There are over 1,500 Integrated Delivery Networks (IDNs) within the United States --a collective of healthcare providers, which, through ownership or partnership, align for the purposes of bringing about governance to ensure improved health outcomes with reduced economic expenditures-- employing over 630,000 healthcare professionals.
Put another way, nearly a third of practicing healthcare providers in the nation are associated with an IDN, most of whom have implemented strict restrictions of sales calls and/or have taken it upon themselves to define the lexicon within a category that physicians and patients use to speak with one another. At the same time, IDN decision makers have expressed willingness and desire to work with pharmaceutical manufacturers in a manner that managed care organizations never even considered. Yet, marketing teams often see the task of developing an IDN Marketing Strategy insurmountable. The question is, is your brand set to take on the growth of this complex organized customer segment?
The U.S. healthcare system has long been characterized as fragmented and inefficient; one where the substantial costs do not correlate with positive health outcomes. While Managed Care may have been seen as the answer to this in the 1970s and 1980s, its impact has added more inefficiency to the system. This has given rise to the growth of Integrated Delivery Networks (or Integrated Delivery Systems), simply referred to as IDNs. The role of these organizations has been to drive down cost, while at the same time improve the quality of patient care through better coordination. As a result, IDNs have taken on ownership of critical functions that were often managed by physicians or hospitals on their own.
While the IDN model offers a lot of upside potential to patients, physicians, and other healthcare professionals, they present challenges to the pharmaceutical industry. Most notably, the IDN model presents a level of complexity, which healthcare marketers have traditionally have been unequipped to service. Specifically, treatment decision-making is now being guided by an administrative body, and pharmaceutical products are being evaluated almost exclusively on their functional, not extrinsic, benefits. This requires the industry to bring more data, education, and support to help aid the selling process.
Considerations for Industry
Fundamentally, IDNs aspire to support the goals of the Institute for Healthcare Improvement’s framework of Quadruple Aim, which essentially specifies that a healthcare provider’s health and satisfaction equates to a healthy and satisfied patient population while reducing costs across the board.
Considering this, IDNs are extremely receptive to working with the pharmaceutical industry. According to a 2017 study among key U.S. Market Access executives, IDN decision makers indicate they’ve been more than twice as likely to pursue patient adherence programs with pharmaceutical companies when compared to their peers working for Managed Care Organizations. Nevertheless, the question remains, “What can my brand offer to an Integrated Delivery Network?”
The answer, quite simply, lies in the principles of Quadruple Aim Can your brand experience improve the health outcomes of a patient population, while reducing friction with the healthcare system at lower cost(s) to all? Some examples where pharma has been successful in this realm include…
- Top-Down Communications to Healthcare Providers and/or Patients: IDNs need well-informed HCPs to understand evolving treatment guidelines, new treatment approaches, etc. Further, they also require patients who are better equipped to take action following a medical appointment to follow-through on their doctors’ recommendations. IDNs don’t have the resources to easily produce brochures, emails, and other resources that facilitate learning and/or behavior modification – and that’s where pharma can play a role.
- Aiding in Quantifying Health Outcomes: By their very existence, IDNs are looking for data that helps inform decision-making. While IDNs routinely retrospectively analyze trends and practices to inform future guidelines, the time and effort to do so is significant. As a result, the industry has stepped in on numerous occasions to provide funding and/or resources, such as tools that enable insight into patient behaviors (e.g. – health apps, patient portals, etc.) treating with their brand or treatment modality. Fundamentally, if these efforts can accelerate attainment of the insights by the physician and IDN, necessary to implement the adoption of their brand within the IDN, it is a win for the manufacturer.
- Reducing Friction With Managed Care and/or Patient Treatment: Manufacturers of biologic and oncologic treatments have initiated programs that assist physicians and their treatment teams in navigating the challenges of managed care (including attaining prior authorizations and easing the burden of patient access to medication) with resources, such as treatment access portals. Further, some manufacturers have implemented programs that help patients overcome the logistical challenges of getting treatment through services, such as sponsored ride-sharing programs. Developing these services at an IDN account level engenders a stronger working partnership between the IDN and the manufacturer as the services can be tailored to the unique needs of HCPs and patients in that IDN’s region.
Considering this, one might ask: “What is the best way to bring about an engagement model for these initiatives?” Unfortunately, selling to IDNs is not a “one and done” engagement. It takes time and effort to demonstrate a brand’s commitment to improving patient and physician experiences and outcomes within the healthcare system. Brands must accept that the selling process to IDNs is complex and high-maintenance. However, the return on investment has such upside potential, given the volume of HCPs affiliated with IDNs, an IDN Strategy makes sense. Specifically, brand managers should consider…
- Potential Long-Term Return – Once a partnership is established, the value story to the IDN becomes real because the partnership is helping not only to drive down costs and improve patient care, but it is manifesting happier patients and physicians. This becomes difficult for competitors to erode.
- Ability to Define the Lexicon in a Category – This is most common with new treatment modalities, such as in oncology, immunology, virology and/or neurology, where there have been considerable advances in the past decade. Establishing a lexicon, particularly within a region, ensures that HCP and patient dialogue is more complementary and aligned towards your brand story.
- Applicability Towards Other Opportunistic IDNs – If you’ve heard the saying “If you’ve seen one IDN, you’ve seen one IDN,” you’re probably correct in assuming the solutions you can offer are not consistently repeatable across IDNs. However, what is repeatable are the insights that demonstrate an improvement in patient health outcomes across patient types over many IDNs. This is most relevant towards brands in the Type 2 diabetes, oncology and cardiovascular disease categories, which account for a significant share of the economic burden facing an IDN.
While the challenges facing IDNs in the coming years will be complex, especially as we consider the uncertain future of the Affordable Care Act and market pressures driving value-based reimbursement programs, they aren’t going anywhere. Increased pressures on private practitioners will likely continue to drive more physicians towards an IDN partnership if only to reduce the increasing administrative burden put upon them. As a result, brands can’t afford to ignore or overlook identifying their IDN-specific strategies in 2019.
If you have any questions about these developments, reach out to your account representative or contact:
|Mark A. McConaghy, VP Strategy
 Precision For Value, “Key Considerations for Identifying and Developing Meaningful Pharma-IDN Partnership Opportunities,” 2017