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Managing Healthcare Reform: Winning Strategies for Engaging the Government Ecosystem That Shapes Healthcare Policy

ID: POP-246


Features:

45 Info Graphics

64 Data Graphics

1125+ Metrics

27 Narratives

17 Best Practices


Pages: 125


Published: Pre-2019


Delivery Format: Shipped


 

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919-403-0251

  • STUDY OVERVIEW
  • BENCHMARK CLASS
  • STUDY SNAPSHOT
  • KEY FINDINGS
  • VIEW TOC AND LIST OF EXHIBITS
The influence of the Centers for Medicare and Medicaid Services (CMS) on healthcare policy and reimbursement is increasing as the US population ages and healthcare reform unfolds. Federal, state and local government healthcare spending is projected to be 50 percent of national health expenditures by 2021. Consequently, the importance of understanding, translating, and engaging CMS and other influential government agencies/groups will only grow.

Best Practices, LLC conducted this research to help biopharmaceutical executives formulate a strategic approach for optimizing engagement with CMS and the ecosystem of agencies and groups that shape U.S. healthcare guidelines and reimbursement policy. The study identifies current trends and future directions in structure, staffing, collaboration, resource allocations, and most-valued group activities across the biopharmaceutical and medical device sector.

The research examines performance excellence by probing how diverse groups such as
Government Affairs, Policy, Managed Markets Marketing and other relevant stakeholders are staffed and organized to influence public policy and regulatory issues, particularly those flowing from CMS and other entities in the public sector healthcare system.

Industries Profiled:
Pharmaceutical; Manufacturing; Biotech; Consumer Products; Diagnostic; Medical Device; Health Care; Chemical; Biopharmaceutical; Clinical Research; Laboratories


Companies Profiled:
Amylin; Astellas; AstraZeneca; Bayer; Boehringer Ingelheim; Cubist; Daiichi-Sankyo; GE Healthcare; Genentech; GlaxoSmithKline; IDEA Pharma; Integrated Diagnostics; Merck; Millenium; Novo Nordisk; ProStraken; Purdue; Sagent; Sanofi; Shionogi; Shire; Smith & Nephew

Study Snapshot

The report is based on the insights of 23 leading healthcare companies. Segmentation analysis was key to examining trends and effective practices. Eight participants represent both the Large Pharma Segment (LPS) and Mid-Cap Segment (MPS). The Emerging Segment consists of seven companies. In addition, deep-dive interviews were conducted with six participating companies to gather additional insights.

Key areas of focus will include looking at:

* Proactively Monitoring & Managing Public Sector Healthcare Changes
* Effectiveness of Managing Public Sector Healthcare Changes
* Managing & Shaping U.S. Public Policy Regarding Healthcare
* Managing & Monitoring State-level Government Affairs
* Government Affairs & Public Policy Resources: Staffing and Resource

Key Findings

Federal Ecosystem Monitoring: A majority of participants monitor four agencies that are part of the U.S. healthcare ecosystem: CMS, AHRQ, FDA and NIH. Most of the LPS monitor two additional agencies: IoM and CDC. A majority of participating companies also monitor four key influencing groups: PCORI, MedPAC, NCQA and NQF.

CMS-FOCUSED FTEs: Study participants dedicate an average of 4 FTEs to monitoring CMS and/or groups that influence CMS; the LPS dedicates an average of 5.7 FTEs to this while Mid-Caps and Emerging firms dedicate about 2.7 FTEs.

Policy Leadership Location: A majority of companies (60%) identified their U.S. HQ as the primary location for Policy. The LPS heavily favor (83%) U.S. HQ as policy’s primary location. The Mid-Cap segment favored Washington D.C. (67%).


Table of Contents

  • Executive Summary, pp. 4-17
  • Universe of Learning: Key Demographics of Participating Companies, pp. 18-22
  • Align Structures, Resources & Groups To Manage The Healthcare “Ecosystem”, pp.23-40
  • Intelligence Gathering: “The Capture”, pp.41-55
  • Intelligence Dissemination: “The Routing,” pp.56-64
  • Intelligence Translation: “The Interpretation”, pp.65-72
  • Intelligence Implementation: “The Response”, pp.73-90
  • Government Affairs, pp.91-97
  • Public Policy Benchmarks, pp.98-109
  • Government Affairs & Public Policy Staffing Benchmarks, pp. 110-117
  • Future Trends & Lessons Learned, pp. 118-121
  • Appendix, pp. 122-125