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# Numerof

## Sitemaps

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## Posts

- [Blog](https://nai-consulting.com/insights/) - Read more to see how the consultants and analysts at Numerof help organizations succeed with practical strategies for industries in transition.
- [Pharma's Commercial Reset: How the Industry is Rewriting the Model](https://nai-consulting.com/commercial-model-survey/) - The traditional pharmaceutical commercial model was built for a market that no longer exists. Greater scrutiny of value, more complex customer relationships, new channels of engagement and mounting pressure on margins are forcing companies to reconsider how they organize, invest and compete. But recognizing the need for change is easier than executing it. Which elements
- [What the AstraZeneca-BMS Merger Talks Reveal About the Future of Market Access](https://nai-consulting.com/what-the-astrazeneca-bms-merger-talks-reveal-about-the-future-of-market-access/) - The rumored $400 billion merger discussions between AstraZeneca and Bristol Myers Squibb didn’t get very far, but the episode offered another indication of the strategic pressure facing large pharmaceutical companies as they confront patent expirations and an increasingly demanding commercial environment. The question for pharma leaders is no longer simply how to reduce costs or
- [The Capability Gap: Why Pharma Companies Are Falling Behind in an Evidence-Driven Market](https://nai-consulting.com/the-capability-gap-why-pharma-companies-are-falling-behind-in-an-evidence-driven-market/) - More than 22,000 pharmaceutical jobs were cut in 2025 as companies brace for a $300 billion patent cliff. But the real story is not workforce reduction. It’s the reshaping of competition, value and decision-making across the entire market. Pharmaceutical companies must move beyond cost-cutting and incremental innovation by embedding evidence, market access and economic value
- [What the Rumored AstraZeneca-Bristol Myers Squibb Merger Suggests About Pharma’s Future](https://nai-consulting.com/what-the-rumored-astrazeneca-bristol-myers-squibb-merger-suggests-about-pharmas-future/) - While the reported $400 billion merger discussions between AstraZeneca and Bristol Myers Squibb never advanced, the fact that a combination of this scale was even rumored sent shock waves through the industry. That the deal may have been considered at all reflects the extraordinary strategic pressure now facing large pharmaceutical companies. Patent expirations, pricing pressure,
- [The Problems of Continuity of Care Have Intensified—Another Reason Why Hospitals Need a New Business Model](https://nai-consulting.com/the-problems-of-continuity-of-care-have-intensified-another-reason-why-hospitals-need-a-new-business-model/) - Recent activity in Washington—from the Patients Deserve Price Tags Act now moving through the Senate, to the House Ways and Means Committee hearing with Hospital CEOs in April—illustrates that dissatisfaction with the current state of healthcare delivery continues to grow. While pricing and affordability are the most visible part of that dissatisfaction—and addressing them is
- [Potential 340B Transformation](https://nai-consulting.com/potential-340b-transformation/) - In its latest annual report, IQVIA showed that the 340B drug pricing program has continued to grow at double digit rates. In 2025, 340B drug sales grew by 20.3% year-over-year reaching $179.5B. If you adjust this data for missing 340B sales, IQVIA projects that the 340B program is “approximately $200B, which is approaching the size
- [Healthcare Delivery Organizations Need to Demonstrate Value. Here’s How to Do It](https://nai-consulting.com/healthcare-delivery-organizations-need-to-demonstrate-value-heres-how-to-do-it/) - The House Ways and Means Committee hearing in late April signaled growing bipartisan frustration with a healthcare system that continues to produce rising costs without demonstrating better value, accountability or outcomes for employers, taxpayers and patient-consumers. Healthcare delivery organizations should treat this moment as an opportunity to redesign how they compete by focusing on measurable
- [Beyond Dissatisfaction: A Framework for Healthcare Transformation](https://nai-consulting.com/beyond-dissatisfaction-a-framework-for-healthcare-transformation/) - As I have covered in the first three columns of this series, the recent House Ways and Means Committee hearing exposed frustration with hospital pricing and affordability and highlighted that policymakers, employers and consumers are increasingly questioning the ability of the current healthcare business model to deliver value. Healthcare leaders should stop asking whether change
- [What Senator Bill Cassidy’s 340B Proposal Reveals About America’s Healthcare Business Model](https://nai-consulting.com/what-senator-bill-cassidys-340b-proposal-reveals-about-americas-healthcare-business-model/) - Sen. Bill Cassidy’s recently proposed discussion draft to reform the 340B Drug Pricing Program marks the most significant congressional effort in more than a decade to increase transparency, strengthen oversight and ensure the program better serves the vulnerable patients it was originally designed to help. Cassidy’s proposal deserves serious consideration. But its greatest value may
- [Design Principles for Value-Based Solutions](https://nai-consulting.com/design-principles-for-value-based-solutions/) - Hospitals and healthcare delivery systems are facing significant pressure to improve quality, reduce costs, and increase revenues. As a result, they are putting pressure on medical device manufacturers for lower prices and better outcomes. In addition, they've put other restrictions in place – like reducing the number of suppliers, limiting physician access, and increasing the
- [Why the Old Drug Development Model Is Breaking Down — And What Comes Next](https://nai-consulting.com/why-the-old-drug-development-model-is-breaking-down-and-what-comes-next/) - Rising evidentiary standards, pricing pressure and policy changes are redefining what it takes for pharmaceutical products to succeed. Pharmaceutical companies must rethink how R&D decisions are made, ensuring that clinical trial designs reflect the kind of evidence required for access and optimal reimbursement. Unfortunately, in too many companies, clinical development processes are out of step
- [Accelerate Your Evidence Planning Process and  Cut Your Time to Market](https://nai-consulting.com/accelerate-your-evidence-planning-process-and-cut-your-time-to-market/) - In the evolving pharmaceutical landscape of 2026, companies face unprecedented financial pressures on multiple fronts, including rising costs and shrinking opportunities for revenue generation. The Inflation Reduction Act (IRA), now in its fourth year, continues to compress peak sales windows for top-selling drugs through price negotiations. At the same time, tariff threats led to pricing
- [Why Changes to the Healthcare Business Model Have Stalled for Decades](https://nai-consulting.com/why-changes-to-the-healthcare-business-model-have-stalled-for-decades/) - The recent House Ways and Means Committee hearing reflected something larger than frustration with hospital pricing. It exposed a growing recognition that decades of effort trying to reform healthcare have produced mounting cost, rising dissatisfaction and little confidence that the current model can deliver results. Healthcare leaders should stop treating reform as a debate about
- [Hospital Costs and Accountability Under Fire: Key Takeaways from the House Ways and Means Hearing](https://nai-consulting.com/hospital-costs-and-accountability-under-fire-key-takeaways-from-the-house-ways-and-means-hearing/) - When hospital CEOs appeared before the House Ways and Means Committee in late April, lawmakers were not content with conducting a traditional oversight hearing. They were signaling growing bipartisan frustration with a healthcare delivery system that has spent decades promising affordability improvements while costs continue to climb. For more than 40 years, CMS and policymakers
- [Strategic Launch Sequencing (SLS)](https://nai-consulting.com/strategic-launch-sequencing-sls/) - Biopharma new product strategic launch sequencing (SLS) is becoming increasingly more controversial and complex. In the first part of this article on biopharma new product SLS, we review the background and significant challenges the Biopharma industry faces in new product launch sequencing. In the second part, we discuss likely ramifications associated with delays in Biopharma
- [Narrow Labels as the Solution to a Shorter Commercial Runway](https://nai-consulting.com/narrow-labels-as-a-strategic-asset-in-the-face-of-shorter-commercial-runways/) - When Congress passed the Inflation Reduction Act in 2022, most headlines focused on lower drug prices for Medicare beneficiaries. Far less attention has been paid to how compressing the product prime earning cycle is reshaping pharmaceutical development and commercialization strategy. Pharmaceutical leaders need an alternative approach to the blockbuster model of drug development. Narrower labels
- [The New Product Development Landscape: Navigating the Challenges](https://nai-consulting.com/the-new-product-development-landscape-navigating-the-challenges/) - The global pharmaceutical industry is in the midst of a redefining transformation. Just as landmark scientific advances have accelerated the pace of innovation, rising costs and demands for affordable healthcare are challenging the economics and traditional business assumptions of the industry. Governments across the globe are becoming more cost-conscious as budget deficits are being compounded
- [Beyond the Patent Cliff: Why Pharma’s Layoffs Signal a Deeper Strategic Shift](https://nai-consulting.com/beyond-the-patent-cliff-why-pharmas-layoffs-signal-a-deeper-strategic-shift/) - Large pharmaceutical companies cut more than 22,000 jobs in 2025 as a $300 billion patent cliff approaches, signaling a broad industry correction in workforce size and cost structure ahead of significant revenue losses. These layoffs are not simply cost containment. They reflect deeper strategic recalibration, and companies must respond with greater discipline in portfolio decisions,
- [After Vinay Prasad: Rethinking Evidence, Access and the Future of FDA Regulation](https://nai-consulting.com/after-vinay-prasad-rethinking-evidence-access-and-the-future-of-fda-regulation/) - The departure of Dr. Vinay Prasad, a high-profile FDA regulator known for his strict adherence to traditional clinical trial standards, has renewed debate about how the agency should balance scientific rigor with timely patient access to emerging therapies. Rather than framing this moment as a binary choice between rigor and access, stakeholders should recognize it
- [How Better Evidence and Patient Reported Outcomes Can Improve Value](https://nai-consulting.com/how-better-evidence-and-patient-reported-outcomes-can-improve-value/) - While both sides of the U.S. political aisle are focused on bringing down drug prices, they’re missing a critical lever for long-term change: raising the evidentiary bar for what qualifies as clinical value. In late 2025 the FDA signaled a major policy shift in removing barriers to the use of real-world evidence in regulatory submissions,
- [Using AI to Improve Decision-Making Across the Drug Lifecycle](https://nai-consulting.com/using-ai-to-improve-decision-making-across-the-drug-lifecycle/) - Artificial intelligence is rapidly becoming embedded across the pharmaceutical industry, from drug discovery to commercialization. Yet as adoption accelerates, many organizations remain unclear about where AI creates real value and where it simply adds complexity. Rather than treating AI as a set of isolated use cases, pharma leaders should approach it as a decision-support capability,
- [Generous, Globe, and Guard: Strategic Implications of CMMI’s MFN Framework](https://nai-consulting.com/generous-globe-and-guard-strategic-implications-of-cmmis-mfn-framework/) - After failing to obtain the needed votes required to include mandatory MFN legislation in his Big Beautiful Bill, President Trump has looked to other avenues to engage MFN pricing with the pharma industry, a position he signaled clearly in two Executive Orders in April and May 2025. Trump sent letters to 17 pharma manufacturers calling
- [FDA Modernizes Evidence Standards: What it Means for Pharma Strategy, Operations and Value](https://nai-consulting.com/fda-modernizes-evidence-standards-what-it-means-for-pharma-strategy-operations-and-value/) - The FDA’s recent move to modernize evidence standards marks a turning point in how drug value will be judged, priced and compared globally, with direct consequences for how pharmaceutical companies operate internally. If evidence is becoming the currency of value, pharmaceutical leaders must stop treating it as a downstream exercise and start redesigning how assets
- [The Implications of PBM Reform Legislation for Pharmaceutical Companies](https://nai-consulting.com/the-implications-of-pbm-reform-legislation-for-pharmaceutical-companies/) - Industry insiders have voiced interesting skepticism in the face of what others outside the industry have described as much needed ground-breaking legislation aimed at curbing long-standing anti-competitive PBM practices. As I noted in a recent post, policymakers have acknowledged for years that opaque PBM practices have distorted drug pricing and eroded trust across the prescription
- [Optimizing Global Launch Sequencing](https://nai-consulting.com/optimizing-global-launch-sequencing/) - Traditionally, launch sequencing has been guided by market size, eligible patient population, and the likelihood of securing market access and adoption. While these criteria are still important, they’re no longer sufficient. Growing budget constraints, more stringent evidence requirements, and the rise of external reference pricing and transparency are forcing pharma companies to rethink how they
- [Prioritizing Real-World Evidence Generation For Impact](https://nai-consulting.com/prioritizing-evidence-generation-for-impact/) - Across the globe, pharma companies are experiencing new levels of price resistance and competitive pressure. No one wants to spend more than they already do – unless they’re given a compelling reason. The only counter to that pressure is compelling evidence of differentiated value. Once considered nice-to-have, real-world evidence (RWE) has become a critical success
- [Cost, Access, Accountability: What 2025 Exposed and the 2026 Outlook for Healthcare Delivery and Payers](https://nai-consulting.com/cost-access-accountability-what-2025-exposed-and-the-2026-outlook-for-healthcare-delivery-and-payers/) - Over the past year, pressures across the U.S. healthcare delivery and insurance ecosystem have intensified on many fronts. Providers remain strained by staffing and margin compression. Insurers face mounting regulatory and competitive pressure. And employers and consumers feel the weight of persistent cost growth. Together, these forces are accelerating disruption heading into 2026. As 2026
- [The Value Mandate: Why 2026 Will Reshape Pharma and Device Strategy](https://nai-consulting.com/the-value-mandate-why-2026-will-reshape-pharma-and-device-strategy/) - This year brought major shifts in the pharmaceutical landscape as the Trump Administration negotiated directly with manufacturers, used tariff threats to force lower prices and reshoring, issued new executive orders on affordability and introduced a national direct-to-consumer pricing model. With policy pressure rising, 2026 will require manufacturers to translate the lessons of this year into
- [Numerof's 2026 Outlooks for the Healthcare Sector](https://nai-consulting.com/numerofs-outlooks-for-the-healthcare-sector/) - What's coming for the healthcare sector in 2026, and more importantly, what do pharma, medical device, insurance and healthcare delivery executives need to do to succeed?
