Healthcare Reform Continues to Roil U.S. Managed Markets as the Number of ACOs Nearly Doubles and State Exchanges Create Clear Winners and Losers

Decision Resources Group’s Experts Define the Most Impactful Data, Analysis and Insights on Healthcare Reform in “Sift Through The Noise” Initiative

February 27, 2014—Burlington, Mass.—Decision Resources Group finds that Healthcare Reform in general—and ACOs and Exchanges in particular—will continue to be highly disruptive to U.S. Healthcare in 2014. Exchanges have the potential to shift the insurance system away from the employer-sponsored status quo to an individually-purchased model. ACOs could shift the healthcare industry away from fee-from-service, as they require providers to manage health for a defined population and ensure they are healthier—even as they reduce costs. Clarity on the impact to stakeholders—from consumers, integrated delivery networks (IDNs) and physicians to pharmaceutical companies—can be hard to find in the wealth of data and perspective flooding the airwaves.

Key Facts:

  • Even though large businesses cannot put their employees into the state exchanges until 2017, millions of small-business employees could go into the exchanges between 2015 and 2017. Meanwhile, several million more individuals who had been uninsured will gain benefits.
  • ACOs fundamentally shift the risk of patient health and costs to providers. They also represent a potential consolidation of power among a more select group of decision-makers—something that is likely to have a tremendous impact on prescribing habits and medication therapy management.
  • There are more than 700 ACOs counted by Decision Resources Group as of January 2014—nearly double the amount counted in January 2013.
  • Almost 75% of U.S. adults believe they will be personally affected by Healthcare Reform. Worries about fewer prescription drug and treatment choices are a top concern.
  • To read more about the impact of Healthcare Reform, visit www.SiftThroughTheNoise.com

Quotes:

  • Jane DuBose, Principal Director of Advisory Services for Decision Resources Group, said: “As ACA implementation rolls into 2014, U.S. healthcare will continue to experience one surprise after another. Keeping up with the changes, challenges, tweaks and setbacks has become a tall order. Pharmas, health systems, payers and others must be at the top of their game to make informed decisions.”
  • Laura Beerman, Director of Customer Segment Analysis for Decision Resources Group, adds: “Now more than ever, specific and actionable knowledge is vital. It is critical for pharma to understand and prioritize the impact of organized customers like ACOs and IDNs from multiple perspectives – from accounts to geography to macro trends. Prioritizing within these segments to develop targeted strategies and messaging is the essence of being a value partner in healthcare’s new world order."
  • Rory Stanton, Consumer Insights Analyst for Decision Resources Group, comments: “Healthcare reform’s impact is arriving at a time when consumer use of the internet for health is shifting dramatically. Consumers not only leverage the internet as a health information source, but now rely on digital tools to support health-related decisions and ongoing health management. As consumers shoulder greater responsibility for costs and care in the post-ACA environment, interactive health services—like patient portals, remote care, data tracking and online research—will play a growing role in consumers’ care paradigm.”

Additional Resources:

  • Links to further insights on ACOs, Exchanges and the broader implications of Healthcare Reform can be found here.
  • Decision Resources Group rated healthcare exchanges in all fifty states plus the District of Columbia on its NEW “State Exchange Report Card.” Grades will be updated regularly as new developments occur. Download the new State Exchange Report Card and explanatory Executive Briefing at www.hl-isy.com/State-Exchange-Report-Card

About “Sift Through The Noise:” Clarity On Healthcare Reform

In the great ocean of data, analysis and talking heads that surround every event of this magnitude, there is great power in simplicity—sifting through the noise takes time, and the essential things businesses need to know to make good decisions are best pulled out by experts. Decision Resources Group offers clarity. Visit SiftThroughTheNoise.com to find out more.

About Decision Resources Group
Decision Resources Group offers best-in-class, high-value information and insights on critical issues within the healthcare industry. DRG insights and analysis on the U.S. managed care market are powered by HealthLeaders-InterStudy. Clients rely on this analysis and data to make informed decisions. Find out more at www.hl-isy.com and www.DecisionResourcesGroup.com.



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