Dan Mendelson: Healthcare Policy Changes Avalere Health Is Paying Attention To

Dan Mendelson, MPP, founder, Avalere Health, outlines what recent healthcare policy changes Avalere Health is paying the most attention to.

TranscriptWhat recent healthcare policy changes has Avalere Health been paying the most attention to?

This is a really vibrant and rapidly changing environment, and I think it’s important for pharmacists to understand that they are really living in a context of a lot of change. A lot of the change is focused around the health plan world. So, health plans today are increasingly being asked to take risk, to improve quality for patients, and really to start to integrate some of the pharmacy offerings into the medical aspects of the offerings. So, the plan environment is changing rapidly, quality measures are really driving a lot of the activity in plans, and that’s kind of the first major piece that’s of relevance.

Second, I’d say that in the provider world, a lot of those incentives that the plans are under are now trickling down into the provider space. I mean, providers know that they are not going to be the one to immunize the patient, they’re not going to be the ones to hand them their medication. So, the plans know that, and the providers ultimately need to be aligned into the kinds of incentives that exist in that context. So, that’s another aspect.

I’d say also that the individual markets are important for pharmacists. The reality is that the individual markets are small as a percentage of total markets but are driving a lot of the trends that we are seeing: high-deductible health plans, restrictive networks, and the like. So, those are some of the things we’re most focused on, and I think kind of speak to the importance of understanding the change environment.