- [The Numerof 2026 Global Medical Device Outlook](https://nai-consulting.com/the-numerof-global-medical-device-outlook/) - Numerof’s 2026 Global Medical Device Outlook infographic maps the major stakeholders in the medical device ecosystem and what we expect from them in the year ahead. The common thread that connects them all is the increasingly focused drive by public and private payers across the globe to reduce the cost of healthcare. That force is
- [The Numerof 2026 Global Pharma Outlook](https://nai-consulting.com/the-numerof-global-pharma-outlook/) - Numerof’s 2026 Global Pharma Outlook infographic depicts a pharmaceutical landscape being reshaped by multiple forces, some of which have been on our radar for years, and some new. In addition to the complex story our infographic tells, there is also the impact of a new activist administration. While it’s tempting to label pressure on drug
- [The Numerof 2026 US Health Insurance Outlook](https://nai-consulting.com/the-numerof-us-health-insurance-outlook/) - As our Numerof 2026 U.S. Health Insurance Outlook infographic illustrates, the story for health insurance continues to be about dramatically changing roles and relationships. Payers will continue to engage in new and different ways with providers, consumers, employers, regulators, medical device makers and pharmaceutical manufacturers. All this will come in the context of significant political
- [The Numerof 2026 US Healthcare Delivery Outlook](https://nai-consulting.com/the-numerof-us-healthcare-delivery-outlook/) - The healthcare industry continues to face significant challenges. Staffing shortages are endemic, impacting patient and non-patient facing roles up to and including physicians; staff dissatisfaction is at historic levels, leading to large scale labor disputes and nurses seeking alternative employment; wage and general inflation have dramatically increased operating costs; balance sheets have been weakened; and
- [The Unintended Consequences of MFN](https://nai-consulting.com/the-unintended-consequences-of-mfn/) - Thanks to John O’Brien and NPC, I had the privilege of recently participating on a panel at the AVBCC meeting in NYC with Beth Hamilton from Astra Zeneca. The panel was a discussion of ex-U.S. drug access and pricing and how it could impact MFN in the U.S. I wanted to share with you just
- [Planning for Market Entry in a Dynamic Environment](https://nai-consulting.com/planning-for-market-entry-in-a-dynamic-environment/) - The pharmaceutical industry is navigating one of the most complex and consequential shifts in its history. The environment for launching new products has changed dramatically, and the legacy model – once the cornerstone of commercial success – is increasingly misaligned with the realities of today’s healthcare ecosystem. Historically, drug launches followed a predictable path: build
- [What Population Health Means for Market Access](https://nai-consulting.com/what-population-health-means-for-manufacturers/) - It’s no secret that the healthcare industry is under growing pressure to reduce the cost of care while improving health outcomes. Linkage of reimbursement to cost and outcomes is the idea behind value-based payment frameworks and is the driving force behind today’s rapidly changing healthcare landscape. Such linkage will likely be achieved using a population
- [Diagnosis-Related Groups (DRGs): Why They Failed and  What Comes Next](https://nai-consulting.com/diagnosis-related-groups-drgs-why-they-failed-and-what-comes-next/) - CMS introduced Diagnosis-Related Groups (DRGs) in the early 1980s with the promise of bending the proverbial healthcare cost curve. It was the start of a prospective payment system aimed at ending the ‘usual and customary’ retrospective reimbursement system. Under this new model hospitals were paid a flat rate for treating a patient with a given
- [Impact of Medicare Fair Price (MFP) on ASP Based U.S. Payment Systems](https://nai-consulting.com/impact-of-medicare-fair-price-mfp-on-asp-based-u-s-payment-systems/) - Mike Ryan and I often discuss various U.S. and Global healthcare payment policies that are insufficiently thought through. When modeling is inadequate prior to implementation or is based on faulty assumptions, the unintended consequences and impacts can be quite negative. We’ve decided to share our thoughts periodically on some of these previous or soon-to-be implemented
- [Developing Novel Approaches to Shaping Policy](https://nai-consulting.com/developing-novel-approaches-to-shaping-policy/) - The business of bringing new medicines to market has never been more difficult. Drug costs are a major focus for policy makers, who are pushing for changes to lower what are seen as exorbitant pharmaceutical prices. The Inflation Reduction Act (IRA), passed in 2022, promises to challenge the traditional price/volume pricing model that the pharma
- [A Recipe for Post-Merger Success: Building  Organizational Alignment](https://nai-consulting.com/a-recipe-for-post-merger-success-building-organizational-alignment/) - With articles about health system mergers and acquisitions becoming a regular fixture in business publications, why is it that anticipated benefits of mergers remain so elusive? Despite countless hours of time spent on identifying the “perfect” partner or target, conducting due diligence, surviving hard fought negotiations, and executing exquisitely detailed post-merger integration plans, the majority
- [The New Product Development Landscape: Navigating the Challenges](https://nai-consulting.com/the-new-product-development-landscape-navigating-the-challenges-md/) - The challenges in bringing new products to market successfully have never been greater. In the past product approval meant demonstrating safety and efficacy to regulatory bodies in discrete countries. Clinical evidence came from trials that focused on device functionality and patient outcomes. Patients included in randomized clinical trials were subjected to inclusion and exclusion criteria
- [Prioritizing Evidence Generation for Impact](https://nai-consulting.com/prioritizing-evidence-generation-for-impact-medtech/) - Across the globe, medical device and diagnostic companies are experiencing new levels of price resistance and competitive pressure. No one wants to spend more than they already do – unless they’re given a compelling reason. The only counter to that pressure is compelling evidence of differentiated value. Once considered nice-to-have, Evidence Generation has become as
- [Common Pitfalls of Integrated Evidence Plans (IEPs): Part 2](https://nai-consulting.com/common-pitfalls-of-integrated-evidence-plans-ieps-part-2/) - In Part 1 of this series, we discussed Integrated Evidence Plans (IEPs) whose purpose is to identify and prioritize evidence gaps aligned with commercial goals to obtain regulatory approval in markets of interest, optimize access, and achieve a price that reflects the holistic value of a given asset. We noted that the creation of a
- [Achieving Launch Access and Value: Common Pitfalls of Integrated Evidence Plans (IEPs)](https://nai-consulting.com/achieving-launch-access-and-value-common-pitfalls-of-integrated-evidence-plans-ieps/) - In the past, product approval meant demonstrating safety and efficacy to regulatory bodies in discrete countries—with a placebo comparator. Today companies must anticipate a changing reimbursement, adoption, and policy environment. The need to make population-based decision-makers aware of the value the new product brings while tailoring evidence to the specific requirements of an increasingly diverse
- [The High Cost of Cutting Staff in Pharma if It’s Not Done Properly](https://nai-consulting.com/the-high-cost-of-cutting-staff-in-pharma-if-its-not-done-properly/) - The latest wave of pharma layoffs – at Moderna, at Biogen, at Johnson & Johnson and beyond – reflects the financial pressures reshaping the industry. Cuts have impacted digital departments, R&D, corporate headquarters, market access, and medical functions. And the cuts have been significant, often reflecting 20-40% of the workforce in specific areas. These layoffs
- [Healthcare Systems are Rebranding. Is it a Real Pivot or Old Wine, Just in New Bottles?](https://nai-consulting.com/healthcare-systems-are-rebranding-is-it-a-real-pivot-or-old-wine-just-in-new-bottles/) - As the adage goes: “The more things change, the more they stay the same.” This certainly holds true for healthcare delivery. Today, health systems are attempting to reinvent themselves again – either by changing their name, logo, North Star vision or all of the above – to better reflect what they claim is a new
- [Mass Layoffs Continue Across the Biotech Sector. What Does This Mean for Pharma’s Future?](https://nai-consulting.com/mass-layoffs-continue-across-the-biotech-sector-what-does-this-mean-for-pharmas-future/) - More than 175 biotech layoffs were announced in 2023, easily surpassing 2022’s number of 119. While this is not a new trend, the current trajectory is concerning, as it portends more difficult times ahead for the pharmaceutical industry–already in the midst of a major upheaval. It should also be another wake-up call to pharma executives:
- [Leveraging the 7Ps of Marketing in Healthcare](https://nai-consulting.com/leveraging-the-7ps-of-marketing-in-healthcare/) - As the healthcare industry across the U.S. continues to consolidate, delivery organizations are becoming more sensitive to the need to differentiate their products and services based on the value they deliver. Historically, healthcare delivery organizations have defined value in narrow terms like complication and mortality rates. In addition, processes were designed to meet the needs
- [Pharma at a Crossroads: Navigating Cost Pressures and Regulatory Shifts in 2025](https://nai-consulting.com/pharma-at-a-crossroads-navigating-cost-pressures-and-regulatory-shifts-in-2025/) - Global cost pressures and a fast-changing political and regulatory landscape indicate that the pharmaceutical industry is at an inflection point as we head into 2025, as we outline in our recently published 2025 Global Pharma Outlook. To navigate this increasingly complex environment, manufacturers must fundamentally rethink their models, focusing on long-term value, evidence-based decision-making and
- [Table Stakes for Success in Value Based Agreements](https://nai-consulting.com/table-stakes-for-success-in-value-based-agreements/) - Successful value-based contracting between healthcare insurers and care delivery organizations is critical to the transition towards a more sustainable healthcare system. As healthcare costs continue rising, there is an urgent need to realign payment models to reward providers for efficiency and optimal patient outcomes rather than fee-for-service care volume. Value-based contracts enable this transition by
- [Built to Flail: Why the Culture of Healthcare Needs to Be Addressed, Stat!](https://nai-consulting.com/built-to-flail-why-the-culture-of-healthcare-needs-to-be-addressed-stat/) - The chief innovation officer of a highly regarded integrated delivery network recently lamented: “Getting people to change is the hard part.” This is a common refrain in administrative suites and medical executive committee meetings as healthcare systems struggle to respond to a marketplace where new competitors and delivery models are emerging at breakneck speed. There’s
- [IDNs & Consolidation:  The Commercial Challenge for Manufacturers](https://nai-consulting.com/idns-and-consolidation-the-commercial-challenge-for-manufacturers/) - Changes in healthcare delivery are rapidly undermining the commercial models on which manufacturers have traditionally relied to market their drug, device, and diagnostic products. Customers are fewer and larger as hospitals consolidate into integrated delivery networks (IDN) in the face of rising cost pressures, stiffer financial penalties and the imperatives of healthcare reform. As IDNs
- [Engaging in Value-Based Contracts with Providers](https://nai-consulting.com/engaging-in-risk-sharing-agreements-with-providers/) - With spiraling cost inflation and outcomes that lag many other developed economies, the US government’s healthcare insurance authority (CMS), is driving reform aimed at better quality and lower cost, and private payers are following suit. Both state and private payers are moving toward alternative payment models, like value-based payments, that make providers accountable for cost
- [Key Takeaways from Numerof’s 8th Annual <i>State of Population Health</i> Survey](https://nai-consulting.com/key-takeaways-from-numerofs-8th-annual-state-of-population-health-survey/) - Numerof’s annual State of Population Health Survey is fast becoming the benchmark for change in healthcare delivery. Our eighth annual report reflects input from nearly 100 executives and interviews with key decision makers across U.S. healthcare delivery organizations on how their population health journey is going, how they feel about it, and what’s getting in the way.
- [Planning for Success in an IDN Environment](https://nai-consulting.com/planning-for-success-in-an-idn-environment/) - Increasingly, manufacturers are feeling pressure to modify their commercial models in light of changes in the market environment. As healthcare delivery organizations consolidate into integrated delivery networks (IDNs) product decision-making processes are changing. The move to institutional decision-making impacts how purchase decisions get made, by whom, and the criteria used, to name just a few
- [Six Keys to Focusing on Social Determinants with the Biggest Economic Impact](https://nai-consulting.com/social-determinants-of-health-the-new-business-imperative/) - Historically, the incentives built into fee-for-service (FFS) payment models actually encouraged providers to ignore social determinants of health (SDH) that impact health outcomes. For example, providers were financially rewarded when “frequent flyers” were readmitted, and it was easy to rationalize such factors as “out of scope”. Ignoring vulnerable populations’ socioeconomic factors may have been good
- [Competitive Strategy for Mid-Sized Payers: Creative Collaborations are Key](https://nai-consulting.com/competitive-strategy-for-mid-sized-payers-creative-collaborations-are-key/) - Long-term success in any industry requires ongoing investment to progress customer-facing capabilities and internal operations. Health insurance is no exception and – one could argue – due to often thin differences among competitors, is a side of the health care ecosystem where smart reinvestment can create the margin to win in the market. This is
- [Numerof State of Population Health Survey](https://nai-consulting.com/numerof-state-of-population-health-survey/) - Population health management has been a national topic of conversation, but to date little effort has been devoted to tracking the actual progress that’s been made toward this new model of care. Now in its eighth year, Numerof’s State of Population Health survey provides an in-depth, national look at the pace of change from fee-for-service.
- [As the Regulatory Landscape Shifts Globally, So, Too, Must the Pharma Commercial Model](https://nai-consulting.com/as-the-regulatory-landscape-shifts-globally-so-too-must-the-pharma-commercial-model/) - In a previous column, I discussed how pharmaceutical and medical device companies are adapting their commercial model approaches in critical areas to address growing economic, market and other competitive pressures. This adaptation is underscored in our new Numerof & Associates 2023 Commercial Model Report, which reveals the strategic changes that manufacturers are making in how
- [Establishing a Research Network to Drive Differentiation in a Dynamic Market](https://nai-consulting.com/establishing-a-research-network-to-drive-differentiation-in-a-dynamic-market/) - Clinical research networks continue to play a pivotal role in supporting pipeline development. However, the importance of these networks extends well beyond the conduct of clinical trials. Clinical investigators can support market conditioning, serve as important levers for informing evidence-based clinical pathways/guidelines, and aid in the generation of real-world evidence – all of which are
- [The Future of Medical Affairs: Impact of the Evolving Healthcare Landscape](https://nai-consulting.com/medical-affairs-survey/) - The pandemic has dramatically accelerated many changes across healthcare, and one of them is redefinition of Medical Affairs’ role in commercialization. The shift to virtual detailing and the increased focus on economic and clinical value have implications for Medical Affairs well beyond staffing numbers. These changes demand that Medical Affairs serve as a strategic partner
- [New Report Highlights Pharma Commercial Model Requires an Urgent Overhaul](https://nai-consulting.com/new-report-highlights-pharma-commercial-model-requires-an-urgent-overhaul/) - The pharmaceutical industry is in the midst of profound transformation. Downward economic pressures, a tightening federal regulatory environment and changes in competition and market expectations are upending the traditional pharmaceutical commercial model. As these pressures intensify, the need for a new model becomes increasingly evident. While many manufacturers are adapting, new research reveals resistance and
- [Five Opportunities for Hospitals to Increase Their Business Model's Sustainability](https://nai-consulting.com/five-opportunities-for-hospitals-to-increase-their-business-models-sustainability/) - The hospital model today stands in the crosswinds of market and nonmarket forces. On the market side, there is the hard reality that sustainable margins are required for financial viability. On the nonmarket side, there are a host of regulations to comply with, a mission that includes caring for those who can’t pay, disproportionate payer
- [Is Medicare Price Negotiation the Solution We Need?](https://nai-consulting.com/is-medicare-price-negotiation-the-solution-we-need/) - On August 29th, the Biden Administration named the 10 drugs that will be subject to price negotiation with Medicare in the initial implementation of the Inflation Reduction Act (IRA) of 2022. Release of the list marked a milestone in a decades-long effort by Democrats to use the purchasing power of the Medicare program to force
- [Transatlantic Perspectives on the Future of Pharma](https://nai-consulting.com/transatlantic-perspectives-on-the-future-of-pharma/) - For years, lawmakers have targeted the pharmaceutical industry, blaming it for the high cost of healthcare – its role in the management of Covid-19 notwithstanding. Despite recent breakthroughs to rid the world of its worst scourges, both the U.S. and EU appear to regard pharma as the single worst actor in the healthcare cost drama.
- [The Inflation Reduction Act: Death by a Thousand Cuts for the Drug Industry Begins in Earnest](https://nai-consulting.com/the-inflation-reduction-act-death-by-a-thousand-cuts-for-the-drug-industry-begins-in-earnest/) - For years, lawmakers have been chomping at the bit to reduce the perceived power of the pharmaceutical industry — once the crown jewel of American business. Their efforts have finally come to fruition with the signing into law of the misnamed Inflation Reduction Act. The law, in part, allows Medicare to begin “negotiating” the price
- [Kaiser is Acquiring Geisinger. As M&A Activity Accelerates, Making These Leadership Mistakes Can Quickly End Them.](https://nai-consulting.com/kaiser-is-acquiring-geisinger-as-ma-activity-accelerates-making-these-leadership-mistakes-can-quickly-end-them/) - Companies across every industry undergo periods of adjustment, which include tapping someone new to steer the organization in a different direction. Changing out the CEO and replacing upper management teams may sometimes be necessary, but when that shift isn’t well-executed, it can exacerbate old problems and create new ones. The reason is simple: those in
- [Pharma Executives are Awakening to a New Reality: Embrace the Future of the Commercial Model Now or Else](https://nai-consulting.com/pharma-executives-are-awakening-to-a-new-reality-embrace-the-future-of-the-commercial-model-now-or-else/) - Pharmaceutical executives are waking up to a hard new reality. The winds of healthcare economic change, accelerated by a historic pandemic, have upended the old “feet on the street” commercial sales playbook by which they successfully operated for good. Whether pharma leaders like it or not, the future of the commercial model is here to
- [Key Takeaways from Numerof's 7th Annual <i>State of Population Health</i> Survey](https://nai-consulting.com/key-takeaways-from-numerofs-7th-annual-state-of-population-health-survey/) - Numerof’s annual State of Population Health Survey is fast becoming the benchmark for change in healthcare delivery. Our seventh annual report reflects input from nearly 300 executives across the country on how their population health journey is going, how they feel about it, and what’s getting in the way. For a shortcut to some of our
- [Look to Clinical Program Effectiveness for your Differentiation Strategy](https://nai-consulting.com/look-to-clinical-program-effectiveness-for-your-differentiation-strategy/) - Success in any market ultimately relies on two things; the effectiveness of your solution in addressing the identified need, and your ability to explain how your product or service is differentiated from the competition. In the increasingly crowded healthcare benefits sector, there’s a compelling need among employers to lower the cost of health insurance, and
- [Key Considerations for Population Health Management](https://nai-consulting.com/key-considerations-for-population-health-management/) - The goal of population health is the systematic and transparent delivery of services to improve the health status of a given population at a prospective price, ultimately delivering better outcomes at lower cost. Population health management reflects a new care delivery model that emphasizes wellness and prevention, and requires new payment models that support that
- [Patients as Partners? The Role for “Patient Centricity” in the New Healthcare Landscape](https://nai-consulting.com/patients-as-partners-the-role-for-patient-centricity-in-the-new-healthcare-landscape/) - The healthcare system -- in the U.S. and globally -- is responding to the need to reduce costs and improve outcomes. The foremost implication for manufacturers of pharmaceuticals, devices, and diagnostics is a drive to demonstrate the economic and clinical value of their products to all stakeholders… including patients. This is an extreme shift in
- [Cultural Implications of Population Health Management](https://nai-consulting.com/cultural-implications-of-population-health-management/) - The rapidly changing healthcare environment has pushed healthcare delivery organizations to adapt to new regulations, new technology, new customers and new partnerships. Preparing to take on population health management is increasingly on the agenda as providers are challenged to provide better quality at lower cost. To do so successfully will require many delivery organizations to make
- [The Three Critical Steps Needed for Building a New Commercial Model](https://nai-consulting.com/the-three-critical-steps-needed-for-building-a-new-commercial-model/) - Driven by transparency requirements from CMS and new competitors entering the marketplace, healthcare delivery organizations are facing an unprecedented increase in their accountability for the quality and cost of care. This has profound implications for the commercial approach that manufacturers take to the market. One clear consequence of this increased pressure has been a spike
- [Care Is Migrating to ASC Settings—What’s Your Strategy?](https://nai-consulting.com/care-is-migrating-to-asc-settings-whats-your-strategy/) - Amidst all the noise about healthcare in the United States, a quiet revolution is reshaping the industry. Care delivery is migrating from inpatient (IP) to outpatient (OP) settings at an accelerating pace. But just because care migration is taking place without much fanfare doesn’t mean device manufacturers should ignore it. Indeed, as this trend continues,
- [Transparency Around Value to Support Rational Pricing Discussions](https://nai-consulting.com/transparency-around-value-to-support-rational-pricing-discussions/) - The issue of drug pricing has become a staple of the news cycle, with fresh headlines every few weeks spotlighting either the high cost of new breakthrough drugs, or jaw-dropping price hikes for established products. While these examples represent two very different sets of issues, in the minds of consumers, they boil down to the
- [What’s the ROI of Your Clinical Programs?](https://nai-consulting.com/whats-the-roi-of-your-clinical-programs/) - Health insurance payers’ original function as financiers of care has evolved over the decades. In the current healthcare environment, payer roles range from risk manager to health navigator to provider of care. Across these roles, the importance of their subscribers’ health outcomes remains at the forefront.
- [Covid-19 Accelerates the Need for a New Commercial Model](https://nai-consulting.com/covid-19-accelerates-the-need-for-a-new-commercial-model/) - As leadership focuses on the trauma of Covid-19 across healthcare delivery and the challenges it presents, it is easy to forget that the traditional commercial model was under serious stress before the pandemic. Consolidation across delivery, changes in product decision-making, and growing limitations on access were making that model increasingly ineffective. Covid-19 has only made
- [Expanding Your Market Access Capability](https://nai-consulting.com/expanding-your-market-access-capability/) - Historically, market access has been seen as the last step in the commercialization process. However, this orientation is increasingly out of step with market reality. Manufacturers face growing resistance from providers who, squeezed by shrinking reimbursement, require economic and clinical value data that establishes the marginal impact of a new product relative to the current standard of care.
