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Impact of the Changing Reimbursement Landscape

Recent legislation and growing anxiety about debt have put healthcare in the spotlight, where it’s likely to stay for an indefinite period. Payers and providers are under enormous pressure to reduce costs and improve quality, manifested in the increasing experimentation with ACOs, bundled pricing, and other alternative delivery models. As reimbursement rates for hospitals decrease, the way decisions about care are made is changing as well. The ability of marketers to impact sales through relationships with physicians is decreasing as the role of institutional policies by payers and providers grows. This creates multiple challenges for product marketers, including increased pricing pressure, reduced resources, and new stakeholder groups with more demanding purchasing criteria to address.
In the face of these challenges, marketers will have to rethink their strategy. Sales tactics to physicians will need to change to become more tailored and efficient, relying on segmentation by more subtle factors than script writing decile. More significantly, marketers will need to shift their attention to institutional decision makers, reframing their approach in terms that are meaningful to this new target audience. And what is the key criterion for this group? Increasingly, it is economic and clinical value. Institutional decision makers are insisting that reimbursement or inclusion on the formulary be linked to clear-cut benefits for the patient and cost effectiveness for the decision maker. Risk-sharing arrangements in which full payment is contingent on clinical outcomes are gaining traction in an environment that is increasingly sensitive to value delivered. Marketers must be aware of these trends and adapt their behaviors to succeed in this challenging marketplace.
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