthcare providers to join or form ACOs. More then 600 ACOs are currently in operation with contracts that span varying payer populations like Medicare, Medicaid, and commercial plans. With steady growth and consolidation, these systems have shown to significantly vary on a case-by-case basis. In addition to regional differences, accountable care has impacted operational and structural decision making which greatly impacts traditional industry engagement.

Key Workshop Components:

• Background on how and which health systems are/have changed from fee-for-service to pay-forperformance models
• Drivers behind the model change
• How these systems are now organizationally structured
• Stakeholders involved with the process and how to engage them

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Real-world evidence is used to show how a medicine can actually change the nature of patient care where it will be more cost-effective, more efficacious, or both, then another therapy. Additionally, this type of data is valued by payers as increasingly there are concerns that drug efficacy proven in the clinical setting might not reflect of realworld factors such as financial constraints, patient disease-state, drug regiment, and other dynamics unaccounted for.

This workshop will help attendees understand the methods and technology available for collecting real-world evidence that can be then disseminated to payers to enhance or protect formulary position.

• How to collaboratively work with a health system or EHR company to gain access and utilize data for outcomes research
• Possible benefits for each stake holder of real-world evidence
• Examples of companies who are successfully utilizing real-world evidence
• How data can be utilized for value dissemination and other initiatives

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Historically, commercial payers have heavily been the focus of attention for the Pharmaceutical / Biotech industry due to their formulary decision-making power and share of business of the United States payer mix. Recently, new emerging payer customers have surfaced, such as IDNs and ACOs, who offer another opportunity of focus for the industry.

The decision-making process for commercial payers and the rationale for use of management controls has been to a certain degree established. However, from an ACO perspective (the ACO as a payer), the drivers for decisions made as a risk-bearing stakeholder may be different from traditional managed care payers. A mix of key criteria such as a drive toward quality metrics, a renewed cost-conscious focus, and an integrated coordinated care effort all impact management decisions.

This workshop will bring together perspectives from various stakeholders involved with the evolving payer landscape, in a roundtable format, to discuss the following questions:

• How is the integration between health systems, physician networks, and commercial insurers unfolding? How are certain trends (i.e. clinical pathways, physician price sensitivity, specialty tiering and new benefit designs, dual-brand combinations, etc.) within the evolving payer landscape impacting commercial MCOs and what implications are there for other emerging customers? How are commercial payers looking at ACOs now? Do they think the current ACO model will stay the same and are they planning to continue to invest in this integration?
• From the ACO side, what is the ultimate vision regarding access to therapies? What is the decision-making protocol and how does that differ from what we know about commercial payers management approach and view of product “value” (i.e. greater emphasis on outcomes)?
• What should pharma understand about the key drivers
  and decision-making criteria payers will be utilizing in the
  future? How should industry best meet the needs of these
  new customers from a commercial perspective?

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Medication non-adherence has been linked to worsening clinical symptoms, disease progression, and increased health care visits, services, and costs. With physicians and health systems putting an increased emphasis on patientcentricity to ensure the best possible health outcomes, combating poor adherence by engaging patients in their care will be the key factor for success.

As a social/behavioral scientist, Emily Freeman has researched the impact of shared treatment decisionmaking on the quality of care received by patients and used shared decision-making as a tool for patient engagement.

Key Workshop Components:

• How medication adherence has traditionally and unsuccessfully been approached
• How patient engagement can dramatically influence the participation a patient has in their own quality of care
• How both health care systems and life sciences companies can utilize shared treatment decision-making to improve medication adherence

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