- [Align Process with Mission and Maintain a Contented Workforce](https://nai-consulting.com/align-process-with-mission-and-maintain-a-contented-workforce/) - Healthcare financial managers have felt steadily increasing pressures over the past decade to reduce costs. A common quick fix for cost containment has been cutting “nonessential” staff and services. Although this approach may reduce targeted operating budgets, some unintended consequences with significant and long-lasting implications have also occurred. Typically, staff reductions do not eliminate work,
- [3 Best Practices for Partnering With Post-Acute Providers for Better Care](https://nai-consulting.com/3-best-practices-for-partnering-with-post-acute-providers-for-better-care/) - Hospital executives are facing a relatively new challenge: managing the financial risk of bundled or capitated payment after a patient is discharged. Now that post–acute care providers are an extension of a hospital’s care delivery model, their performance has direct implications for the hospital’s reputation and bottom line. Not only must these providers meet threshold
- [In Search of the Silver Bullet: The Illusion of Big Data](https://nai-consulting.com/in-search-of-the-silver-bullet-the-illusion-of-big-data/) - While big data by definition captures a large amount of detail for a large number of patients, what it can’t do is provide a company with the big picture, “the wide angle view.” While big data sets such as SharedClarity, formed by UnitedHealthcare and several large provider systems, can be excellent tools for answering specific
- [Telehealth Needs Legislation that Enables Fundamental Change](https://nai-consulting.com/telehealth-needs-legislation-that-enables-fundamental-change/)
- [Hospital Closures Call for a Reimagined Approach to Care Delivery](https://nai-consulting.com/hospital-closures-call-for-a-reimagined-approach-to-care-delivery/)
- [Key Takeaways from Numerof's 6th Annual <i>State of Population Health</i> Survey](https://nai-consulting.com/key-takeaways-from-numerofs-6th-annual-state-of-population-health-survey/) - Numerof’s annual State of Population Health Survey is fast becoming the benchmark for change in healthcare delivery. Our sixth annual report reflects input from nearly 300 executives across the country on how their population health journey is going, how they feel about it, and what’s getting in the way. For a shortcut to some of our most
- [Coming to Terms With Care Migration](https://nai-consulting.com/coming-to-terms-with-care-migration/) - The migration of care from inpatient (IP) to outpatient (OP) and ambulatory surgery center (ASC) settings is revolutionizing healthcare delivery. Beginning with cataract and cosmetic surgery more than a decade ago, the list of ASC procedures has grown to include endoscopy, colonoscopy, anterior cruciate ligament and shoulder repairs, sinus and cataract surgery, and most recently
- [Science: Our Covid-19 Savior, and Manufacturers’ Key to Future Vaccine Success](https://nai-consulting.com/science-our-covid-19-savior-and-manufacturers-key-to-future-vaccine-success/)
- [Even Less Incentive for Pharma to Innovate Threatens Global Health & Our Economy](https://nai-consulting.com/even-less-incentive-for-pharma-to-innovate-threatens-global-health-our-economy/)
- [IP Giveaway Threatens the Future of Pharma](https://nai-consulting.com/ip-giveaway-threatens-the-future-of-pharma/)
- [Putting the Consumer at the Center of Healthcare](https://nai-consulting.com/putting-the-consumer-at-the-center-of-healthcare/)
- [The Pharma Commercial Model was Under Stress Before Covid-19. Here’s What Needs to Change](https://nai-consulting.com/the-pharma-commercial-model-was-under-stress-before-covid-19-heres-what-needs-to-change/)
- [Jeff Bezos was Never <i>the</i> Future of Amazon Health](https://nai-consulting.com/jeff-bezos-was-never-the-future-of-amazon-health/)
- [RAND’s Recommendation for Reducing Healthcare Spending isn’t Right or Realistic](https://nai-consulting.com/rands-recommendation-for-reducing-healthcare-spending-isnt-right-or-realistic/)
- [Not All Hospitals Need Substantially More Government Relief](https://nai-consulting.com/not-all-hospitals-need-substantially-more-government-relief/)
- [When Dogma and Politics Trump Science](https://nai-consulting.com/when-dogma-and-politics-trump-science/)
- [What Mercy Hospital’s $1 Sale Says About Safety Nets’ Future](https://nai-consulting.com/what-mercy-hospitals-1-sale-says-about-safety-nets-future/)
- [It’s Time for Pharma to Reimagine a New Role for Medical Affairs](https://nai-consulting.com/its-time-for-pharma-to-reimagine-a-new-role-for-medical-affairs/) - Among the many trends accelerated by the pandemic was the overhaul of pharma’s commercial model. It was tacitly understood to be ripe for change – the cost was increasingly conspicuous, and the results increasingly suspect. The prior model had grown out of step with field realities. Employed physicians had less time available for reps, and
- [The Role of Telehealth in an Evolving U.S. Marketplace](https://nai-consulting.com/telehealth-survey-report/) - Covid-19 led to a surge in the use of telehealth across the U.S. But what’s likely to happen next? Will we see long-term impact on healthcare business models, health outcomes, and consumer expectations about healthcare convenience and access? To understand how industry leaders are thinking about telehealth in light of Covid-19 and its place in
- [New Commercial Models for the New Hospital Customer](https://nai-consulting.com/new-commercial-models-for-the-new-hospital-customer/) - Facing lower reimbursements and growing demands for price transparency, hospitals are demanding more evidence of differentiated value as they select medical device products. Moreover, hospitals are seeking performance guarantees and other risk-sharing arrangements in the hopes that they can offset the financial risks they are assuming by adopting population health management and new payment models.
- [Managing Portfolios to Deliver Economic and Clinical Value](https://nai-consulting.com/managing-portfolios-to-deliver-economic-and-clinical-value/) - Economic and clinical value has become the basis for both differentiation and maintaining premium pricing, and the importance of the economic and clinical value case is likely only to increase. This trend is truly global in scope, applies to multiple key stakeholder groups (payers, physicians, and patients), and is particularly apparent in high-cost therapeutic areas
- [Market Access in China](https://nai-consulting.com/market-access-in-china/) - Many pharmaceutical manufacturers consider China as one of the most important strategic markets for future growth. It’s the second largest market in the world after the United States. More importantly, China currently accounts for less than 3% of global revenue for most major pharmaceutical companies, leaving significant opportunity for expansion and growth.1 China is more
- [Navigating Emerging Markets – Southeast Asia](https://nai-consulting.com/navigating-emerging-markets-southeast-asia-2/) - Southeast Asia is a growing pharmaceutical market. Much like Latin America, the countries of southeast Asia, especially the members of the Association of Southeast Asian Nations (ASEAN: Brunei, Burma, Cambodia, Indonesia, Laos, Malaysia, the Philippines, Singapore, Thailand, and Vietnam), have taken initial steps towards seeking more harmonized regulation of pharmaceutical and medical device industries. However,
- [Telehealth After Covid-19 - There’s No Turning Back](https://nai-consulting.com/telehealth-after-covid-19-theres-no-turning-back/) - Well before Covid-19 came on the scene, telehealth had earned its stripes as a cost-effective care delivery and population health platform. Despite numerous benefits, telehealth’s potential was marginalized by the lobbying efforts of hospitals, medical associations, and specialists seeking to defend their turf and the lucrative nature of current fee-for-service payment models. However, Covid-19 has
- [Case Study: Developing Medical and Scientific Narratives to Support Product Differentiation](https://nai-consulting.com/case-study-developing-medical-and-scientific-narratives-to-support-product-differentiation/) - This leading global pharmaceutical company recognized the need for an approach to ensure continued product differentiation in light of downward reimbursement pressure and changes in product decision making. Numerof was engaged to establish differentiated scientific and medical narratives for key components of the portfolio, including in-market and soon to launch products.
- [Coronavirus' Silver Lining - Innovation in Healthcare](https://nai-consulting.com/coronavirus-silver-lining-innovation-in-healthcare/)
- [The Problem with Half-Truths about Coronavirus](https://nai-consulting.com/the-problem-with-half-truths-about-coronavirus/)
- [Sensationalizing COVID-19: Why the Facts are Critical for Healthcare Delivery](https://nai-consulting.com/sensationalizing-covid-19-why-the-facts-are-critical-for-healthcare-delivery/)
- [In Healthcare the Problem isn't Competition, It's Lack of Transparency](https://nai-consulting.com/in-healthcare-the-problem-isnt-competition-its-lack-of-transparency/)
- [It's Been 10 Years Since the ACA Passed: What's Been the Impact?](https://nai-consulting.com/its-been-10-years-since-the-aca-passed-whats-been-the-impact/)
- [Coronavirus: Strategic Questions Underlying the Outbreak](https://nai-consulting.com/coronavirus-strategic-questions-underlying-the-outbreak/)
- [Epic Carries on an Industry Tradition: Resistance Masquerading as Patient Advocacy](https://nai-consulting.com/epic-carries-on-an-industry-tradition-resistance-masquerading-as-patient-advocacy/) - A few short months after Google came under fire for not being forthright about Project Nightingale – its data-sharing partnership with Ascension – EHR vendor Epic Systems warned hospitals that it would halt further work with the company’s cloud-based system, aligning itself with the many individuals who felt the partnership violated patient rights. This was
- [Thinking Beyond the Rebate Debate: Strategies to Bring Value to Healthcare](https://nai-consulting.com/thinking-beyond-the-rebate-debate-strategies-to-bring-value-to-healthcare/)
- [What's Causing Providers' Slow Shift to Value? A Deeply Ingrained Business Model](https://nai-consulting.com/whats-causing-providers-slow-shift-to-value-a-deeply-ingrained-business-model/) - There are myriad reasons why providers have yet to adopt the risk-based arrangements that add value to care delivery, 2 of the latest claims being a lack of adequate data and quality-measure incentives. However, statements like these largely reflect resistance. Most have more data than they realize, and they have the capacity to design and
- [IDNs - 3 Things Manufacturers Need to Know](https://nai-consulting.com/idns-what-manufacturers-need-to-know/) - One of the most rapidly emerging trends in healthcare is the formation of integrated delivery networks (IDNs). Manufacturers must understand what's unique about these large networks and how they're different from traditional providers.
- [As Business and Payment Models Evolve, Nimbleness Trumps Scale](https://nai-consulting.com/as-business-and-payment-models-evolve-nimbleness-trumps-scale/) - In February, Dallas-based health systems Baylor Scott & White and Memorial Hermann decided to call off a proposed merger, claiming they were “capable of achieving [their] visions for the future without merging at this time.” What looks like a bit of face-saving public relations language might be truer than it immediately appears.
- [CMS' RFI Will Shine a Light on Fundamental Issues with Hospital Accreditation](https://nai-consulting.com/cms-rfi-will-shine-a-light-on-fundamental-issues-with-hospital-accreditation/) - Hospitals keep making preventable mistakes, and patients continue to pay the ultimate price for them. Just before the new year, an update of the investigation by The Wall Street Journal found that more than 100 psychiatric hospitals hold their accreditation despite safety violations, 16 percent of them severe. Why is this still happening, especially when we
- [‘Disruption’ Defined Healthcare in 2019. 2020 Will Be About Acceleration](https://nai-consulting.com/disruption-defined-healthcare-in-2019-2020-will-be-about-acceleration/) - It’s nearly 2020, and those healthcare providers that are struggling are, for the most part, clinging to their dying business models in an effort to manage shrinking revenues. The majority of hospitals continue to operate as they always have, and hospital groups like the American Hospital Association (AHA) continue threatening legal action to block changes
- [The AHA is Suing the Trump Administration, But Here’s Why It’s a Losing Strategy](https://nai-consulting.com/the-aha-is-suing-the-trump-administration-but-heres-why-its-a-losing-strategy/) - In a last-ditch attempt to preserve their historic practice of charging whatever the market will bear, almost always after the fact, U.S. hospitals filed a lawsuit against the Trump administration over its proposed Transparency in Coverage rule. The suit, brought by the American Hospital Association (AHA) trade group, isn’t surprising. Hospitals have long resisted efforts
- [Walgreens Closes Nearly 160 Walk-In Clinics – What It Means for Retail Healthcare](https://nai-consulting.com/walgreens-closes-nearly-160-walk-in-clinics-what-it-means-for-retail-healthcare/) - Walgreens made headlines recently with the news that it was getting out of the walk-in clinic business. The news sparked interesting reactions across the industry. Some pundits pointed to managerial missteps; healthcare delivery insiders breathed a sigh of relief, while others shot a knowing smile that said, “I told you so. Healthcare is complex and
- [Payers Will Put an End to The AHA’s Predictable Resistance to Site-Neutral Payments](https://nai-consulting.com/payers-will-put-an-end-to-the-ahas-predictable-resistance-to-site-neutral-payments/) - As a spectator of the tug-of-war between the Centers for Medicare and Medicaid Services (CMS) and the American Hospital Association (AHA) for some years now, all I can do is shake my head at the industry group’s dug-in opposition to change. In the latest face-off between the two entities, the AHA is again looking to
- [Healthcare’s ‘Bigness’ Solution Was A Half-Truth](https://nai-consulting.com/healthcares-bigness-solution-was-a-half-truth/) - A decade ago, pundits were beating the drum about “bigness,” saying things like: “You need to get bigger.” “You need to have scale.” “You need local market dominance to matter.” Similarly, healthcare leaders were told: “This is the only way to get to value.” “This is the only way to successfully invest in the technology
- [Healthcare "Excellence" Will Only Come from a Better Business Model](https://nai-consulting.com/healthcare-excellence-will-only-come-from-a-better-business-model/) - Consumers’ dissatisfaction with our current healthcare system has existed for years, yet we still hope and pray it gets better. Instead of waiting for the industry to fix itself, some employers—whose health plans allow most Americans to afford healthcare services—have taken matters into their own hands. They’ve chosen to dedicate substantial time, money and resources
- [Big Pharma Needs a Better Business Model, Not More Legislation](https://nai-consulting.com/big-pharma-needs-a-better-business-model-not-more-legislation/) - When the Trump administration dropped the drug rebate rule it introduced back in January – a rule that intended to prohibit pharmacy benefit managers (PBMs) from pocketing some of the rebates they should be passing along to patients – the decision sent shockwaves through the healthcare industry, particularly the pharma sector. PBMs were obviously pleased,
- [Timid Federal Health Care Policy Sets Digital Innovators Up for Failure](https://nai-consulting.com/timid-federal-health-care-policy-sets-digital-innovators-up-for-failure/) - According to our fourth-annual State of Population Health Survey, progress toward such accountability has stalled. In large part, this is because progress requires providers to choose to put some portion of their revenues at risk, based on their ability to manage cost and quality. Years of pilot programs by the Department of Health and Human Services
- [All of Us Are Impacted by These 3 Healthcare Startup Mistakes](https://nai-consulting.com/all-of-us-are-impacted-by-these-3-healthcare-startup-mistakes/) - The healthcare industry is ripe with opportunity. It’s a $3 trillion market whose customers mostly feel they pay too much for what they get. The growing linkage of provider reimbursement to cost and outcomes creates room for innovators whose product or service can lower cost or improve outcomes. This is why we’ve seen significant moves
- [No Business – Especially Healthcare – Can Afford to Take “Baby Steps”](https://nai-consulting.com/no-business-especially-healthcare-can-afford-to-take-baby-steps/) - Healthcare is an industry in transition, being slowly prodded along by ever-increasing public scrutiny over cost and quality. Unfortunately, this transitory phase feels endless, as the obvious solutions—ending fee-for-service and connecting payments to outcomes—seem to remain forever out of reach.
- [These Three Things Will Solve Surprise Bills Better Than Any New Legislation](https://nai-consulting.com/these-three-things-will-solve-surprise-bills-better-than-any-new-legislation/) - There’s been a whole lot of talk – and a little bit of action – concerning surprise bills recently. Vox and Kaiser Health News, the latter in partnership with NPR, initiated these conversations by shining a light on so-called “balance billing” with their respective hospital ER bills and bill of the month series. When President
- [Cultivating Physician Leaders of the Future](https://nai-consulting.com/cultivating-physician-leaders-of-the-future/) - Driven by unsustainable cost increases, increased public and regulatory scrutiny, as well as shifting alliances, healthcare is undergoing a radical transformation. New competitors, value-conscious employers and consumers, new technologies, changing payment models, and shrinking reimbursements are altering where and how care is delivered. As a result, healthcare organizations are under increasing pressure to deliver differentiated
- [ECV as Marketing Strategy: What Payer Changes Mean for Your Business](https://nai-consulting.com/economic-and-clinical-value-as-marketing-strategy/) - As payers around the globe increasingly demand more data regarding a product’s value - from comparative information to real-world evidence - companies will need to build the infrastructure and capability set to meet these demands. These changing requirements for reimbursement have implications that extend from product development through commercialization. To successfully adapt to these requirements, organizations
- [The Future of Care Isn’t in Your Hospital](https://nai-consulting.com/the-future-of-care-isnt-in-your-hospital/) - It’s a tough time to be a health system chief executive officer (CEO). Rising consumerism, new competition, and payment models designed to keep patients out of acute care are forcing hospital-centric enterprises to rethink their delivery models. Articles and news feeds rife with stories about hospital closings, layoffs, and the shuttering of underutilized services and
- [Case Study: Building a Strategic Approach to IDNs](https://nai-consulting.com/case-study-building-a-strategic-approach-to-idns/) - This global manufacturer had limited sales infrastructure for effectively engaging larger health systems and hospitals. They engaged Numerof to develop a comprehensive strategy for engaging and managing IDN accounts across the entire product portfolio.
- [Growing Your Market in a Value-Based World](https://nai-consulting.com/how-hospitals-can-grow-in-a-value-based-world/) - As part of their growth strategy, more hospital executives are seeking to extend the geographic reach of their centers of excellence.To do this successfully, they’ll need to move beyond the hospital-centric focus of past expansion efforts. They’ll need to build an efficient, high-quality-care model that spans the continuum; the marketing infrastructure to position it; and
- [Key Takeaways from Numerof's 4th Annual <i>State of Population Health</i> Survey](https://nai-consulting.com/key-takeaways-from-numerofs-4th-annual-state-of-population-health-survey/) - Numerof’s annual State of Population Health Survey is fast becoming the benchmark for change in healthcare delivery. Our fourth annual report reflects input from more than 500 executives across the country. To see some of the most important takeaways, download our Population Health Insights infographic.
- [Healthcare Culture is Slowing the Move Toward Population Health](https://nai-consulting.com/healthcare-culture-is-slowing-the-move-toward-population-health/) - Progress toward the implementation of population health as a model for organizing healthcare delivery appears to have stalled in 2018. Unfortunately, that’s the key finding from Numerof’s fourth annual State of Population Health survey, which revealed that organizations are well behind where, two years ago, they thought they’d be – especially when it comes to alternative
- [Population Health Adoption has Stalled, but Health Care is on the Brink of Change](https://nai-consulting.com/population-health-adoption-has-stalled-but-health-care-is-on-the-brink-of-change/) - The writing is on the wall: Today’s health care system is antiquated and inefficient, and industry leaders can’t shy away from change. Alongside local, state and federal officials, consumers and business owners outside the health care sector are demanding answers — questioning outrageous hospital bills and prescription drug prices, plus wondering why they pay so much for “sick
- [Building the Infrastructure to Support Value-based Care](https://nai-consulting.com/building-the-infrastructure-to-support-value-based-care/) - Mounting pressure to deliver better care at lower cost is driving profound change across healthcare. Consolidation, new sources of competition, and new payment models like bundled pricing and population health demand new priorities in operational and strategic management. Success will depend on leadership realigning organizational expectations and accountabilities with the requirements of a value-based approach.
- [Case Study: Bringing Value-Based Services to Market](https://nai-consulting.com/case-study-bringing-value-based-services-to-market/) - A leading regional healthcare system faced intense pressure to raise quality, reduce costs, and increase revenue, and engaged Numerof to structure a value-based care delivery model to address these challenges.
- [Case Study: Developing an ECV Framework and Portfolio Risk Assessment](https://nai-consulting.com/developing-an-ecv-framework-and-portfolio-risk-assessment/) - A global biotechnology market leader became concerned by a new level of buyer resistance its sales teams were facing. The company worked with Numerof to undertake a portfolio-wide assessment of the strength of the economic and clinical effectiveness message being delivered to key stakeholders.
- [Case Study: Creating a Differentiated Value Case](https://nai-consulting.com/case-study-creating-a-differentiated-value-case/) - This nationally recognized healthcare system had determined that early adoption of bundled pricing offered potential for competitive differentiation and engaged Numerof to assess their readiness, and to define/support implementation of this change.
