As accountable care becomes increasingly prevalent across the U.S. health care landscape, how can pharmaceutical companies and health care organizations work together to address opportunities and challenges with improved patient outcomes? That’s the question that has brought Mallinckrodt Pharmaceuticals and the Baylor Scott & White Health (BSWH) STEEEP® Global Institute (SGI) together toward the shared goal of achieving quality and safe patient care.
Through its “New Era of Partnership” leadership training, Baylor Scott & White Health – which operates SGI – and Mallinckrodt engaged in discussions on best collaboration practices across a wide range of matters such as population health management, methods to improve performance, the impact of technology and development of value-based purchasing models.
Need for Change
Historically, the U.S. health care system reimbursement model has been fee-for-service, with payment for volume-based delivery of clinical care in discrete units. Due to a variety of factors (increasing percentage of the population over age 60 or living with a chronic condition, legislative mandates, and market forces), the fee-for-service model is unsustainable over the long-term, according to Andrew Masica, MD, MSCI, Vice President, Chief Clinical Effectiveness Officer, BSWH.
“A fragmented health care system results in paying more per capita with lower quality as compared to other developed countries,” said Dr. Masica. “There is now a real focus on addressing accountability for transforming care delivery to achieve the three elements of the ‘Triple Aim’ framework developed by the National Institute of Healthcare Improvement – improved experience of care, improved health for a population and reduced cost per capita.”
SGI leverages the expertise and experience of BSWH, the largest not-for-profit health care system in Texas, toward improving health care quality. SGI works toward problem solving for the delivery of higher quality health care, i.e. care that is more safe, timely, effective, efficient, equitable, and patient-centered (STEEEP).
Greater Understanding, Innovation through Collaboration
Masica notes that as the focus of health care changes to fee-for-value, pharmaceutical companies must also demonstrate the value of their products. Value is defined as outcome divided by cost per episode or condition.
“Delivery organizations need information beyond a randomized clinical trial demonstrating efficacy (Can a drug work?) in a specialized population,” he said. “Health care systems and clinicians are looking for more: What is the value proposition of a new agent? Can you demonstrate a drug’s effectiveness (does it work in the real world in populations similar to those cared for by the organization)? What is the operational impact of the new agent? Can you show that a front-end expense of a drug has other measurable benefits such as reductions in length of stay, better patient experience or fewer adverse events?”
For Mallinckrodt, working with SGI is helping to enable greater understanding of the complexity of a changing reimbursement model, and this understanding helps position the value Mallinckrodt and its products can bring to patients. To achieve quality goals, organizations must identify organizations with aligned objectives.
“Our team has been able to broaden our perspectives and gain important customer insights including financial priorities, the role of IT, accountable care organizations and triple-aim impacts on health care systems,” said Kim Bell, Corporate Account Solutions Director at Mallinckrodt. “Understanding what our customers face each day helps us see how we can build on shared initiatives that demonstrate value and better patient outcomes.”
These learnings are transferable and can be helpful in establishing further integrated delivery network partnerships.
Helping Define the Future
As the marketplace evolves, the health care industry is accountable for transforming the way it delivers care, improves quality, reduces cost and creates a seamless, integrated care experience for patients. This means increased partnership is needed among all stakeholders– pharmaceutical companies, health care systems and providers, technology partners, payers, researchers, government agencies and patients.
“Integration and coordination across this range of stakeholders are fundamental concepts to drive the delivery of value-based care,” said Dr. Masica. “To a large extent, we are currently in an infrastructure building phase for elements needed to support the transforming health care environment – robust data systems with applied analytics capacity, evidence-based care protocols, provider alignment, and access to care with new touch points for patients outside of the traditional office visit, among other components. Now is the time to be proactive and pilot novel approaches so we are ready for the new value-based health care model.”
What STEEEP Stands For
STEEEP is an acronym for safe, timely, effective, efficient, equitable, and patient-centered care. The acronym was trademarked by Baylor Health Care System in 2001 to reflect the challenge of delivering STEEEP care, and the framework was implemented within the health care system as its quality management program. This framework enables BSWH to prioritize the focus on the essential elements of health care. BSWH works to spread the STEEEP health care framework to other organizations to change the way health care is delivered.
Avoiding injuries to patients from care that is intended to help them, without accidental error or inadvertent exposures
Reducing waits and harmful delays impacting smooth delivery of care
Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding overuse and underuse)
Using resources to achieve best value by reducing waste and reducing production and administrative costs
Providing care that does not vary in quality according to personal characteristics such as gender, income, ethnicity, or location
Providing care that is respectful of and responsive to individual patient preferences, needs, and values