Greater Provider & Payer Risk Sharing Equals Greater Outcomes: Where will Pharma Fit in?

The recent Integrated Healthcare Associations California Health Care Cost & Quality Atlas measures clinical quality, utilization and total cost of care in the State of California. A key takeaway is that capitation payment models equal improved outcomes and over greater value than fee-for-service models. For example, when providers take on full risk preventive screening rates for patients of providers increases by 11% than for fee for service-based providers. That equates, according to the California-based report, to 60,000 more breast cancer screenings than would have otherwise been the case. Overall capitation equals lower costs.  Cost per patient in the fee for service model equals $672 while for risk-sharing models the per patient total is $268.  Chronic condition patients may even introduce greater savings with risk sharing.

How will biopharmaceutical and medical device industry sponsors adjust their models to this new emerging reality?