- [Case Study: Building the Economic Case for a Novel Medical Device](https://nai-consulting.com/building-the-economic-case-for-a-novel-medical-device/) - An early phase manufacturer developed an innovative medical device and was rapidly gaining market traction and generating impressive sales. Facing the growth of bundled and capitated payment plans, the company engaged Numerof to develop a compelling economic and clinical effectiveness case to support product sales, and improve the company's valuation and attractiveness as an investment.
- [Accelerating the Shift of Care to Lower Cost Settings](https://nai-consulting.com/accelerating-the-shift-of-care-to-lower-cost-settings/) - The migration of care from inpatient (IP) to outpatient (OP) and ambulatory surgery center (ASC) settings is revolutionizing healthcare delivery. The trend began with cataract and cosmetic surgery moving from IP to OP and ASC settings more than a decade ago, and now the list of ASC procedures has grown to include endoscopy, colonoscopy, ACL
- [Case Study: Differentiating a New MOA in a Crowded Therapeutic Area](https://nai-consulting.com/differentiating-a-new-moa-in-a-crowded-therapeutic-area/) - A global pharmaceutical company acquired a newly approved product with a unique MOA and needed to prove its economic and clinical value to decision makers that were generally satisfied with available, cheaper alternatives. Numerof conducted a thorough assessment to identify new claims and supporting data that could be used to influence purchase decisions.
- [Service Line Management in Healthcare](https://nai-consulting.com/service-line-management-in-healthcare/) - The term service line management refers to the healthcare industry’s version of a longstanding marketing approach called product management. Since its inception in the 1950s, the product management approach has been employed with varying degrees of success by many for-profit businesses. It has been effective in both industrial and consumer products industries, but only when
- [What Service Lines Are Really Supposed to Do](https://nai-consulting.com/what-service-lines-are-really-supposed-to-do/) - Delivery organizations face growing pressure to raise quality, reduce costs and increase revenues in an environment of reimbursement constraints, demographic shifts and accelerating technological change. New types of competition are emerging, more nimbly developing better business models that "cherry pick" the highest margin business. And as patients bear more responsibility for the cost of care,
- [Rethinking Service Lines in a Value-Based World](https://nai-consulting.com/rethinking-service-lines-in-a-value-based-world/) - The U.S. healthcare landscape is rapidly being reshaped by a variety of economic, political, and socio-demographic forces. While the issue of health insurance has dominated much of the national dialogue, most agree that changing the way that healthcare is delivered and paid for is needed to get to better care at lower cost. As providers
- [Building Value Considerations into R&D](https://nai-consulting.com/building-value-considerations-into-rd/) - With spiraling cost inflation and lagging quality indicators driving a transition to a value-based system, public and private payers are using sophisticated tools, including health technology assessment (HTA), to evaluate the benefits of the products they buy. In this environment, companies must demonstrate both clinical efficacy and differentiated economic value to gain optimal payer reimbursement
- [Three Keys to Defending Your Margins](https://nai-consulting.com/three-keys-to-defending-your-margins/) - Healthcare consolidation took a new turn this year, and in a big way. On top of deals by Anthem and Optum to acquire delivery operations, the formation of the Amazon, Berkshire Hathaway, and JP Morgan (ABJ) healthcare partnership has raised anxiety to unprecedented levels. Margin compression was already a fact of life. But the entry
- [Economic and Clinical Value: Key Drivers For New Product Development Strategy](https://nai-consulting.com/economic-and-clinical-value-key-drivers-for-new-product-development-strategy/) - To be successful in today’s dynamic and increasingly cost conscious healthcare environment requires companies to fundamentally change the way they think about their products. Companies need to develop an understanding of how their products contribute to improved clinical outcomes against existing therapies and what data they will need to prove it. Government agencies are increasingly
- [4 Cultural Challenges of Bundled Pricing](https://nai-consulting.com/4-cultural-challenges-of-bundled-pricing/) - Historically, a cardinal rule guiding decision making in hospitals was that administrators made decisions on administrative matters, but decisions impacting physicians and their practice of medicine could only be made by other physicians. However, as organizations respond to current cost and quality pressures by making pricing more transparent through bundling of services, these cultural norms
- [Ready for Risk Sharing? Challenges and Implications for Manufacturers](https://nai-consulting.com/ready-for-risk-sharing-challenges-and-implications-for-manufacturers/) - With spiraling costs and outcomes that consistently lag many other developed nations, the U.S. healthcare system is in the midst of fundamental change. In response, payers have been exploring ways to restructure payments (and risk) to increase accountability for cost and quality. Thus far, most activity has occurred between payers and providers through such mechanisms
- [Building a Differentiated Center of Excellence](https://nai-consulting.com/building-a-differentiated-center-of-excellence/) - Along almost every major urban expressway, billboards extoll the virtues of leading area medical institutions. Smiling faces accompanied by messages like “We put our patients first”, or “Ranked #1 in cardiac care for the 5th straight year” are designed to reassure potential patients that they needn’t look further for outstanding medical care. Hospital marketing departments
- [Unlocking the Value of Clinically Integrated Networks](https://nai-consulting.com/unlocking-the-value-of-clinically-integrated-networks/) - There are a number of strategic reasons for establishing a clinically integrated network (CIN), but there is only one that offers a path to sustainability. That reason is to provide a competitive vehicle for contracts with payers and employers that would otherwise be unavailable because of legal constraints. Indeed, CINs that have no contracts and
- [Succeeding Today While Preparing for Tomorrow](https://nai-consulting.com/succeeding-today-while-preparing-for-tomorrow/) - With a lot of uncertainty about the future, hospital leaders are asking: What's the best way forward? How do I succeed in today's fee-for-service system while preparing for — but not getting too far ahead of — value-based payment? The question has become more pressing since the Centers for Medicare & Medicaid Services and leading
- [Five Steps to Monetizing the Value of Your Care](https://nai-consulting.com/five-steps-to-monetizing-care-model-value/) - The time has come for organizations with superior outcomes to translate that critical asset into revenue. From defining your care model to refining your processes, here is how to monetize care value. Olmsted Medical Center's 80,000-square-foot Women's Health Pavilion assembles all women's health services under one roof. Offering a high-quality, cost-effective patient experience, the pavilion
- [Real World Evidence: Making the Case for Market Access](https://nai-consulting.com/pharma-brief-10-real-world-evidence-making-the-case-for-market-access/) - The pharmaceutical, biotech and medical device industries are facing a list of unprecedented challenges led by the global economic crisis and concerns about escalating healthcare costs. A series of well-publicized recalls and regulatory settlements have left policymakers and consumers questioning the safety of medical products and their trust in manufacturers. Related to all of this
- [What You Need to Know about Late-Stage Clinical Trials (Pharma)](https://nai-consulting.com/pharma-brief-12-what-you-need-to-know-about-late-stage-clinical-trials/) - The global market for pharmaceuticals continues to grow as manufacturers move to expand their market strategy and product pipeline to new markets and therapeutic areas. Increasing globalization has fueled changes in the regulatory environment, including increased data requirements at the various stages of product development, validation, approval, and production. Additionally, numerous recalls and regulatory settlements
- [What You Need to Know about Late-Stage Clinical Trials](https://nai-consulting.com/medical-device-brief-15-what-you-need-to-know-about-late-stage-clinical-trials/) - The global market for medical devices continues to grow as manufacturers move to expand their market strategy and product pipeline to new markets and therapeutic areas. Increasing globalization has fueled changes in the regulatory environment, including increased data requirements at the various stages of product development, validation, approval, and production. Additionally, numerous recalls and regulatory
- [How to Pick the Right Provider Partner for a Value-Based Care Arrangement](https://nai-consulting.com/how-to-pick-the-right-provider-partner-for-a-value-based-care-arrangement/) - As the healthcare industry continues to move toward value-based delivery and payment models, payers must rethink the way they engage with provider partners. Building new payer-provider collaborations will be critical to success in a value-based healthcare world where both parties share financial risk for achieving health outcomes. Under such models, payers and providers have incentives
- [What MACRA Means for Healthcare Executives](https://nai-consulting.com/what-macra-means-for-healthcare-executives/) - Recent announcements from CMS regarding the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) have the healthcare community buzzing. It’s not surprising considering this piece of legislation represents the most sweeping set of changes to Medicare’s physician payment methodology since the current system was put in place 25 years ago. MACRA is also yet
- [Value-Based Payment Models: Implications for Medical Device Manufacturers](https://nai-consulting.com/value-based-payment-models-implications-for-medical-device-manufacturers/) - The healthcare industry is facing enormous pressure in the form of spiraling cost inflation, lagging quality indicators, rising insurance premiums, and increased demand for price transparency to deliver better health outcomes at lower prices. The historical fee-for-service business model that rewards the volume of treatments and encourages unnecessary care without reference to outcomes is being
- [The Role of Post-Market Studies in Market Access](https://nai-consulting.com/the-role-of-post-market-studies-in-market-access/) - As payers and providers continue to explore ways to reduce healthcare spending and improve patient outcomes, there is a growing trend to require more evidence of product safety and effectiveness across the product lifecycle. For manufacturers, the failure to develop such data can result in reduced formulary access and lower reimbursement by payers and providers.
- [To Remain Independent or Not?  That is the Question](https://nai-consulting.com/to-remain-independent-or-not-that-is-the-question/) - Provider consolidation has been accelerating at a rapid clip in the healthcare industry in recent years. In fact, the pace has increased 14% on average in each of the last seven years, impacting all delivery system types.1 “Mega-mergers” involving combined assets of 2B or more are growing more frequent, too. These have typically averaged four per
- [4 Steps to Successful Collaborative Relationships with Downstream Providers](https://nai-consulting.com/4-steps-to-successful-collaborative-relationships-with-downstream-providers/) - On the morning of April 1, hospital executives in 800 hospitals in 67 selected market service areas across the U.S. will wake up to a new model of orthopedic bundled pricing. The pending implementation of CMS's Final Rule for the Comprehensive Care for Joint Replacement (CJR) model will force business model change on at least
- [Why Post-Acute Care Partners Are Critical to Hospitals' Future](https://nai-consulting.com/why-post-acute-care-partners-are-critical-to-hospitals-future/) - Health care executives are facing new management challenges as payers shift more risk to providers. As evidenced by the Bundled Payments for Care Improvement initiative and, most recently, the Comprehensive Care for Joint Replacement model, hospitals are being pushed to assume greater risk for care episodes. This risk can extend well beyond the acute care
- [Preferred Provider Partnership System™](https://nai-consulting.com/preferred-provider-partnership-system/) - Your post-acute care network is becoming a key factor in quality and financial outcomes. Have you built the infrastructure to manage it effectively?
- [Feeding a Board’s Appetite for Strategy](https://nai-consulting.com/feeding-a-boards-appetite-for-strategy/) - The first half-decade of the 21st century has witnessed a dramatic sea-change in the expectations for corporate boards and their role in governance. In light of major securities scandals and the government’s response to them – particularly the Sarbanes-Oxley Act – much of the focus has been on compliance and the board’s fiduciary responsibility for
- [Payer-Provider Collaboration: Time to Bury the Hatchet](https://nai-consulting.com/payer-provider-collaboration-time-to-bury-the-hatchet/) - In the healthcare industry, the relationship between payers and providers has long been adversarial--and it's become counterproductively so. Financially unsustainable Affordable Care Act exchanges and CO-OPs are collapsing all over the country (seven since Oct. 1 alone). Major player UnitedHealth Group is threatening to withdraw from the marketplaces entirely in 2017, citing half a billion
- [Rethinking Customers and Products](https://nai-consulting.com/rethinking-customers-and-products/) - As the financial dynamics of the healthcare industry have become increasingly challenging, much of the healthcare insurance industry has defined its strategic response as doing what it’s always done, but for less. Insurers have gotten tougher in negotiations with providers and employers in order to pay for less. And repeated internal cost cutting efforts have
- [Why Population Health?](https://nai-consulting.com/why-population-health/) - Understanding what population health means and how to get there will be critical for all specialties. However, the recent launch of the Comprehensive Care for Joint Replacement initiative, the first compulsory bundled payment program coming out of CMS, amplifies the need for the orthopaedic community to understand what it means to operate in this new
- [Payment Reform: A Primer for Taking on Risk](https://nai-consulting.com/payment-reform-a-primer-for-taking-on-risk/) - Our healthcare system today is broken in large part because of how we pay for it. Our fee-for-service legacy gives providers an incentive to deliver as many exams, tests, and treatments and fill as many beds as possible. But as we know, piling on services does not equate to high-quality care. The new payment and
- [MACRA Readiness Assessment](https://nai-consulting.com/macra-readiness-assessment/) - Is your organization ready for prepared for success under MACRA?
- [Payment Reform: Preparing to Go At-Risk](https://nai-consulting.com/payment-reform-preparing-to-go-at-risk/) - Episode-based (bundled) or capitated payment for delivery of quality care across multiple providers can be a significant stimulus of lower costs and improved clinical outcomes. Implicit in such approaches is that it incentivizes better care coordination and cost-effective decision making. The flip side of this equation is, of course, that provider organizations take on some
- [A New Day is Dawning: What Manufacturers Can Expect from a Trump Administration](https://nai-consulting.com/a-new-day-is-dawning-what-manufacturers-can-expect-from-a-trump-administration/) - The results of the recent presidential election caught many by surprise, including much of the healthcare industry. Given her track record as first lady, senator, and secretary of state, many felt they knew what to expect from a Clinton administration and were building plans for it. However, a Trump win has left many wondering what
- [Theranostics: The Way Forward?](https://nai-consulting.com/theranostics-the-way-forward/) - Governments and commercial payers across the world are hitting the wall with respect to healthcare costs. Drug costs have spiraled out of control especially in the area of specialty medicine. As physicians treat complex and chronic diseases, such as cancer, they’re using increasingly expensive specialty medicines and treatment regimens. But they face another challenge. While
- [Barriers to Realizing Biosimilars’ Potential](https://nai-consulting.com/barriers-to-realizing-biosimilars-potential/) - For quite some time, providers, public and private payers, policy-makers, pharmacy benefit managers and patients have hoped the arrival of biosimilars would usher in a new era of competitive drug prices. However, as the U.S. market prepares to welcome its second biosimilar, Celltrion’s Inflectra, the future of biosimilars in this country remains unclear. Barriers that
- [Adapting the Commercial Process to the Evolving Healthcare Delivery Landscape](https://nai-consulting.com/adapting-the-commercial-process-to-the-evolving-healthcare-delivery-landscape/) - In July 2016, CMS’ announced that it plans to initiate a mandatory bundled-payment program in cardiology that parallels its current orthopedic bundled pricing program. This is another indication of CMS’ commitment to alternative payment models that make delivery organizations financially accountable for the cost and quality of care they provide. As healthcare delivery organizations prepare
- [Taking the Leap into Provider-Owned Health Plans](https://nai-consulting.com/taking-the-leap-into-provider-owned-health-plans/) - Provider-owned health plans are commanding a larger share of the strategic dialogue in hospital boardrooms. POHPs aren’t a new phenomenon. Emerging from a history of mixed success in the 1980s and '90s, they have gained popularity as the industry moves from volume- to value-based payment and as risk shifts from payers to providers. For providers,
- [Six Actions to Prepare for a Transparent World](https://nai-consulting.com/six-actions-to-prepare-for-a-transparent-world/) - Greater transparency is coming to the healthcare delivery industry. The current spotlight is on the new (and controversial) overall hospital quality ratings from the Centers for Medicare and Medicaid Services (CMS) – but the introduction of this rating system isn't just a passing fad, it's a sign of the times. Consumers can already access key
