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Reasons Why You Need An Experienced Account Manager
 

Reasons Why You Need An Experienced Account Manager

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Current Economic and Health Care Conditions call for Companies to Hire Experienced Executives

Current Economic and Health Care Conditions call for Companies to Hire Experienced Executives

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  • Health care cost is one benchmark against which both employers and employees measure health care. By that measure, with costs nearly doubling over the last five years, we should be getting more and better health care. While it’s true that there have been important advances in technology and new services, it is also sadly true that there is a huge value disconnect in our health care system . This Slide summarizes research done by RAND which found that American’s likelihood of getting the right care at the right time was about 50 percent. This landmark RAND study reveals substantial gaps between what clinicians know works and the care actually provided. These deficits persist despite initiatives by both the federal government and private health care delivery systems to improve care. Key findings: Overall, adults received about 55 percent of recommended care; The level of performance was similar for chronic, acute, and preventive care; Underuse of care was a greater problem than overuse. For example, patients failed to receive recommended care about 46 percent of the time, compared with 11 percent of the time when they received care that was not recommended and potentially harmful; Quality of care varied substantially across conditions. For example, people with cataracts received about 79 percent of recommended care; those with hip fractures received about 23 percent. Does Poor Quality Matter? The deficits in care documented by this study and others translate into thousands of preventable complications and deaths per year and billions of dollars wasted. People with diabetes received only 45 percent of the care they needed. Poor control of blood sugar can lead to kidney failure, blindness, and amputation of limbs. Patients with hypertension received less than 65 percent of recommended care. Poor blood pressure control is associated with increased risk for heart disease, stroke, and death. In fact, poor blood pressure control contributes to more than 68,000 preventable deaths annually. People with coronary artery disease received 68 percent of recommended care, but just 45 percent of heart attack patients received beta blockers and 61 percent got aspirin – medications that could reduce their risk of death by more than 20 percent. Additional information: http://www.rand.org/publications/RB/RB9053-1/RB9053-1.pdf
  • The state of health care quality in the United States is accurately summed up in this quote by Mark Chassin, a preeminent health services researcher (read quote). Quality and cost should be correlated the other way around.
  • Continued low impact of ratings. They have virtually no impact on consumer behavior.
  • Heather, Can we make this a trend line graph. Here is the question text: “ Do you think each of the following generally do a good or bad job of serving their consumers?” Following are the notations for this data: Harris Poll #31, April 25, 2006 Notes: (1) *In 1997 “computer companies” were rated together (i.e., hardware and software companies were not measured separately). N/A= Not Asked (2) The trends for airlines are from 1998, as they were not included in the 1997 survey. Heather, Can we make this a trend line graph. Here is the question text: “ Do you think each of the following generally do a good or bad job of serving their consumers?” Following are the notations for this data: Harris Poll #31, April 25, 2006 Notes: (1) *In 1997 “computer companies” were rated together (i.e., hardware and software companies were not measured separately). N/A= Not Asked (2) The trends for airlines are from 1998, as they were not included in the 1997 survey.

Reasons Why You Need An Experienced Account Manager Reasons Why You Need An Experienced Account Manager Presentation Transcript

  • Mark N Reeves Experienced Pharmaceutical & Biopharmaceutical Account Manager http://www.linkedin.com/in/mreeves4
  • Outline
    • Models of Change
    • The Quest for Value
    • Political Scenarios and Implications
    • What does all this mean for the Pharmaceutical & Biotech industries and your customers?
    • Reasons why I can help your organization
    Page
  • Models of Change
    • Pearl Harbor
      • A sudden crisis causes fundamental change
    • The Tipping Point
      • Pressures build to an inflection point of change
    • Glacial Erosion
      • Steady growth of grinding, inexorable and hard to resist pressures
        • Aging
        • Technology
        • Unaffordability
        • Disparities
        • Tiering
    Page
  • The Holy Trinity
    • Cost
    • Quality
    • Access
    • (Security of Benefits)
    Page
  • Page Value = (Access+Quality+Security) Cost
  • Health Care Spending per Capita in 2004 (Adjusted for Differences in the Cost of Living) Page Source: OECD Health Data Published in Health Affairs, Volume 26:5 2007
  • International Health Comparisons, 2004-05 Page Source: OECD 2002-2007
  • International Health Comparisons, 2004-05 Page Source: OECD 2002-2007
  • Why the Big Difference?
