How will reform impact the healthcare ecosystem?Now that the fight over the healthcare bill is over and the election-cycle fight over its repeal is just beginning, I decided to step away from the politics and try to decipher the business impact of the changes to the healthcare ecosystem. “Follow the money,” advised Deep Throat, and so I recently attended a conference to find out what the healthcare private equity and M&A firms had to say about winners and losers in this new world. What I found surprised me.
I had expected a negative reaction to the bill, and what I found was that from lenders to investors to pharma M&A executives, everyone was happy that the fight is over, the bill is done and we now have a comprehensive roadmap that takes into account the entire spectrum of providers, payers, services, and pharma. According to Anne Phelps from the Washington Council Ernst & Young, while the bill is complicated, it represents a lot of opportunities for growth.The industry cut its deal with the government early on, and the 32 million Americans with new access and coverage will deliver a 10% surge in patient volume. Although the industry agreed to new fees and to a 50% discount for Part D beneficiaries during the “donut hole,” the expanded Part D coverage will discourage pill slicing and encourage compliance, leading to better outcomes and increased revenue, a net positive for the industry.
As long as pharma remains solely focused on product volume and pricing, it will continue to walk around with a fat target on its back. A renewed focus by Congress and the states on bending the cost curve will eventually make its way back to pharma. If we can show we are helping to bend the “wellness curve” then we can show we are part of the solution, not the problem.While the bill has been a popular punching bag for the last year, now that it is law, it represents an opportunity for leadership. Pharma, with its culture of innovation and its reach to millions of consumers, can be part of the solution. Those companies and brands that broaden their vision of wellness to consider disease management partnerships, explore new models of consumer engagement and invest in integrated approaches to patient care will be the winners not only in terms of financial success but better outcomes and reputation.
David Ormesher is CEO at closerlook, inc.