- [The Role of Finance in Managing Variation in Clinical Cost and Quality](https://nai-consulting.com/the-role-of-finance-in-managing-variation-in-clinical-cost-and-quality/) - As a response to mounting healthcare costs and concerns about the quality of the care those dollars are buying, payers increasingly are exploring ways to bend the cost curve and improve quality to yield greater value. For healthcare delivery organizations in this environment, strategic alignment with clinicians has never been more important. Both public and
- [Numerof’s Precision Diagnostic<sup>™</sup>](https://nai-consulting.com/numerofs-precision-diagnostic/)
- [Hospital Star Ratings Show Patients, Providers That Not All Care Is Equal](https://nai-consulting.com/hospital-star-ratings-show-patients-providers-that-not-all-care-is-equal/) - It’s not as user-friendly as Consumer Reports, but the Centers for Medicare & Medicaid Services’ overall star rating system represents progress in getting data into the hands of health care consumers. And despite some methodological shortcomings, it puts providers on their toes, which is a good thing. On July 27, CMS published one-to-five-star ratings of
- [Engaging Physicians to Improve Quality and Lower Costs](https://nai-consulting.com/engaging-physicians-to-improve-quality-and-lower-costs/) - Reform is driving an industry redefinition of "value" that challenges traditional healthcare business models. As demand for better outcomes at lower cost continues to grow, healthcare organizations that lack evidence-based value propositions will struggle to compete. In order to adapt to this new environment, healthcare executives will need to move their institutions toward a new
- [Disrupt Yourself or Be Disrupted: Insurers’ Role in Changing the Business Model](https://nai-consulting.com/disrupt-yourself-or-be-disrupted-insurers-role-in-changing-the-business-model/) - Let’s face it: Insurers are the one segment of the health care sector that everyone has loved to hate. Employers blame insurers for rising premiums; physicians and hospitals blame them for their declining reimbursement rates; consumers blame them for lack of sufficient coverage; and policymakers think they make too much money. As if being at
- [5 Tips On How To Compete in Bundled Care Environment](https://nai-consulting.com/5-tips-on-how-to-compete-in-bundled-care-environment/) - On the morning of April 1, hospital and medical device company executives woke up to yet another new chapter in bundled pricing — CMS’ Comprehensive Care for Joint Replacement (CJR) initiative. Unlike the Bundled Payments for Care Improvement (BPCI) programs that preceded it, there is no opt-out clause for the 800 hospitals designated as participants
- [Population Health and Its Implications for Manufacturers](https://nai-consulting.com/population-health-and-its-implications-for-manufacturers/) - It's no secret that the global healthcare industry is increasingly challenged to reduce costs while still delivering innovative, high-quality care. This transition toward a value-based framework for healthcare delivery and payment is the driving force behind today's rapidly changing healthcare landscape. In past columns, I’ve discussed the growing importance of “population health” in the journey
- [Money-Back Guarantee: The New Trend in Drug and Device Marketing](https://nai-consulting.com/money-back-guarantee-the-new-trend-in-drug-and-device-marketing/) - Imagine buying a new car only to learn that it doesn’t work as advertised and there’s nothing you can do about it. That’s essentially what happens when you take a pricey medication or need an expensive medical device like a heart valve or new knee — there’s no guarantee it will work and you won’t
- [Star Ratings Delayed, But Need for Transparency Remains](https://nai-consulting.com/star-ratings-delayed-but-need-for-transparency-remains/) - Hospital industry lobbyists earned their money recently when the Obama administration bowed to Congressional pressure and delayed the release of a new system to rate hospitals based on health outcomes for patients treated under Medicare. The delay is likely to be just a short-term respite for the industry. Hospital ratings – whether based on patient
- [3 Strategies for Changing the Health Insurance Business Model](https://nai-consulting.com/3-strategies-for-changing-the-health-insurance-business-model/) - In the face of a market-wide demand for lower costs, many of the players in the healthcare space have defined their strategic response as doing what they've always done--but for less. After decades of financial success, it's difficult to think about meaningfully changing the business model. For their part, insurers have gotten tougher in negotiations
- [The Evolving War on Drug Prices](https://nai-consulting.com/the-evolving-war-on-drug-prices/) - Over the past few years, the war on drug prices has intensified and been marked by a series of signal events—for example, oncologists publically refusing to allow a pricey new therapy such as Sanofi’s Zaltrap on their formulary, and pharmacy benefit managers (PBMs) (e.g., Express Scripts) and governments (e.g., the United Kingdom’s National Health System)
- [Rising to the Challenge of Transparency: Key Next Steps for Healthcare Leaders](https://nai-consulting.com/rising-to-the-challenge-of-transparency-key-next-steps-for-healthcare-leaders/) - The healthcare delivery world is rapidly becoming more transparent. Efforts by consumers, the government, and private institutions to make price and quality data available are growing – and they will transform how healthcare executives think and operate. Neither a hard-earned reputation nor brand equity purchased with expensive advertising are enough to maintain consumers’ trust. Increasingly,
- [Building Value for Payers, Patients, and Physicians](https://nai-consulting.com/building-value-for-payers-patients-and-physicians/) - An aging population, technological advances, and societal attitudes regarding what health care can and should be delivered to all members of society have produced rapidly rising health care costs. As a consequence, there is a major global trend toward more stringent assessment of the costs and benefits of treatments produced by the pharmaceutical and medical
- [Market Segmentation in the New Healthcare Landscape](https://nai-consulting.com/market-segmentation-in-the-new-healthcare-landscape/) - Increasingly, pharmaceutical companies are being asked – if not required – to demonstrate that their products deliver economic and clinical value to a wide range of stakeholders, including payers, providers, pharmacy benefit managers (PBMs), and patients. In the past, regulatory approval alone was sufficient to successfully bring a new product to market (with subsequent reimbursement
- [Critical Management Tools for Getting Costs Under Control](https://nai-consulting.com/critical-management-tools-for-getting-costs-under-control/) - As the national debate continues over spending, deficits, taxes and the fiscal direction of he country, one point of general agreement is that fundamental change to the American healthcare system is needed: healthcare costs must be brought under control. As hospitals grapple with ways to adapt, physician leaders have a critical role to play. Only clinical
- [Medical Device Marketing: Successful Approaches to Market Segmentation](https://nai-consulting.com/medical-device-marketing-successful-approaches-to-market-segmentation/) - In our continuing series on the topic of market transformation within the pharmaceutical and medical device industry, we have highlighted the need for a more sophisticated, strategic approach to market segmentation. Several factors are combining to require successful companies to approach market segmentation more effectively. These factors include market dynamics, shifts in the power of who
- [7 Steps to Population Health](https://nai-consulting.com/7-steps-to-population-health/) - In an effort to broaden availability of healthcare insurance coverage and to control spiraling premiums and underlying costs, Congress passed the Patient Protection and Affordable Care Act (PPACA) in 2010. While the law’s ability to address these issues has been called into question, the legislation was ultimately an indicator of broad dissatisfaction with an expensive
- [The Path to Population Health](https://nai-consulting.com/the-path-to-population-health/) - Healthcare in the U.S. is being challenged from all fronts, with changes in regulations, reimbursement, competition… and even the definition of the consumer. This shifting environment has caused considerable economic concern among all of the stakeholders: providers and physicians are worried about revenues, and payers and patients are worried about the quality and affordability of
- [The Challenges Facing Dr. Population Health](https://nai-consulting.com/the-challenges-facing-dr-population-health/) - The bad news continues daily. Current generations are on track to live less healthy lives than previous generations for the first time in history. Yet healthcare costs keep rising. As the industry tackles this challenge, the “population health” buzz is everywhere—and it means different things to different people. It means promoting prevention and wellness to
- [Toward Population Health Management](https://nai-consulting.com/toward-population-health-management/) - Unsustainable growth of health costs along with inconsistent clinical outcomes has forced the U.S. to reevaluate how healthcare is delivered. Healthcare costs have grown from 7.2% of GDP in 1970 to 17.9% in 2009 and 2010. Despite this spending increase, Americans’ average life expectancy and the efficiency of our healthcare system are ranked near the
- [Getting to Population Health](https://nai-consulting.com/getting-to-population-health/) - Healthcare delivery organizations are in the midst of a broader industry shift that is forcing all stakeholders – providers, payers, and manufacturers of drugs and devices – to reduce the costs associated with care delivery, and to improve its quality. The pressure comes in part from recognition that the current rate of increase – from
- [Preparing for Population Health Management](https://nai-consulting.com/preparing-for-population-health-management/) - Although there have been modest successes in “bending the cost curve,” healthcare spending in the U.S. continues to reach unprecedented heights. Over the next decade, healthcare costs are on track to nearly double, going from $2.9 to $5.2 trillion.1 What’s worse is that while the U.S. spends far more per capita on healthcare than any
- [Leading Factors for Making the Transition to Population Health](https://nai-consulting.com/leading-factors-for-making-the-transition-to-population-health/) - It’s clear that the U.S. health care system is in need of significant change. Despite modest successes in “bending the cost curve,” health care spending is expected to expand from 17 to 19 percent of GDP in less than a decade1, 2, 3. What’s worse is that we’re generally not getting our money’s worth. According
- [Market Access Outlook for Canada](https://nai-consulting.com/market-access-outlook-for-canada/) - Canada remains the ninth largest pharmaceutical market in the world, close to Spain and the United Kingdom. Drug makers operating in Canada have benefited from high per capita spending on pharmaceuticals and rising procurement as a result of the country’s aging population. In 2014 alone, the country spent an estimated $28.8 billion on prescribed drugs.1
- [Navigating Emerging Markets -- Middle East and North Africa](https://nai-consulting.com/navigating-emerging-markets-middle-east-and-north-africa/) - The Middle East and North Africa have been rocked in recent years by upheaval ranging from moderate protest to full-scale revolution, leading to a variety of changes in government, and more changes to come. Still, medical products companies such as GE Healthcare have described the region as its “hidden jewel,” citing rapid spending growth by
- [Risk-Sharing Agreements in the EU and Considerations for Moving Forward](https://nai-consulting.com/risk-sharing-agreements-in-the-eu-and-considerations-for-moving-forward/) - Payers across the globe are becoming increasingly assertive regarding products whose costs aren’t in line with perceived performance—a trend that shows no signs of slowing down. In fact, Express Scripts, one on the largest pharmacy benefit managers (PBMs) in the United States, recently announced a plan that would link the price of some cancer drugs
- [Is Your Commercial Operation Ready for Healthcare 2.0?](https://nai-consulting.com/is-your-commercial-operation-ready-for-healthcare-2-0/) - The healthcare delivery market is undergoing dramatic change, adapting to survive in a much tougher business climate we call Healthcare 2.0. This should prompt pharma and medical device manufacturers to reevaluate the assumptions on which they’ve built their commercial model, or they risk falling behind the curve. Across the healthcare delivery landscape, virtually everything related to purchase
- [Preparing for an At-Risk Era](https://nai-consulting.com/preparing-for-an-at-risk-era/) - Hospital boards and C-suite executives have a major strategic decision to make in the near future: Should they go at-risk? Risk-based payment structures take on various forms. Some provide opportunities to share in savings when care is provided at a lower than expected cost (“upside risk”); others also demand financial penalties when costs exceed a
- [Making Joint Ventures Work](https://nai-consulting.com/making-joint-ventures-work/) - Ambivalence is common for hospital leaders considering a joint venture with a physician group. On one hand, there is fear that the new venture will bleed off the most profitable patients and leave the hospital to deal with the complicated, unprofitable ones. On the other hand, the new venture will probably get off the ground
- [6 Hurdles to Bundled Pricing](https://nai-consulting.com/6-hurdles-to-bundled-pricing/) - Bundled pricing represents an alternative approach to fee-for-service that shifts the risk of extraordinary costs from payers to providers, and it creates incentives for providers to make cost effectiveness a factor in clinical decisions. Both of these outcomes are attractive to payers, who increasingly have an interest in containing healthcare cost inflation. That’s why this
- [Implementing the Chronic Care Model: A Grassroots Approach](https://nai-consulting.com/implementing-the-chronic-care-model/) - Chronic diseases have largely replaced acute illness as the major driver of health care costs in the United States.1 However, most medical practices are organized along the transactional model established for treatment of acute illness, in which a single office visit is used to diagnose and treat an illness or injury. Under this model, chronic
- [Reference Pricing on the Horizon](https://nai-consulting.com/reference-pricing-on-the-horizon/) - The progression toward value-based care has enormous implications for manufacturers, influencing change in everything from pipeline investments to sales strategy. Two critical trends stemming from the move to value are the increasing role of the consumer, and demands for price and outcome transparency. Tapping into both of these trends is reference pricing – a practice
- [Does Accountable Care Require an ACO?](https://nai-consulting.com/healthcare-brief-9-does-accountable-care-require-an-aco/) - One consequence of the Patient Protection and Affordable Care Act is that it has everyone in the industry talking about ACOs: What exactly is an ACO? What infrastructure do we need to establish an ACO? Does it even make sense for our organization to become an ACO? These questions remain largely unanswered, which presents a
- [Accelerating Network Adoption of Bundled Pricing](https://nai-consulting.com/healthcare-insurance-brief-5-accelerating-network-adoption-of-bundled-pricing/) - In February 2014, the Centers for Medicare & Medicaid Services (CMS) announced it would consider additional health care organizations for participation in its Bundled Payments for Care Improvement (BPCI) initiative. CMS' continued support for this initiative clearly suggests that policy makers believe bundled payments holds promise for managing costs and improving quality. Private payers have
- [Adapting to the Evolving Healthcare Delivery Marketplace](https://nai-consulting.com/adapting-to-the-evolving-healthcare-delivery-marketplace/) - Earlier this year, HHS secretary Sylvia Burwell announced that by 2018, at least half of all Medicare payments would be made through programs that put providers at risk for quality, cost, or value. On the heels of that announcement came another by the Health Care Transformation Task Force that also vowed by 2020 to move
- [How to Address Cost Outliers](https://nai-consulting.com/how-to-address-cost-outliers/) - The spiraling costs of healthcare in the U.S. have precipitated a tangible backlash -- as demonstrated by the passage of the Patient Protection and Affordable Care Act in 2010 -- that suggests that demands for better care at lower cost are not simply going to go away. In light of this, it’s become critical for
- [Market Access Outlook for France](https://nai-consulting.com/market-access-outlook-for-france/) - In France, the pricing and reimbursement landscape is certainly changing. Take for instance the case of Gilead’s Hepatitis C blockbuster, Sovaldi. According to clinical trial data, 90% of patients for whom this drug is indicated for are for all intents and purposes cured upon treatment completion. A few years ago, Sovaldi would have likely been
- [Selling to IDNs: Strategies for Success](https://nai-consulting.com/selling-to-idns-strategies-for-success/) - Changes in healthcare delivery are rapidly undermining traditional pharmaceutical commercial models. Customers are fewer and larger as hospitals consolidate into integrated delivery networks in the face of rising cost pressures, stiffer financial penalties and the imperatives of healthcare reform.
- [Considerations for Risk Sharing Agreements](https://nai-consulting.com/considerations-for-risk-sharing-agreements/) - In a recent move that garnered considerable attention, Express Scripts, one of the largest pharmacy benefit managers (PBMs) in the US, announced a plan that would link the price of some cancer drugs to their real-world performance.1 Although this isn’t the first time that an alternative pricing model for drugs has been suggested, the timing of
- [Value Added Services: The Second Wave of Disease Management](https://nai-consulting.com/value-added-services-the-second-wave-of-disease-management/) - Pharmaceutical companies are facing numerous well documented challenges, including an evolving customer landscape, more restrictive formulary and reimbursement pressures, and technical hurdles to discovering and developing new products. As one strategy to offset declining revenues, companies are testing a variety of initiatives focused on creating value added services (VAS) for drugs and medical devices. The
- [From Volume to Value: Changing the Incentives in Healthcare Delivery](https://nai-consulting.com/from-volume-to-value-changing-the-incentives-in-healthcare-delivery/) - With healthcare costs spiraling out of control, and quality of care lagging behind other developed countries, there is general agreement in the U.S. that significant changes are needed in order to achieve better health outcomes at lower cost. Because there is some uncertainty about the “right” way forward, some have adopted a “watchful waiting” approach.