    • The Fallacy of Excellence
    • The Six-Point Spread
      • Everyone makes more money: Not just doctors; higher prices and incomes for everyone
      • Administrative waste motion: 25%-30% price of pluralism
      • Intensive and expensive use of technology
        • End-of-life care: 30% of Medicare
        • Intensive use of diagnostics, procedures and high-tech interventions
        • Primary versus specialty care balance
    • Is It Fixable?
      • Some is culture: Values, expectations and attitudes
      • Some is population differences: Way too much is made of this; e.g., The Natural Experiment Paper
      • Most is policy, management and payment system
    Page
  • Premium Increases Compared to Other Indicators, 1988-2007 Page Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2006; KPMG Survey of Employer-Sponsored Health Benefits: 1988, 1993, 1996, 1998; Bureau of Labor Statistics, 2000. ^
  • Health Care Costs and Consequences
    • For the Uninsured: Rising From 45 Million Today to 56 Million in 2013
    • For the Working Poor: In 1970, Health Benefits Cost 10% of the Minimum Wage; Today It Is 100%
    • For the Median Household: Health Benefits Are 20% of Median Compensation; Will Rise to 60% by 2020 if Trends Continue
    • For Retirees: A Couple on Retirement at 65 Needs $200,000 in Cash to Pay for Lifetime Out-of-Pocket Costs for Medical Care
    • For Small Businesses: Only 60% of Firms Offer Insurance in 2005; Down From 69% in 2000
    • For Big Business: Delphi Goes Bankrupt; Big Auto Renegotiates Because Corporate Health Care Costs Surpass the Net Profit of All Business
    • For Big Labor: UAW, SEIU, AFL-CIO Conflicts, Challenges and Opportunities for Strife
    Page
  • Quality Shortfalls: Getting it Right 50% of the Time
    • Adults receive about half
    • of recommended care
      • 54.9% = Overall care
      • 54.9% = Preventive care
      • 53.5% = Acute care
      • 56.1% = Chronic care
    Page Source: McGlynn EA, et al., “The Quality of Health Care Delivered to Adults in the United States,” New England Journal of Medicine, Vol. 348, No. 26, June 26, 2003, pp. 2635-2645 Not Getting the Right Care at the Right Time
  • Quality and Efficiency Vary Widely by State Health Affairs April 7, 2004
  • The Progressive Transformation Story
    • Cost and Quality Are Correlated Inversely
    • Utilization Is Not Based on Need and Doesn’t Create Outcomes
    • Measurement Matters
    • Transparency on Cost and Quality Will:
      • Embarrass providers to improve
      • Motivate payers to differentially pay
      • Motivate consumers to change providers
      • Steer business to the high-performance providers
      • Do all of the above given enough time
    • Re-engineering of Delivery System Will Ensue
    • Value Gains Will Make Health Care More Affordable and of Much Higher Reliability and Quality
    Page
  • The Future of Health Care in the OECD
    • Fat People Meet Skinny Benefits
    Page
  • Consumer Use of Quality Ratings Remains Low Page Considered a change based on these ratings Seen information that rates ... Actually made a change Physicians Health Plans Hospitals Source: Harris Interactive, Strategic Health Perspectives 2001-2006 13% 2% <1% 2001 15% 1% 1% 2006 18% 4% <1% 2001 23% 4% 1% 2006 22% 4% 2% 2001 21% 3% 1% 2006
  • Page Primary Care Practices With Advanced Information Capacity * Count of 14: EMR, EMR access other doctors, outside office, patient; routine use electronic ordering tests, prescriptions, access test results, access hospital records; computer for reminders, Rx alerts, prompt tests results; easy to list diagnosis, medications, patients due for care. Percent reporting seven or more out of 14 functions* Source: 2006 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.
  • Page Capacity to Generate List of Patients by Diagnosis Percent reporting very difficult or cannot generate Source: 2006 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.
  • Page Percent reporting any financial incentive* Primary Care Doctors’ Reports of any Financial Incentives Targeted on Quality of Care * Receive or have potential to receive payment for: clinical care targets, high patient ratings, managing chronic disease/complex needs, preventive care or QI activities. Source: 2006 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.