- [Retooling Your Sales Function to Ensure Market Access](https://nai-consulting.com/retooling-your-sales-function-to-ensure-market-access/) - Just as landmark scientific advances have accelerated the pace of innovation, rising costs and demands for affordable healthcare are challenging the economics and traditional business assumptions of the industry. Markets are becoming fragmented as physicians, providers, patients, and payers look for focused solutions that have optimal efficacy and safety profiles for narrower patient populations. Finally,
- [Key Considerations for Entering Into Risk Sharing](https://nai-consulting.com/key-considerations-for-entering-into-risk-sharing/) - Anyone looking at the healthcare system in the U.S. agrees that the dual goals of any reform have to be better outcomes at lower cost. However these two factors, cost and quality, have not previously been linked -- a situation that is almost unique to healthcare. Imagine purchasing a new car or appliance only to
- [When Care Models Collide](https://nai-consulting.com/when-care-models-collide/) - Healthcare companies are being challenged to reduce costs while delivering innovative, quality care. A host of factors—shrinking reimbursement, penalties for quality shortfalls, more assertive payers, and the increasing transparency of provider pricing—are challenging traditional operating assumptions. Some of these changes are mandated by recent legislation, and others are market responses to this fundamental mandate for
- [Cultural Challenges of Bundled Pricing](https://nai-consulting.com/cultural-challenges-of-bundled-pricing/) - Recent changes in the external healthcare environment have greatly altered the landscape in which hospitals operate. Strategies that may have worked for institutions in the past are no longer viable. Hospitals are being forced to do more with fewer resources, straining management and employees alike. The pace of change is accelerating, and traditional cultural expectations
- [Transparency, Transformation and Trust](https://nai-consulting.com/transparency-transformation-trust-and-trustees/) - Neither a hard-earned reputation nor brand equity purchased with expensive advertising are enough to maintain consumers’ trust. Increasingly, for non-emergent care, consumers want to know how much a procedure will cost, and they want to compare providers’ quality, safety and outcomes records. They want transparency, with essential information provided in a way that facilitates comparison
- [The Bullish Outlook for Biosimilars](https://nai-consulting.com/the-bullish-outlook-for-biosimilars/) - There are several important reasons for stakeholders to be optimistic about prospects for biosimilars. During the past few years, questions about the underlying technology and market acceptance have begun to resolve themselves in a positive manner. Regulatory pathways are being defined, and major players and investments are lining up. Most importantly, a number of patents
- [The Future of the U.S. Oncology Market](https://nai-consulting.com/the-future-of-the-u-s-oncology-market/) - Long taken for granted, premium oncology drug pricing is coming under fire. Payers are experimenting with new tools to manage oncology costs. Emerging reimbursement models separate physician income from prescribing decisions. Providers, payers, and patients are increasingly asking about cost-effectiveness, quality of life, and outcomes. Are you ready for the Future of the U.S. Oncology
- [Key Considerations for Successful Data Collaborations](https://nai-consulting.com/key-considerations-for-successful-data-collaborations/) - With the recent explosion of healthcare data in the U.S. as well as the announcement of several well-publicized partnerships between manufacturers and providers or payers, the emergence of data collaborations is currently one of the hottest trends in healthcare. It’s no secret that the pharmaceutical industry is facing a series of unprecedented challenges. Payers are
- [Market Access Outlook for Australia](https://nai-consulting.com/market-access-outlook-for-australia/) - The pharmaceutical industry is grappling with pressures including changing business models, a more competitive market, shifts in customers’ demands (e.g., patients and providers), major patent expiries, shifting technology, constrained budgets, increasing scrutiny from payers and regulators, and fundamental questions regarding the industry’s integrity. Many of these internal and external pressures exist in emerging and developed
- [Value-Based Healthcare in the UK](https://nai-consulting.com/value-based-healthcare-in-the-uk/) - Bio/pharmaceutical companies in the United Kingdom have recently been struggling to convince the National Institute for Health and Care Excellence (NICE) that their products are worth the price. “Although obinutuzumab is a clinically effective treatment, there were too many uncertainties in the company’s submission and we cannot be confident that it is an effective use
- [Matrix Management: Recipe For Chaos?](https://nai-consulting.com/matrix-management-recipe-for-chaos/) - The mention of its name can stir a gamut of reactions. Supporters call it invaluable, a critical component to the success of their organization. Detractors rail against it as the worst idea ever devised, that has cost businesses untold amounts in lost productivity. In reality, it may be more the victim of misinterpretation and misapplication
- [The Affordable Care Act’s Impact on Innovation in Biopharma](https://nai-consulting.com/the-affordable-care-acts-impact-on-innovation-in-biopharma-2/) - The Affordable Care Act (ACA) has elicited intense national debate and sent biopharmaceutical companies scrambling to understand how their business model, including its ability to innovate, will change as healthcare reform moves forward. Within this uncertain market, what is obvious is that the industry is in the midst of significant transition. Critical drivers of this
- [Practical Healthcare Reform and the Impact of Change](https://nai-consulting.com/practical-healthcare-reform-and-the-impact-of-change/) - As a consequence of recent healthcare reforms, providers are facing increasing financial pressure. This pressure has resulted in new market structures and dynamics that are affecting pharmaceutical and medical device manufacturers’ commercial business models. In this article we will explain how reform has altered the landscape, why manufacturers need to develop a new commercial model,
- [Length of Stay - The Management Headache That Won't Go Away](https://nai-consulting.com/length-of-stay-the-management-headache-that-wont-go-away/) - Like antibiotic-resistant bacteria, the challenge to reduce length of stay (LOS) persists...despite the best efforts of even the leading healthcare organizations. And this uncomfortable reality comes at a time when the need to improve LOS couldn’t be greater. The current financial crisis notwithstanding, as operating margins have continued to shrink raising capital has become a
- [Not All Bundled Payments are Created Equal](https://nai-consulting.com/not-all-bundled-payments-are-created-equal/) - The New Year brings a big decision for the more than 6,600 providers newly enrolled in Medicare’s Bundled Payments for Care Improvement (BPCI) program. If you’re one of these new BPCI participants, do you assume the risk of bundled payment for at least one care episode or drop out of the program? You have until
- [ Capturing the Value from Value-Added Services](https://nai-consulting.com/capturing-the-value-from-value-added-services/) - What is one of the hottest topics among pharmaceutical and medical device companies looking for a way to grow or even maintain top line revenues? In three words, Value Added Services (VAS). Creating these programs does come with significant challenges, such as demonstrating the value created—whether as a service wrap in conjunction with a product
- [Building the Value Narrative for Employers and Insurers](https://nai-consulting.com/building-the-value-narrative-for-employers-and-insurers/) - Customers are expecting more of health care providers. The national debate about skyrocketing costs, concerns about quality and lack of transparency — plus the fact that consumers are shouldering more responsibility for the cost of insurance and treatment — have placed health care delivery in the crosshairs. Employees insured under group plans are paying a
- [A Market-Based Model for Healthcare](https://nai-consulting.com/a-market-based-model-for-healthcare/) - In the fury of the healthcare debate most people have come to realize that we spend a lot of money on healthcare in this country, and in many ways, we aren’t getting our money’s worth. "Better health outcomes at lower cost" has become the common theme for efforts to reform the system. The billion-dollar question
- [Real World Evidence: Medical Device and Diagnostic Perspectives](https://nai-consulting.com/real-world-data-medical-device-and-diagnostic-perspectives/) - The life sciences industry faces an unprecedented number of challenges led by concerns about escalating healthcare costs. With a consolidating payer base increasingly driving healthcare decision-making, more evidence of both safety and effectiveness is required than randomized clinical trials (RCTs) -- the familiar “gold standard” -- can offer. Against this background, real world evidence is
- [Economic and Clinical Value:  The Future of Cancer Care](https://nai-consulting.com/economic-and-clinical-value-the-future-of-cancer-care/) - During the American Society of Clinical Oncology (ASCO) meeting earlier this year, a leading pharmaceutical company announced positive results for one of its drugs. For the first time in 10 years, a drug used to battle a recurrent cancer had been found to prolong life, in this case by more than a month. However, by
- [Germany Post AMNOG: Insights for BioPharma](https://nai-consulting.com/germany-post-amnog-insights-for-biopharma/) - Manufacturers exploring opportunities in global markets face dynamic demographic and disease trends, changing market demands, and evolving regulatory requirements—all of which differ from one country to another. While emerging markets continue to represent a new channel of demand for pharmaceutical products, manufacturers have quickly realized that significant attention must still be given to more established
- [How to Get Premium Reimbursement for Premium Care](https://nai-consulting.com/healthcare-brief-15-how-to-get-premium-reimbursement-for-premium-care/) - More than a decade of spiraling healthcare inflation combined with fiscal contraction and stagnant wage growth have put the cost of care in the spotlight. Payers and employers are increasingly looking to reduce their healthcare expenditures, while still obtaining high quality care for their subscribers and employees. Simultaneously, there is a convergence of trends, including
- [Oncology Market Access – Trends, Challenges, and Strategies for US Pharmaceutical Companies](https://nai-consulting.com/oncology-market-access-trends-challenges-and-strategies-for-us-pharmaceutical-companies/) - With the cost of cancer care set to continue to spiral, manufacturers must understand and adapt to the new access and reimbursement landscape in order to ensure the success of their oncology pipelines. That’s why eyeforpharma partnered with Numerof & Associates to produce an authoritative whitepaper that frames the changing dynamics in the oncology landscape and provides
- [Pharma’s in a Bind - Here’s a Way Out](https://nai-consulting.com/pharmas-in-a-bind-heres-a-way-out/) - Pharma’s in a bind, attacked over the high price of new life-saving specialty drugs, staggered by the $2.6 billion Tufts says it costs to bring a new drug to market, and confronted by steeper reimbursement and market access hurdles. More fodder for critics came with the news that spending on prescription drugs is accelerating despite
- [Post-Acute Care in a Post-Election World](https://nai-consulting.com/post-acute-care-in-a-post-election-world/) - In three months, during the 2014 mid-term election campaign, Congress unanimously passed the bipartisan IMPACT Act to improve post-acute care quality and coordination. Post-election, it’s safe to say this is one healthcare reform that will remain intact. As it should, because days before the President signed the IMPACT Act on October 6, CMS levied readmission fines
- [Defining the Job Description for Population Health](https://nai-consulting.com/defining-the-job-description-for-population-health/) - The term population health is being used everywhere, and it means different things to different people… even on the same executive team. Many organizations try to develop a “population health strategy” without fully understanding what it means, and are turning to their physician leaders to take charge. Physician leaders who suddenly find themselves in this
- [Supermarket Chain Offers Infusion Services](https://nai-consulting.com/supermarket-chain-offers-infusion-services/) - Managing Partner Michael Abrams discusses Schnuck Markets' new outpatient infusion center and the growing opportunities to bring more health care services into the retail setting in Supermarket Chain Offers Infusion Services, as seen in Strategic Health Care Marketing. While most consumers think first of a physician office or hospital as a place to go, “the challenge for
- [Navigating Emerging Markets – Eastern Europe](https://nai-consulting.com/navigating-emerging-markets-eastern-europe/) - The regulatory environment in Europe is evolving, with significant effort to make regulations – including those governing pharmaceuticals and medical devices – more uniform across the region. Change toward harmonization has come in waves and been characterized by country assimilation into the European Union. Thus, countries can be grouped by their status: the “original” (largely
- [India's Developing Market Offers Opportunities](https://nai-consulting.com/indias-developing-market-offers-opportunities/) - Recognizing that emerging markets continue to play a significant role in terms of future growth, most major pharmaceutical companies have accelerated efforts to strengthen their presence within these markets through R&D investment, licensing deals, acquisitions, or other partnerships. However, with global markets facing dynamic demographic and disease trends, changing market demands, and evolving regulatory requirements,
- [Navigating Emerging Markets](https://nai-consulting.com/pharma-brief-9-navigating-emerging-markets/) - The global market for pharmaceuticals and medical devices continues to grow rapidly, and in response, manufacturers are moving to align their market strategy and product pipeline to meet emerging, unmet needs. Companies exploring opportunities in global markets face dynamic demographic and disease trends, changing market demands, and evolving regulatory requirements -- all of which differ
- [The Silver Tsunami](https://nai-consulting.com/the-silver-tsunami/) - There is a looming population group poised to impact the US healthcare system with a voracious appetite for healthcare. The group has been dubbed the ‘silver tsunami’-- a name that our research shows first appeared in a 2002 paper by University of Nevada, Reno professor Mary Finn Maples. So how big of a problem will
- [Transparency in Healthcare: Coming to Your Hospital Soon!](https://nai-consulting.com/transparency-in-healthcare-coming-to-your-hospital-soon/) - In August, 2013, Priority Health claimed the title of first health plan in Michigan to publish specific, regionalized health care costs and quality information by procedure, facility and physician. The company launched this tool so plan members could review and compare prices and quality for more than 300 of the most common health care services.
- [Creating a Framework for Accountable Care: Ensuring Product Value](https://nai-consulting.com/creating-a-framework-for-accountable-care-ensuring-product-value/) - The U.S. healthcare system is currently undergoing what will ultimately be a radical transformation, driven by unsustainable cost increases, increasing regulation, and shifting power relationships among payers, providers, physicians, and patients. Technology advances are accelerating the pace of innovation, while rising costs and demands for affordable healthcare and greater transparency are challenging the economics and
- [Distribution of Sales and Marketing Spend Must Change](https://nai-consulting.com/distribution-of-sales-and-marketing-spend-must-change/) - In recent years, pharma companies have reduced their cost base in response to decreasing revenues due in part to patent expirations and thin pipelines. Companies have taken the budget axe to both their R&D and Sales organizations, often drastically reorganizing R&D in an effort to generate improved productivity. While considerable effort has gone into reshaping
- [How Payers Can Promote Accountable Care without an ACO](https://nai-consulting.com/how-payers-can-promote-accountable-care-without-an-aco/) - The Accountable Care Organization (ACO) was promoted by the Affordable Care Act as one way to address the spiraling cost increases and disappointing quality outcomes that had characterized U.S. healthcare to date. The bill offered financial incentives to encourage adoption of the ACO format, and appears to have been successful in that regard – hundreds
- [Post-Market Safety Surveillance](https://nai-consulting.com/post-market-safety-surveillance/)
- [Big Pharma – How to Regain Success](https://nai-consulting.com/big-pharma-how-to-regain-success-3/) - Successful companies and even entire industries all have a lifecycle, and all eventually reach a point where their business model approaches the end of that lifecycle and is no longer viable. Companies that are early in recognizing the shift and can execute the successor model effectively will typically become leaders in the next stage of
- [Infrastructure Development: It’s Time To Get Serious](https://nai-consulting.com/infrastructure-development-its-time-to-get-serious/) - Healthcare providers today are facing unprecedented challenges. Remaining financially viable and sustaining a high level of performance in the patient care mission appear to be more in conflict than ever before. Competition from niche hospitals for patients is getting stronger. As if these issues were not challenging enough there is no end in sight to
- [Building Leadership Infrastructure: An Executive Summary](https://nai-consulting.com/building-leadership-infrastructure-an-executive-summary/) - The business environment demands that organizations not only execute effectively against current strategies and objectives, but also anticipate those that have yet to come. From the executive management team to individual employees, organizations face daily challenges in focusing efforts on what matters most -- the effective implementation of the organization’s mission and strategy. One key
- [Uses and Abuses of Dashboards](https://nai-consulting.com/uses-and-abuses-of-dashboards/) - Dashboards provide an at-a-glance overview of progress against goals, and have gained wide acceptance as a tool for managing organizational performance. With good reason -- when they provide a valid, holistic view of progress they focus attention on critical operational strengths and weaknesses, allowing corrective action to be taken where it is needed, when it
- [Restoring Pharma’s Reputation for Ethical Leadership](https://nai-consulting.com/pharma-brief-4-restoring-pharmas-reputation-for-ethical-leadership/) - The pharmaceutical industry has entered a critical period of transition. Business models that have proven remarkably successful over the past twenty years are now encountering major challenges. As companies grapple with the leading symptoms of these challenges -- pricing pressures, pipeline productivity concerns, growing public distrust, and greater political scrutiny -- it’s becoming increasingly clear
- [Why Global Brands Have Become a Long Shot](https://nai-consulting.com/why-global-brands-have-become-a-long-shot/) - The allure of the blockbuster global brand is irresistible. Emerging countries represent large and growing populations with, presumably, unmet needs. An established brand in the U.S., with a leading market share and a proven business model, stands ready to be unleashed to garner enticing potential revenue projections based on demographic extrapolations. The obvious strategy and
- [Getting Out of the Planning Rut: Business-Market-Product Strategy (Part 2)](https://nai-consulting.com/getting-out-of-the-planning-rut-mapping-the-proper-relation-between-business-market-product-strategy-part-2/) - Even the most successful companies often find their annual planning efforts devolving into a rut. Where flagship products are “king”, the strategic plan tends to be a roll-up of product plans. Instead of re-thinking business models and go-to-market strategies in response to a dynamic market, planning often ends up as a projection of current business
- [Getting Out of the Planning Rut: Business-Market-Product Strategy (Part 1)](https://nai-consulting.com/getting-out-of-the-planning-rut-mapping-the-proper-relation-between-business-market-product-strategy-part-1/) - Even the most successful companies often find their annual planning efforts devolving into a rut. Instead of re-thinking their business models and go-to-market strategies in response to a dynamic market, they often end up simply projecting current business into the future as a basis for establishing next year’s budget. In turbulent markets, such "business as
- [Financial Challenges of Bundled Pricing](https://nai-consulting.com/financial-challenges-of-bundled-pricing/) - The U.S. healthcare industry is currently undergoing what will ultimately be a radical transformation, driven by unsustainable cost increases, increased regulation, and shifting power relationships among payers, providers, physicians, and patients. We have reached the point where all four of these key constituent groups have significant economic concerns -- providers and physicians about their revenues,
- [Changing Payer Perspectives on Market Access Across the G-5](https://nai-consulting.com/changing-payer-perspectives-on-market-access-across-the-g-5-3/) - It was less than a decade ago that most pharmaceutical manufacturers considered market access the last step in the commercialization process… maybe even something that happened post-launch! However it has become increasingly clear that this approach must change. Companies exploring opportunities in global markets face dynamic demographic and disease trends, changing market demands, and evolving
- [Making the Transition from Volume to Value](https://nai-consulting.com/making-the-transition-from-volume-to-value/) - With healthcare costs now claiming nearly 20% of GDP and quality lagging behind benchmarks, the urgent need to ensure better care at lower cost is increasingly plain to healthcare leadership. Providers at all levels need to begin the shift from a volume-based model to a value-based one that offers the promise of a sustainable approach
- [Creating Disruptive Innovation](https://nai-consulting.com/healthcare-insurance-brief-1-creating-disruptive-innovation-2/) - The outlook for private health insurance remains fraught with uncertainty. After decades of financial success, it’s difficult for many in the industry to think about meaningfully changing the current model beyond responding to the latest reinterpretation of the Affordable Care Act (ACA). However, no business model cast in stone can deliver results when the very
- [Exchanges: Shaping the Consumer of the Future](https://nai-consulting.com/exchanges-shaping-the-consumer-of-the-future/) - The individual and SHOP (small business health options program) exchanges are getting significant media attention these days. When PPACA was enacted in 2010, one of its components was the creation of federal and state-based exchanges. The intent of these new marketplaces was to give more Americans access to affordable, quality health insurance and to reduce
- [Will Biosimilars Meet the Market Similar Test?](https://nai-consulting.com/will-biosimilars-meet-the-market-similar-test/) - The approval last year in the EU of generic Remicade represents a milestone of sorts. Biosimilars aim to replace, or at least compete with, products that generated over $100 billion in worldwide sales in 2013. While Europe has led the way in the development of a regulatory pathway for the approval of such products, the
- [Engaging Boards in the Transition from Volume to Value](https://nai-consulting.com/engaging-boards-in-the-transition-from-volume-to-value/) - Hospitals face profound operational and cultural challenges in meeting the demands of value based reimbursement, reference pricing and transparency. As they take on more risk and focus on outcomes based performance, Boards as well will struggle with the need for transformational change -- what it means for their organization and for their own governance practices.
- [ACA Will Bring More Patients to ASCs - But Will Profits Follow?](https://nai-consulting.com/aca-will-bring-more-patients-to-ascs/)
- [Marrying Big Data with Personalized Medicine](https://nai-consulting.com/marrying-big-data-with-personalized-medicine/) - Global healthcare systems are currently undergoing major transformations spurred by increasing regulation, record public debt and shrinking budgets. The U.S. has the dubious distinction of leading the way in this regard. The mandates of the Affordable Care Act, along with shrinking reimbursement to providers are fundamentally changing the operation of the U.S. healthcare system. At
- [Integrating RWE into Investigator Initiated Trials](https://nai-consulting.com/integrating-rwe-into-investigator-initiated-trials/) - Expanding government and payer requirements for additional data on products, whether for safety monitoring, efficacy confirmation or economic and clinical value evaluation, underscore the importance of an integrated strategy for investigator initiated trials (IIT) and real world evidence (RWE) research. In developing an IIT/RWE strategy, companies need to be clear up front about why specific
- [Transforming a Broken Development Engine](https://nai-consulting.com/pharma-brief-2-transforming-a-broken-development-engine/) - The pharmaceutical industry has entered a critical period of transition. Business models that have proven remarkably successful over the past 20 years are now encountering major challenges. As companies grapple with the leading symptoms of these challenges -- pricing pressures, pipeline productivity concerns, a growing public distrust, and greater political scrutiny -- it is becoming
- [Healthcare Alliances -- Considerations for Leadership ](https://nai-consulting.com/healthcare-brief-12-healthcare-alliances-considerations-for-leadership/) - As the pressure to deal with a dynamic market and changing regulatory environment continues to increase, many hospitals are considering some form of affiliation or acquisition to bolster their competitive position. Healthcare consolidation is driven by a number of factors, most often including the need to build referrals, gain market share, or broaden service offerings
- [Healthcare Consolidation and What It Means for Manufacturers](https://nai-consulting.com/healthcare-consolidation-and-what-it-means-for-manufacturers/) - As has been true in years past, recent industry consolidation and attempts to leverage size and scale are being used to stave off competitive threat. In the 1990s, hospitals and systems embarked on massive affiliations and buying sprees. Independent hospitals fled to the safety of systems. Hospitals scooped up primary care practices as a defensive
- [Diagnosing and Treating Readmissions](https://nai-consulting.com/diagnosing-and-treating-readmissions-2/) - Hospital readmissions arguably are one of the biggest clinical issues facing healthcare systems today. Otherwise known as “bouncebacks”, readmissions have proven to be extremely costly, and are taken as a concrete metric of inadequate quality. According to a September 19, 2013 study in The New England Journal of Medicine, nearly one in seven patients hospitalized
- [Navigating Emerging  Markets – South Korea](https://nai-consulting.com/navigating-emerging-markets-south-korea/) - South Korea is a rapidly growing pharmaceutical market. Previously considered a developing economy, this country was reclassified as a developed economy in 2010, though it is still considered an emerging market. In recent years, South Korea's high growth rate has continued amid worldwide economic downturns and is expected to continue in years to come. It
- [Navigating Emerging  Markets – Latin America](https://nai-consulting.com/navigating-emerging-markets-latin-america/) - Like Eastern Europe, Latin America is one of the top emerging markets. This region shows a great deal of diversity in its approach to pharmaceutical products as a result of differences in economics, resources, access to care, and definition of regulatory requirements by country. Common guidelines from groups like the Pan American Health Organization (PAHO,
- [Pharma’s Stake in CER ](https://nai-consulting.com/pharmas-stake-in-cer/) - Until recently, comparative effectiveness research (CER) was a term that only surfaced in conversations among health policy specialists, academicians, and other observers of the healthcare marketplace. No longer. The allocation of $1.1 billion to CER in the American Recovery and Reinvestment act (ARRA, 2009) rep-resented a paradigm shift. And the inclusion of CER in every
- [3 Steps to Build Your Hospital’s Value Case](https://nai-consulting.com/3-steps-to-build-your-hospitals-value-case/) - The healthcare industry is in the midst of a revolutionary upheaval reflecting the concerns of patients, payers, providers and policymakers over spiraling costs, lagging quality and lack of transparency. In this time of heightened sensitivity by all parties to the value received and the cost incurred, it’s essential that you be able to differentiate yourself
- [Clinical Care Paths – A Foray into Clinical Decision-Making for the Finance Professional](https://nai-consulting.com/clinical-care-paths-a-foray-into-clinical-decision-making-for-the-finance-professional/) - For over two decades, healthcare delivery organizations have devoted extensive resources to cost management in response to shrinking reimbursement. They've used vendor consolidation and contract renegotiation to lower supply costs, and shared services to lower overhead. Combined with the wholesale consolidation of hospitals into larger systems with corresponding purchasing power, these actions have done much
- [You Can’t Afford Your Current Sales Model](https://nai-consulting.com/pharma-brief-1-you-cant-afford-your-current-sales-model/) - The pharmaceutical industry has entered a critical period of transition. Business models that have proven remarkably successful over the past twenty years are now encountering major challenges. As companies grapple with the leading symptoms of these challenges -- pricing pressures, pipeline productivity concerns, growing public distrust, and greater political scrutiny -- it’s becoming increasingly clear that
- [It's Time to Sink or Swim: The Future of HR](https://nai-consulting.com/its-time-to-sink-or-swim-the-future-of-hr/) - Now, more than ever, HR management needs to choose to implement a consultative model of service delivery to increase the function’s relevance to the organization. The proliferation of Human Resource Information System (HRIS) software applications that enable self-service by organizational end-users is merely the latest push towards the imperative of the HR function to find
- [Value Added Services: What It Takes to Do It Right](https://nai-consulting.com/pharma-brief-15-value-added-services-what-it-takes-to-do-it-right/) - As a strategy to offset declining revenues, companies are testing a variety of initiatives focused on creating value added services (VAS) for drugs and medical devices. Disease management programs have been tried before by product manufacturers with limited success. This new wave differs from prior experiments in that it leverages emerging mobile/handheld technologies and the
- [Are De Facto Price Controls Imminent?](https://nai-consulting.com/are-de-facto-price-controls-imminent/) - By and large the pharmaceutical industry has escaped price controls in the U.S. -- especially when compared to other markets around the world. Is this situation tenable, and if not, what will the implications be for the industry? Since 2003, Congress has prohibited Medicare from negotiating drug prices directly with pharmaceutical manufacturers. Even though Barack
- [Navigating Emerging Markets -- Israel](https://nai-consulting.com/navigating-emerging-markets-israel/) - The Middle East has been rocked in recent years by upheaval. While the potential for disruption is real, the region has been characterized as well by rapid growth in the healthcare sector. One of its brightest lights is Israel. It is a developed, industrialized nation that, despite ongoing conflict with neighboring Arab countries, remains committed
- [The Breakthrough Designation Program: Four Factors for Long Term Success](https://nai-consulting.com/the-breakthrough-designation-program-four-factors-for-long-term-success/) - The FDA’s Breakthrough Therapy Designation -- created when the FDA Safety and Innovation Act was signed on 9 July 2012 -- is in its second year after a successful start. Enacted to provide another mechanism to accelerate the path of critical therapeutics to market, the statute has exceeded expectations. The regulatory agency has granted the
- [Using Data to Link Product Value and Price](https://nai-consulting.com/using-data-to-link-product-value-and-price/) - While the pharmaceutical and medical device industries have found themselves in a turbulent healthcare marketplace rife with changing regulations, new competitive challenges, and increasing pricing pressures, the end goal for manufacturers remains the same -- product reimbursement and optimal pricing. These two terms are regularly linked together because reimbursement is influenced by pricing. In this
- [Improving the Bottom Line: Prioritizing Cost and Quality Initiatives ](https://nai-consulting.com/improving-the-bottom-line-prioritizing-cost-and-quality-initiatives/) - Imagine the following case… The executive team is meeting to decide which cost reduction projects to fund. Each has a supporting “business case”, but everyone knows the numbers are soft. Comparing financial impact across projects is difficult, and debates about assumptions and scenarios to test lead to months spent on analysis and additional meetings, rather
- [Improving Margins: New Approaches to an Old Problem](https://nai-consulting.com/improving-margins-new-approaches-to-an-old-problem/) - The U.S. healthcare industry is currently undergoing what will ultimately be a radical transformation, driven by unsustainable cost increases, increased regulation, and shifting power relationships among payers, providers, physicians, and patients. We have reached the point where all four of these key constituent groups have significant economic concerns -- providers and physicians about their revenues,
- [Tighten Up Your Product Lifecycle Management](https://nai-consulting.com/tighten-up-your-product-lifecycle-management/) - In today’s global market environment, payers are looking hard to reduce reimbursement and resist paying for incremental product enhancements. On top of that, manufacturers’ revenue streams continue to be threatened by looming patent expiration dates and the simultaneous influx of generic competition. What actions should companies consider taking to protect their existing businesses and extend
- [Healthcare Alliances -- Ensuring ROI from an Affiliation](https://nai-consulting.com/healthcare-brief-13-healthcare-alliances-ensuring-roi-from-an-affiliation/) - The most difficult challenges hospitals face in an affiliation or acquisition are not price or financial due diligence, but cultural issues. In fact, the most significant problems that occur post-acquisition usually are directly attributable to insufficient integration planning, a poorly defined vision for the combined company, and an underestimation of people issues, or cultural integration.
- [The Bar for Product Reimbursement Just Moved Higher](https://nai-consulting.com/pharma-brief-14-the-bar-for-product-reimbursement-just-moved-higher/) - After seeing their products being rejected in recent years by reimbursement agencies overseas, pharmaceutical manufacturers are suffering the same fate in the U.S., as PBMs refuse to include a growing list of drugs on their formularies. The country’s largest PBM, Express Scripts, recently announced that 48 products, including a range of new and older drugs,
- [Market Access -- Global Challenges for Oncology Drugs](https://nai-consulting.com/market-access-global-challenges-for-oncology-drugs-2/) - Oncology drug and biologics makers face increasing demands for data that demonstrates the benefit and cost-effectiveness of their products. Not only are treatment cost increases considered unsustainable, questions about new product effectiveness are being openly raised by physicians and payers alike. Pharmaceutical companies are increasingly being expected to demonstrate the overall economic and clinical value
- [The New Wave of Product Positioning](https://nai-consulting.com/the-new-wave-of-product-positioning/) - As the rules for success change, pharmaceutical and medical device companies must rethink their approach to the market. One critical element that requires transformation is product positioning. Historically, a product’s ‘value’ was determined by clinicians as they made decisions about which products to use for their patients. Yet, there is growing awareness that decisions by
- [Big Data and the Convergence of R&D and the Commercial Organization](https://nai-consulting.com/big-data-and-the-convergence-of-rd-and-the-commercial-organization/) - As payers around the world try to figure out how to get spiraling healthcare costs under control, big data has been hailed as a silver bullet. The underlying premise is that, with enough data and enough analysis, we can figure out how to best treat patients for the least amount of money. It’s becoming clear
- [Pharma Marketing: Successful Approaches to Market Segmentation](https://nai-consulting.com/pharma-marketing-successful-approaches-to-market-segmentation/) - In our continuing series on the topic of market transformation within the pharmaceutical and medical device industry, we have highlighted the need for a more sophisticated, strategic approach to market segmentation. Several factors are combining to require successful companies to approach market segmentation more effectively. These factors include market dynamics, shifts in the power of who
- [Adapting to the Changing Landscape of Healthcare: A Transfusion of Fresh Thinking](https://nai-consulting.com/adapting-to-the-changing-landscape-of-healthcare-a-transfusion-of-fresh-thinking/) - The hospital model today stands in the crosswinds of market and non-market forces. On the market side, there is the hard reality that sustainable margin is required for financial viability. On the non-market side, there are a host of regulations to comply with, a mission that includes caring for those who can’t pay, disproportionate payer
- [Managing Key Physician Groups as Major Accounts  (Part 2)](https://nai-consulting.com/managing-key-physician-groups-as-major-accounts-part-2/) - In our previously published companion article, we made the case that hospitals and health delivery systems need a systematic and proactive focus on managing physician relations, especially with key physician groups that generate a disproportionate share of hospital referrals. We also suggested that hospitals and systems could borrow profitably from the approach that leading- edge
- [The Impact of Comparative Effectiveness Research on Spine Care Device Companies](https://nai-consulting.com/the-impact-of-comparative-effectiveness-research-on-spine-care-device-companies/) - Recent trends in healthcare expenditures related to spine care show increasing costs and significant geographical variations in treatment patterns. This data, along with a lack of consistent success for spinal surgeries, has led to increased scrutiny of the spine care industry by payers. Expenditures associated with spine problems totaled $86 billion in 2005, an increase
- [Building a Foundation for the Future: Reflecting on the State of the Pharmaceutical Business Model](https://nai-consulting.com/building-a-foundation-for-the-future-reflecting-on-the-state-of-the-pharmaceutical-business-model/) - Successful companies -- even entire industries -- have a lifecycle. All of them eventually reach the point where their business model approaches the end of its lifecycle and is no longer viable. Companies that recognize the shift early on, assuming they execute the successor model effectively, become leaders as the next stage emerges. Sometimes the
- [Sunshine and Transparency: Building Positive Industry-Physician Relationships](https://nai-consulting.com/sunshine-and-transparency-building-positive-industry-physician-relationships/) - As life sciences companies address Sunshine Act requirements and other growing demands for transparency, they also face concerns from physicians that this publically available information may distort the often necessary and beneficial aspects of relationships physicians maintain with industry. Already, anecdotal evidence indicates some physicians will be reluctant to work with industry if the payments
- [The Impact of the 2012 Election Is All About Product Value](https://nai-consulting.com/the-impact-of-the-2012-election-is-all-about-product-value/) - After seemingly endless rounds of rhetoric and debate, the 2012 Presidential Campaign has finally reached its conclusion. We know what each of the candidates had said they would do, but now that the President has been re-elected, the focus has moved from politics to policy. So what can pharmaceutical and medical device manufacturers expect to
- [Making the Value Case for Your Wellness Programs](https://nai-consulting.com/making-the-value-case-for-your-wellness-programs/) - Private health insurance stands on the precipice of an uncertain future. With the creation of health insurance exchanges and the entry of as many as 15 million uninsured into the market, insurance companies will need to become more effective at consumer based marketing. Clearly, cost will be a major factor, but if insurance companies are to
- [Linking Activity to Cost: A Critical Role for the Finance Professional](https://nai-consulting.com/linking-activity-to-cost-a-critical-role-for-the-finance-professional/) - The Supreme Court’s decision to uphold the ACA made it all but certain that targeted reimbursement reductions are on the horizon. The law created the Independent Payment Advisory Board (IPAB) with a mandate to drive down healthcare costs. With the power to modify reimbursement rates and requirements as their principal tools, providers can expect both
- [How the New Healthcare Law Will Impact Payers and Pharma Manufacturers](https://nai-consulting.com/how-the-new-healthcare-law-will-impact-payers-and-pharma-manufacturers/) - Now that the Supreme Court has upheld the healthcare reform law, many in the pharmaceutical sector see the path ahead as straightforward. However, simply preparing for those components of the law that directly affect manufacturers won’t be the only challenge. Payers recognize that they have to slow the growth of healthcare costs -- and their
- [Transparency in Investigator Initiated Trials](https://nai-consulting.com/transparency-in-investigator-initiated-trials/) - Professional relationships with physicians are extremely important sources of collaboration for medical products companies. Physicians provide technical input, identify unmet needs, and perhaps most critically, conduct clinical trial administration and oversight. But these very areas have been underlined by OIG and DOJ investigators as targets of special scrutiny going forward. The FDA is also tightening
- [Post Marketing Safety Surveillance -- A Call to Action](https://nai-consulting.com/medical-device-brief-10-post-marketing-safety-surveillance-a-call-to-action/) - Exacerbated by recalls and other issues in recent headlines, medical device companies operating on a global basis face an expanding set of legal and regulatory risks and concerns around product safety. Scrutiny from the public and regulators is increasingly focused on ensuring product safety, as demonstrated by FDA funding increases to CDRH (the Center for
- [Regulatory Affairs - The Shape of Things to Come](https://nai-consulting.com/regulatory-affairs-the-shape-of-things-to-come/) - The global market for pharmaceuticals and medical devices continues to rapidly evolve, driven in part by significant regulatory changes across regions. Regulatory requirements across markets have a significant impact on matters such as clinical trials and market entry strategies in different regions. In response, companies will need to reevaluate their local and global market strategies
- [Marketing Implications of the Essential Healthcare Benefits Package (EHB)](https://nai-consulting.com/healthcare-insurance-brief-4-marketing-implications-of-the-essential-healthcare-benefits-package-ehb/) - By mid-2013, the debate regarding the official Essential Healthcare Benefits Package (EHB) will likely be at full volume. That's because, by 2014, the required baseline coverage mandated by the Patient Protection and Affordability Act of 2010 (PPACA) will become effective. The definition of this product standard will focus the industry and the public on what
- [Reinventing Marketing to Reinvigorate Growth](https://nai-consulting.com/reinventing-marketing-to-reinvigorate-growth/) - The escalation of healthcare costs is rapidly changing the basis for competition in the industry. Across the world, payers are clamping down on healthcare costs by saying "no" to new products, line extensions, and, of course, price increases. Reacting to the prospect of exponentially increasing financial liabilities, payors of all types are demanding hard comparative
- [Laying the Foundation for Success in Bundled Pricing](https://nai-consulting.com/laying-the-foundation-for-success-in-bundled-pricing/) - The ongoing upheaval around healthcare reform reflects the fact that spiraling cost increases, coupled with lagging quality outcomes and a chronic lack of transparency have gotten the attention of payers, patients, and policymakers. Healthcare delivery organizations face growing pressure to address these issues. Bundled pricing is an innovation being implemented by market leaders that promises
- [ECV: The Antidote to Commoditization Under Bundled Pricing](https://nai-consulting.com/ecv-the-antidote-to-commoditization-under-bundled-pricing/) - The healthcare industry is in the midst of a revolutionary upheaval reflecting the concerns of patients, payers, providers, and policymakers over spiraling costs, lagging quality, and a lack of transparency. Bundled pricing -- the provision of a flat rate for an entire episode of care -- is an approach to pricing and care delivery that
- [Engaging Physicians in Bundled Pricing](https://nai-consulting.com/engaging-physicians-in-bundled-pricing/) - Spiraling U.S healthcare costs have garnered considerable national attention. Cost inflation, coupled with lagging quality outcomes and a lack of transparency has fueled legislative reform efforts that have roiled the entire sector. The industry has reached a point where all four of the key constituent groups (payers, providers, physicians, and patients) have significant economic concerns
- [Market Access: Is the Right Price Enough?](https://nai-consulting.com/market-access-is-the-right-price-enough/) - Just a few years ago, most companies looked at market access, and specifically reimbursement, as the last step in the commercialization process. Only after a product was close to launch was it considered, and even then it was tactically addressed, as in "what price can we get?" The function was divorced from other aspects of
- [7 Ways to Improve Accountability for Care](https://nai-consulting.com/7-ways-to-improve-accountability-for-care/) - One consequence of the Patient Protection and Affordable Care Act is that it has shown a spotlight on what’s missing in the current business model of healthcare: accountability -- for coordination of care, for outcome measures that are more demanding and meaningful, for evidence-based, cost-effective decision making at all levels -- in short, accountability for
- [ACOs and Their Impact on Pharma](https://nai-consulting.com/acos-and-their-impact-on-pharma/) - Obamacare, officially known as the Patient Protection and Affordable Care Act (PPACA) was signed into law March 23, 2010. It’s now being challenged in the Supreme Court by the Department of Justice and 26 states on constitutional grounds … namely that the Federal Government has no basis to mandate individual purchase of particular products or
- [Bundled Pricing: Strategies for Success](https://nai-consulting.com/bundled-pricing-strategies-for-success/) - The spiraling costs of healthcare have pushed the entire system to the brink. To make matters worse, quality in the US lags other developed economies. This has precipitated a backlash demanding both better care and lower cost. Although the main focus of reform legislation was on improving access through regulation of healthcare insurance, it has
- [Impact of the Changing Reimbursement Landscape](https://nai-consulting.com/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 Medical Voice -- From Product Development to Post-Market Surveillance](https://nai-consulting.com/medical-device-brief-11-the-medical-voice-from-product-development-to-post-market-surveillance/) - The medical device industry is in the midst of a redefining transformation, posing both opportunities and threats to manufacturers’ current business model. Global device companies must address significant operational challenges to ensure that monitoring and safety surveillance practices address growing concerns about the safety of products introduced to the market. Recalls of medical devices nearly
- [Post-Market Safety Surveillance and Medical Devices](https://nai-consulting.com/post-market-safety-surveillance-and-medical-devices/) - Medical device companies face an expanding set of legal and regulatory requirements to address risks and concerns around product safety. Scrutiny from the public and regulators increasingly focuses on safety concerns, as demonstrated by the FDA’s recent changes to the 510(k) process and draft guidance for post-market safety. As product safety requirements increase, device companies
- [Bundled Pricing: Overcoming the First Hurdles](https://nai-consulting.com/bundled-pricing-overcoming-the-first-hurdles/) - Bundled pricing is an innovation in healthcare delivery that promises to deliver reduced costs, improved quality, and greater transparency. At a high level, the concept is a single fixed price for a defined set of physician and facility services with a specified quality outcome. Currently being piloted by a small number of market leaders and
- [Orphan Drugs -- Niche Strategy, Mainstream Potential](https://nai-consulting.com/orphan-drugs-niche-strategy-mainstream-potential/) - While historically on the margins of R&D spend, orphan drug development increasingly looks like a strategy whose time has arrived for delivering value in drug development. The blockbuster model is wearing thin -- the pressure for lower cost drugs with better outcomes flies in the face of the "one-size-fits-all" approach to drug development where outcomes
- [Improving Diagnostic Precision for Spinal Surgery in a Cost-Constrained Environment](https://nai-consulting.com/improving-diagnostic-precision-for-spinal-surgery-in-a-cost-constrained-environment/) - Over the past 15 years, the number of spinal fusion surgeries has drastically increased, but unfortunately, the rate of success hasn’t been commensurate with that growth. There’s been a 77% increase in the number of annual spinal fusion surgeries between 1996 and 20011, but studies indicate that as few as 50% of these fusion patients
- [Incorporating Nonsurgical Procedures in the Continuum of Care for Spine Patients](https://nai-consulting.com/incorporating-nonsurgical-procedures-in-the-continuum-of-care-for-spine-patients/) - In recent years, growing concern about the overuse of certain spinal procedures, especially spinal fusion, has led to a more restrictive attitude by payers about such interventions. Skepticism about the clinical value -- coupled with concerns about ballooning cost -- has led to a higher bar for approval and reduced coverage for spinal fusion surgeries.