  • What We Have to Change … Not Much Except …
    • Our Values
    • Our Strategic Focus: From Pimp My Ride to Primary Care and Prevention
    • Our Reimbursement System
    • Our Delivery System
    • Our Individual and Collective Behavior
    • Our Expectations
    • Our Business Models
    • Our Electronic Infrastructure to Support It All
    Page
  • Key Driving Forces: Political
    • Presidential Election Year Where Candidates Are Focusing on Change
    • Many Republican Incumbents in House and Senate Not Seeking Re-election
    • Possible Big Turnout of Youth: The Echo Boom Can’t Drink Yet, but They Can Vote
    • Health Care Is the Number Two Domestic Issue (Behind the Economy) Among Democrats and Independents
    • Growing Sense of Anti Corporatism Even Among Republican Candidates (Huckabee and McCain)
    • The big move to a Government driven Health Care System
    Page
  • Republican and Democratic Attitudes about Who Has the Best Health Care System Debating Health: Election 2008, Harvard School of Public Health/Harris Interactive. March 5-8, 2008
  • Republican and Democratic Beliefs about the State of Healthcare NEJM, “Health Care in the 2008 Presidential Primaries,” January 2008.
  • Key Driving Forces: Economic
    • Economic Slowdown 2008-2012 and may a slow recovery
    • Continued Involvement in Iraq Short Term Means Big Government Deficits
    • Little Government Opportunity for Big Expansion in Short Run
    • Subprime Mess Lingers and Perhaps Worsens, Declining Consumer Confidence, Weakening Dollar, Continued High Energy Prices.
    • Out of control stimulus packages that have done little more than make the possibility of future high inflation
    • Business Sees Profit Squeeze After Long Run-up and High Performance Expectations From Investors
    Page
  • Key Driving Forces: Health Reform
    • Health Reform Options Are in a Narrow Range (Democrats’ Positions Are Right of Richard Nixon’s)
    • New American Compromise of Shared Sacrifice and Incremental Expansion of Coverage Is Favored by Both Democratic Presidential Candidates and Some Republicans at State Level
    • Focus Is on Coverage Expansion for an Anxious Middle Class; Not Wholesale Transformation of Health Care, but …
    • Health Care Glitterati Honing in on Elements of a Compromise (Commonwealth Fund 15 Is a Good Starting List of Cost Containment Options)
    • Unlikely Coalitions Are Forming; e.g., SEIU, Wal-Mart
    • Big Actors Are Staking Positions Near and Around the New American Compromise; for Example, the AHA, AHIP, Mayo Clinic, Committee on Economic Development and Others
    • Big Business Not as Ready to Bail Out of Health Care as Some Pundits Think
    • Seniors Are Satisfied With Medicare (Including Part D) and Are Not Pressing for Health Reform of Medicare Yet, but How Will Part D Play in 2014?
    • Doctors Are Cranky and Depressed
    • Managed Care Organizations are struggling to survive and keep their doors open
    Page
  • Page Source: Harris Interactive, Strategic Health Perspectives 2007 N=20* Pacific Business Group on Health, July 2007 Retreat % Answering Describes My Company Well
  • Page Source: Harris Interactive, Strategic Health Perspectives 2007 N=20* Pacific Business Group on Health, July 2007 Retreat % Answering Describes My Company Well
  • Page Physician Satisfaction with Current Practice Situation % Satisfied % Dissatisfied Source: Harris Interactive, Strategic Health Perspectives 1995-2007
  • The Commonwealth Fund 15
    • Promoting Health Information Technology
    • Center for Medical Effectiveness and Health Care Decision Making
    • Patient Shared Decision Making
    • Public Health: Reducing Tobacco Use
    • Public Health: Reducing Obesity
    • Positive Incentives for Health
    • Hospital Pay-for-Performance
    • Episode-of-Care Payment
    • Strengthening Primary Care and Care Coordination
    • Limit Federal Tax Exemptions for Premium Contributions
    • Reset Benchmark Rates for Medicare Advantage Plans
    • Competitive Bidding
    • Negotiated Prescription Drug Prices
    • All Payer Provider Payment Methods and Rates
    • Limit Payment Updates in High-Cost Areas
    Page
  • Covering the Uninsured: Who Pays? Who Gets? Who Cares?
    • Who Pays?
      • American health care financing is regressive
      • Single payer is a massive transfer of income from rich to poor
      • Making $20,000 earners buy a $15,000 health care policy is problematic
    • Who Gets?
      • Having a card doesn’t guarantee getting care
      • Growing use of ER, minute clinics and off-shore options even by the insured population
    • Who Cares?
      • How much reimbursement goes with the card?
      • Do we need coverage, or do we need care?
      • Are the insured getting the right care?
    Page
  • Number of Uninsured 2005 Page Source: KFF, 2006
  • Payment to Cost Ratio (Illustrative) Page Source: Morrison Estimates, in other words a good guess
  • Payment to Cost Ratio (Illustrative) Page Source: Morrison Estimates, in other words a good guess Single Payer Schwarzenegger
  • Political Scenarios
    • Scenario 1: Democratic Landslide
      • Big majority in Senate
      • Make health reform the key domestic priority
      • Seize a historic opportunity for reform: coverage expansion and health system transformation
    • Scenario 2: Democratic Incrementalism
      • Bailing out Large Banks and Automobile Makers who made bad loans and promised too much to Unions concerning benefits thus creating the current situation
    • Scenario 3: Republican Landslide
      • Republicans win back the White House
      • Republicans work to regain certainty for small to large companies sitting on large chunks of cash
      • The stock market rebounds as investors gain confidence that their life’s saving won’t go down the tube again.
    Page
  • Features of Building Blocks + System Reform and Presidential Candidates’ Approaches to Health Care Reform Source: S. R. Collins and J. L. Kriss, Envisioning the Future: The 2008 Presidential Candidates’ Health Reform Proposals , The Commonwealth Fund, January 2008. Building Blocks/ System Reform Clinton Republican Obama Coverage Expansion Aims to cover everyone X X X Individual requirement to have insurance X X Children only Employer shared responsibility X X X Group insurance “connector” X X X Medicare/public plan option for < 65 X X X Subsidies/tax credits for low- to moderate income families X X X X Regulation of insurance markets X X X Improves Medicare benefits for > 65 and buy-in for older adults X Medicaid/SCHIP expansion X X X System Improvements Expanded use of Health IT X X X X Medical effectiveness research X X X X Pay providers for performance X X X X Reduced Medicare Advantage payments X X X Negotiated Medicare Rx prices X X X Primary care and care coordination X X X X
  • Reputation of Pharma and Other Healthcare Industries was Improving after declines in 1990s *Condensed list of industries. (1) *In 1997 “computer companies” were rated together (i.e., hardware and software companies were not measured separately). (2) The trends for airlines are from 1998, as they were not included in the 1997 survey. N/A= Not Asked . Source: Harris Poll #79, August 8, 2007. Do you think each of the following generally do a good or bad job of serving their consumers? % Point difference between those indicating good vs. bad 2000 2001 2002 2003 2004 2005 2006 2007 1997-2007 2006-2007 Supermarket N/A N/A N/A 74 79 84 83 84 N/A +1 Computer software companies 71 72 48 57 62 67 67 61 -10 -6 Online search engines N/A N/A N/A N/A N/A 68 67 77 N/A +10 Computer hardware companies 70 71 49 57 64 74 64 64 -7 0 Banks 49 46 54 50 52 57 61 56 +4 -5 Packaged food companies N/A N/A N/A 58 62 67 59 55 N/A -4 Hospitals 48 41 56 53 49 59 51 58 +1 +7 Life insurance companies 39 36 34 29 27 44 42 18 -17 -24 Airlines 45 15 47 40 61 62 42 26 -40 -16 Telephone companies 32 27 22 20 17 42 38 35 -26 -3 Car manufacturers 40 40 41 38 44 34 31 46 +2 +15 Pharmaceutical and drug companies 24 20 30 4 -4 13 25 21 -39 -4 Managed care companies such as HMO -27 -30 -12 -23 -23 -13 -3 -20 -33 -17 Health insurance companies -15 -19 13 -12 -20 -19 -3 -21 -34 -18 Oil companies -13 -39 -6 -6 -25 -36 -24 -33 -57 -9 Tobacco companies -34 -37 -36 -32 -30 -28 -25 -46 -18 -21
  • Reputation of Pharma and Health Insurance Industries was Improving after big declines in the 1990s Do you think each of the following generally do a good or bad job of serving their consumers? % Point difference between those indicating good vs. bad Pharmaceutical and drug companies Managed care companies such as HMOs Health insurance companies Source: Harris Poll #79, August 8, 2007. Hospitals
  • Total Drug Spending in US 1965-2017 Source: CMS, 2008
  • The Changing Payer Mix: The Long View Source: CMS, 2008
  • Total Drug Spending in US 1965-2017 Source: CMS, 2008
  • Public Payment: Impact of Part D Source: CMS, 2008
  • SOURCES: Kaiser Family Foundation & IMS Health
  • ADHD SOURCE: Manhattan Research Cancer Heart Disease Diabetes HRT Skin Conditions Asthma Smoking Cessation Insomnia Chronic Pain Depression Migraine Hypercholesterolemia Arthritis Hypertension Allergies Acid Reflux
  • SOURCE: Ellis JJ. J Gen Intern Med 2004;19:639-646. $0 to <$10 Compliance with Statin Therapy Stratified by Mean Prescription Copayment $10 to <$20 >$20
  • Reported Total Savings and Investments by Amount and Age Group SOURCE: 2007 Retirement Confidence Survey – EBRI NET WORTH All Workers Ages 25-34 Ages 35-44 Ages 45-54 Ages 55+ All Retirees <$10,000 35% 50% 36% 24% 26% 32% $10,000-$24,999 10% 18% 16% 10% 5% 13% $25,000-$49,999 13% 9% 10% 11% 9% 10% $50,000-$99,999 8% 10% 14% 15% 11% 12% $100,000-$149,999 7% 7% 7% 9% 11% 8% $150,000-$249,999 7% 1% 9% 10% 9% 12% $250,000-$499,999 7% 1% 4% 12% 11% 5% >$500,000 7% 4% 4% 9% 17% 9%
  •  
  • Summary, Conclusions, Forecasts… “So What Does this Mean for You?”
    • A physician-centric view of the customer base is no longer sufficient as a tool to measure the commercial risk you face
      • Consumers and third party views on affordability must be evaluated
      • PR and policy ramifications also deserve consideration
    • Assumptions that the attractiveness of the current specialty drug model will continue indefinitely are probably over-optimistic – this is not a long-term safe haven
    • Pursuit of new markets and new customers internationally is not likely to allow you to circumvent the big policy/strategy issues of healthcare
    • Brand and corporate planning now needs to include payer/reimbursement considerations as a “must do” – sooner is better than later
    • Partnership with these entities is both necessary and possible, and should be pursued
    • Good insight into the “big picture” issues is important in helping you avoid “penny wise/pound foolish” approaches and allow you to develop strategically sound solutions to business problems
  • The New Pharma Business Model: Some Thoughts
    • Demonstrated Scientific Innovation will always win
    • Payer sensitive innovation
      • Novel Clinical pay-off compared to all available therapies
      • Payer’s dream: reduction in PMPM cost for therapy
    • Radical restructuring of the sales and marketing function
      • Focus on evidence and guidelines
      • Comparative Effectiveness Evidence
      • Consultative selling
      • Reduction in traditional channels
      • Making the value case to end user consumers
      • Focus sales effort on compliance, adherence and persistence among chronically ill not just new Rx
    • Conditional Approval to Market Entry
      • Monitoring in real clinical use
      • Reference Pricing
    • Global Scale, Global Pricing, Global Product Launches
    • It is still a great business
  • A compelling Story to Hire Mark N Reeves
    • Dynamic, award-winning, Regional & National Account Manager.
    • 22 years of top performing sales
    • Account management, contracting, and business development experience.
    • Strategic thinker and results-driven team player.
    • Excellent collaborator, with influential interpersonal skills who works effectively in a heavily matrixed environment.
    • Excellent oral and written communication skills, analytic skills, and a successful negotiator.
    • Experienced in launching branded drugs: Cardiovascular, biopharmaceuticals for immune diseases, Rheumatology, Endocrinology, Neurology, Infectious diseases, Lipid lowering, Nephrology, Transplantation and immunosuppressant’s, Psychiatry and Primary Care.
    • Out of the box thinker who do analysis first then works in internal and external customers to come up with results driven goals for their challenges and opportunities.