- [3 Financial Challenges of Bundled Pricing](https://nai-consulting.com/3-financial-challenges-of-bundled-pricing/) - The concept of bundled pricing is gaining momentum as a reimbursement model designed to address demands for better health outcomes at lower cost. Promising to deliver a standardized set of services for a fixed price with specific quality commitments will create incentives -- lacking in the current fee-for-service payment system -- for providers to align
- [Demonstrating Product Value](https://nai-consulting.com/medical-device-brief-12-demonstrating-product-value/) - Medical products companies are increasingly challenged to demonstrate the value of new products -- in particular by payers who are demanding hard comparative economic and clinical value (ECV) data to justify premium pricing, price increases and sometimes just to maintain the status quo. On a global basis, government health authorities are increasingly requiring economic and
- [What Payers Value: Understanding the Impact of the Supreme Court Ruling](https://nai-consulting.com/what-payers-value-understanding-the-impact-of-the-supreme-court-ruling/) - Since the Supreme Court has upheld the healthcare reform law, many in the pharmaceutical industry now see a clearer path forward. However, simply preparing for the implementation of those components of the law that directly affect manufacturers won’t be the only challenge. Payers recognize they have to slow the growth of healthcare costs -- and
- [Lowering Costs per Case](https://nai-consulting.com/lowering-costs-per-case/) - There are several ways an administrator can cut costs from materials management to revenue cycle review, but one of the least-charted territories has been cutting costs related to clinical decision making. "Most delivery organizations have had some kind of cost efficiency activity going on for the last decade, but the general focus has been on
- [A 25-Year Retrospective on Orphan Drugs](https://nai-consulting.com/a-25-year-retrospective-on-orphan-drugs/) - In 1988, the Orphan Drug Act was barely five years old and still coming of age in the industry. Created in 1983, the act provided financial incentives (including research grants, tax credits for development costs, and seven years of market exclusivity) to sponsors of products intended for conditions affecting fewer than 200,000 persons. The point
- [Choosing the Right Chief Compliance Officer](https://nai-consulting.com/choosing-the-right-chief-compliance-officer/) - Finding the right CCO isn’t a simple hiring decision for life sciences companies. They face a range of complex business, regulatory, and market challenges in a dynamic and heavily scrutinized environment. Creating and maintaining a culture of ethics and compliance isn’t about just about the CCO. It’s a decision that ultimately reflects an organization’s values.
- [PDUFA V - A Step in the Right Direction](https://nai-consulting.com/pdufa-v-a-step-in-the-right-direction/) - In a Congressional cycle paralyzed by partisan gridlock, early reauthorization of PDUFA -- the user fee act for drugs -- was hailed as a triumph for the current Congress. Not only did the law pass with bipartisan support, it passed ahead of schedule. So why was this particular piece of “must-pass” legislation able to garner
- [The Board's Role in Pharmaceutical Compliance](https://nai-consulting.com/the-boards-role-in-pharmaceutical-compliance/) - It’s become commonplace to talk about the demanding regulatory and enforcement environment that pharmaceutical companies face. The number and size of recent settlements keep this topic top-of-mind for many. Recent settlements by Johnson & Johnson and Pfizer created significant board oversight requirements, underlining questions about what the role of the board should be in ensuring
- [Bundled Pricing: Getting Physician Buy-In](https://nai-consulting.com/bundled-pricing-getting-physician-buy-in/) - The health care industry has reached a point where all four of the key constituent groups (providers, physicians, payers, and patients) have significant economic concerns -- providers and physicians about their revenues, and payers and patients about the affordability of care. As a result, concepts like "bundled pricing" -- which seek to realign incentives toward
- [In the Eye of the Storm: Payer Value Perspective Key to Market Access](https://nai-consulting.com/in-the-eye-of-the-storm-payer-value-perspective-key-to-market-access/) - Pharmaceutical companies are increasingly challenged to demonstrate the value of new products -- in particular by payers who are demanding hard comparative economic and clinical value (ECV) data to justify premium pricing, price increases and sometimes just to maintain the status quo. On a global basis, government health authorities are increasingly requiring economic and clinical
- [Adapting to the Changing Landscape of Healthcare Insurance](https://nai-consulting.com/adapting-to-the-changing-landscape-of-healthcare-insurance/) - The healthcare insurance business model today stands in the crosswinds of market and non-market forces. On the market side, there is a now daunting challenge to remain competitive to sustain, much less increase, market share and margin. The constantly escalating costs of healthcare, increasingly passed on to consumers by their employers and health insurers, have
- [Comprehensive Risk Assessments: A New Approach](https://nai-consulting.com/comprehensive-risk-assessments-a-new-approach/) - With multi-billion dollar settlements becoming common, companies operating on a global basis continue to face a variety of legal and regulatory risks, and as a result, huge operational challenges to ensure practices satisfy different rules in different markets. This environment requires companies to enhance their traditional risk assessment methods. Risk assessment isn’t a checkbox; in
- [Building a Data Driven Market Claims Strategy](https://nai-consulting.com/building-a-data-driven-market-claims-strategy/) - Success in today's rapidly changing and increasingly competitive market requires both flawless execution of traditional marketing activities, as well as critical assessment of the product’s clinical and economic value proposition in the context of strategic marketing. Rising health care costs within the global marketplace and higher expectations of improved outcomes associated with new pharmaceuticals and
- [510(k) Clearance: Change is in the Wind](https://nai-consulting.com/510k-clearance-change-is-in-the-wind/) - Over the past several years the medical device industry has been rocked by product recalls, Department of Justice investigations into improper marketing practices, and incidents that highlight the potential conflicts of interest with physicians. Product safety concerns are especially predominant, given FDA reports that nearly 2,500 medical devices were recalled for potential safety problems in
- [Making the Most of Instability](https://nai-consulting.com/healthcare-insurance-brief-2-making-the-most-of-instability/) - These are unsettling times. Confronted with unsustainable costs and tens of millions without health insurance, our national debate over healthcare reform continues despite the passage of the Patient Protection and Affordable Care Act (PPACA) in March 2010. While virtually all stakeholders agree with the overall objective of reform -- achieving better health outcomes at lower
- [How to Build a Post Reform Commercial Model](https://nai-consulting.com/how-to-build-a-post-reform-commercial-model/) - The pharmaceutical industry is in a critical period of transition. Business models that have proven remarkably successful over the past twenty years are now encountering major challenges. As companies struggle with some of these challenges – pricing pressures, pipeline productivity, and greater public scrutiny – it’s becoming clear that a profound shift is underway in
- [Management Competencies: The Linchpin for Reform Success](https://nai-consulting.com/management-competencies-the-linchpin-for-reform-success/) - Significant transitional challenges lie immediately ahead for healthcare delivery organizations to meet the "better care at lower cost" mandate of healthcare reform. In many cases, delivery systems will need to develop a new business model, challenging base assumptions, and rethinking both the care they deliver and how they deliver it. A handful of healthcare systems
- [Disease State Modeling: A New Tool for Competitive Differentiation](https://nai-consulting.com/disease-state-modeling-a-new-tool-for-competitive-differentiation/) - The cost of health care has been on an unsustainable upward path, and the burden is finally becoming too large for the nation to bear. With costs that are higher than those of other developed nations and outcomes that are not commensurately better, the question is finally being asked - what are we paying for,
- [FMV: Ensuring a Defensible Framework](https://nai-consulting.com/fmv-ensuring-a-defensible-framework/) - Pharmaceutical and medical device companies' financial relationships with physicians are a large and growing focus of OIG and DOJ enforcement activity. That makes it more important than ever to ensure that these arrangements can withstand critical examination. Determining fair market value (FMV) fees is difficult, and little practical guidance is available. Old ways of valuing
- [Why Should Anyone Come to Your Hospital?](https://nai-consulting.com/why-should-anyone-come-to-your-hospital/) - It's hard to imagine a more stressed industry than healthcare. All healthcare delivery organizations have been facing on-going pressures to raise quality, reduce costs, and increase revenues in an environment of reimbursement constraints, demographic shifts, and accelerating technological change. New types of competition are emerging, including physicians that used to be your best patient referral
- [Getting Ready for Bundled Pricing](https://nai-consulting.com/healthcare-brief-8-getting-ready-for-bundled-pricing/) - The U.S. healthcare industry is currently undergoing what will ultimately be a radical transformation, driven by unsustainable cost increases, increased regulation, and shifting power relationships among payers, providers, physicians, and patients. The passage of the Patient Protection and Affordable Care Act is just the first of many steps intended to reshape the U.S. healthcare system.
- [The Case For Bundled Payments](https://nai-consulting.com/the-case-for-bundled-payments/) - Confronted with unsustainable costs and millions of uninsured, Congress passed the Patient Protection and Affordable Care Act in March 2010. This is likely the first of many steps intended to reshape the U.S. healthcare system. While virtually all stakeholders agree with the overall objective of healthcare reform -- achieving better health outcomes at lower cost
- [Hospital as Customer](https://nai-consulting.com/medical-device-brief-8-hospital-as-customer/) - Savvy medical device marketers have built their reputations and success focused on the "surgeon-as-customer". Sales strategy and process have been defined on the premise that the surgeon was the only decision-maker that counts, because they define patient needs, and that drives clinical choices. This has been a relatively simple sale, managed through a rep organization
- [Developing Effective and Compliant Advisory Boards](https://nai-consulting.com/developing-effective-and-compliant-advisory-boards/) - Physician advisory boards are used to provide medical products companies with real-time, expert insight and feedback on clinical and marketing issues to inform business decision making. Such insights can be critical to understanding the clinical landscape and marketplace, identifying unmet needs, and building the value case for products in development. Unfortunately, engagement of physicians by
- [Growing Regulation in Developing Markets: Trends and Implications](https://nai-consulting.com/growing-regulation-in-developing-markets-trends-and-implications/) - The Appeal of Clinical Development in Emerging Markets A growing number of clinical trials are being conducted in emerging markets (i.e., China, India, Southeast Asia, and certain Latin American countries) in order to generate data for product submissions in both the US and developing markets. Pharmaceutical and medical device companies often pursue product approval in
- [Managing Variability in Cost and Quality](https://nai-consulting.com/healthcare-brief-10-managing-variability-in-cost-and-quality/) - Spiraling healthcare costs and growing concern over the quality of patient care are topics of intense focus across the industry. One key to improving quality and reducing cost lies in monitoring, analyzing, and reducing variability that does not add value. These capabilities are critical now, and will become even more so as the industry continues
- [Strategic Questions Posed by Medical Loss Ratios](https://nai-consulting.com/healthcare-insurance-brief-3-strategic-questions-posed-by-medical-loss-ratios/) - The debate over healthcare reform continues despite, or perhaps because of, passage of the Patient Protection and Affordable Care Act (PPACA) in 2010. This is due in part to the fact that U.S. healthcare spending remains at an all-time high at a whopping 17% of GDP. Another reason the debate continues is the fact that
- [The Essence of Accountable Care](https://nai-consulting.com/the-essence-of-accountable-care/) - For all the debate, virtually all stakeholders agree with the overall objective of healthcare reform: achieving better health outcomes at lower cost. Different views have emerged as to how best achieve this objective, but the vehicle favored in healthcare reform legislation is the Accountable Care Organization (ACO). As set out in the legislation, ACOs are
- [Managing Investigator Initiated Trials](https://nai-consulting.com/managing-investigator-initiated-trials/) - Investigator Initiated Trials (IITs) can be a valuable part of a pharmaceutical or medical device manufacturer’s marketing claims arsenal. IITs are relatively low cost, because much of the upfront work is performed by the investigator, and the investigator normally "donates" facilities and staff to the conduct of the trial. In addition, ideas received from independent
- [Considerations for Outsourcing](https://nai-consulting.com/considerations-for-outsourcing/) - Much of the common advice related to outsourcing of clinical research focuses on the obvious issues -- the relative cost of performing research internally versus turning all or part of it over to a CRO, the impact of internal time and resource constraints on time-to-market, the relative experience of the CRO versus the CRO-hiring organization
- [Deploying New Commercial Models: Lessons from the Field](https://nai-consulting.com/deploying-new-commercial-models-lessons-from-the-field/) - Over the past few years, the concept of "New Commercial Model" (NCM) has rapidly progressed from novel idea to overused buzzword in the pharmaceutical industry as leading companies strive to adapt their sales and marketing infrastructures to changing market realities. However, the record of accomplishment so far has generally not matched either the grandiose language
- [Strategic Positioning In China and Other Emerging Markets](https://nai-consulting.com/strategic-positioning-in-china-and-other-emerging-markets/) - Historically, the global pharmaceutical industry has focused almost exclusively on the established regional markets of North America (particularly the US), Europe (particularly the ‘big 5’ West European nations), and Japan. For an industry whose business model is founded on charging premium prices for novel therapies, these markets possess the scale and wealth to generate the
- [Strategic Portfolio Management](https://nai-consulting.com/medical-device-brief-1-strategic-portfolio-management/) - The medical device business isn’t as much fun as it used to be. Products are aging, and increasingly more difficult to differentiate. Market success has attracted more competitors. Regulatory requirements are increasing the costs and time to develop new products. Advertising and selling costs are also skyrocketing. And payers are demanding hard clinical and health
- [FMV Fees for Clinical Trial Consultants: Meeting Compliance and Market Demands](https://nai-consulting.com/fmv-fees-for-clinical-trial-consultants-meeting-compliance-and-market-demands/) - Pharmaceutical and medical device companies face serious business challenges in conducting clinical research. The importance of data from clinical trials for obtaining FDA product approval is obvious. What may not be as immediately obvious is that the number of qualified research sites and competent investigators is limited. From a market standpoint, this situation involves buyers
- [Capitalizing on Strategic Market Insight](https://nai-consulting.com/capitalizing-on-strategic-market-insight/) - Maintaining a winning portfolio of products requires many things -- knowing what products to support through development, knowing how to position existing products in the market, making the right moves to counter the competition, and knowing when to kill a product to reallocate resources to a new one. But all of these decisions have one
- [Why Should Anyone Come To Your Hospital?](https://nai-consulting.com/healthcare-brief-1-why-should-anyone-come-to-your-hospital/) - It’s hard to imagine a more stressed industry than the healthcare provider industry. All healthcare delivery organizations have been facing on-going pressures to raise quality, reduce costs, and increase revenues in an environment of reimbursement constraints, demographic shifts, and accelerating technological change. New types of competition are emerging, including physicians that used to be your
- [Building Capability to Sell to C-Suite Hospital Leaders](https://nai-consulting.com/building-capability-to-sell-to-c-suite-hospital-leaders/) - Maintaining, much less increasing market share and margins has become an increasingly time sensitive struggle for medical device manufacturers. Many are recognizing that their traditional sales model, focused on physicians, is increasingly ineffective in a healthcare market undergoing a fundamental transformation. With the costs of healthcare reaching the breaking point for government, private payers, and
- [Getting Better At Reducing Costs](https://nai-consulting.com/healthcare-brief-2-getting-better-at-reducing-costs/) - It’s hard to imagine a more stressed industry than healthcare delivery. Hospitals and systems have been facing ongoing pressures to raise quality, reduce costs, and increase revenues in an environment of reimbursement constraints, demographic shifts, and accelerating technological change. The consensus at this point however, is "not good enough". The new Administration in Washington has
- [Rebuild Your Company to Deliver Superior Economic and Clinical Value](https://nai-consulting.com/pharma-brief-3-rebuild-your-company-to-deliver-superior-economic-and-clinical-value/) - The pharmaceutical industry has entered a critical period of transition. Business models that have proven remarkably successful over the past twenty years are now encountering major challenges. As companies grapple with the leading symptoms of these challenges -- pricing pressures, pipeline productivity concerns, growing public distrust, and greater political scrutiny -- it’s becoming increasingly clear
- [Develop Real Strategic Marketing -- Yesterday!](https://nai-consulting.com/medical-device-brief-3-develop-real-strategic-marketing-yesterday/) - The medical device business isn't as much fun as it used to be. Products are aging, and increasingly more difficult to differentiate. Market success has attracted more competitors. Regulatory requirements are increasing the costs and time to develop new products. Advertising and selling costs are also skyrocketing. And payers are demanding hard clinical and health
- [Serving More Patients with Your Existing Bed Count](https://nai-consulting.com/healthcare-brief-3-serving-more-patients-with-your-existing-bed-count/) - It's hard to imagine a more stressed sector than healthcare providers. All healthcare delivery organizations have been facing on-going pressures to raise quality, reduce costs, and increase revenues in an environment of reimbursement constraints, demographic shifts, and accelerating technological change. New types of competition are emerging, including physician collaborators-turned-competitors that used to be key patient
- [The COO's Leadership Role in Implementing Strategy](https://nai-consulting.com/the-coos-leadership-role-in-implementing-strategy/) - All health care leaders are developing fresh strategies to maximize their limited resources. But coming up with new, transformative strategies is only the first step: Translating those strategies into action is the real work, and it almost always requires fundamental changes to job roles, work processes and daily task activity. As the top operational leader,
- [Building Leadership Infrastructure to Succeed in Tough Times](https://nai-consulting.com/healthcare-brief-4-building-leadership-infrastructure-to-succeed-in-tough-times/) - It’s hard to imagine a more stressed industry than the healthcare provider industry. All healthcare delivery organizations have been facing on-going pressures to raise quality, reduce costs, and increase revenues in an environment of reimbursement constraints, demographic shifts, and accelerating technological change. New types of competition are emerging, including physicians that used to be your
- [Compliance and Risk Management: Lessons Learned](https://nai-consulting.com/compliance-and-risk-management-lessons-learned/) - The shock waves from Pfizer’s 2009 recordbreaking $2.3 billion settlement for off-label marketing continue to reverberate. For example, as part of the recent settlement of a lawsuit filed after paying the huge civil and criminal fine, Pfizer agreed to create a "Regulatory and Compliance Committee" of the Board of Directors, and fund it with a
- [Staying Financially Viable](https://nai-consulting.com/healthcare-brief-5-staying-financially-viable/) - It's hard to imagine a more stressed industry than the healthcare provider industry. All healthcare delivery organizations have been facing on-going pressures to raise quality, reduce costs, and increase revenues in an environment of reimbursement constraints, demographic shifts, and accelerating technological change. New types of competition are emerging, including physicians that used to be your
- [The Need for Compliance as Business Strategy](https://nai-consulting.com/the-need-for-compliance-as-business-strategy/) - Viewed broadly, increasing compliance requirements are part of an array of steadily growing pressures that the medical device industry faces, including rising product development costs and greater pricing sensitivity. Regulations and enforcement actions on a variety of compliance issues, including conflicts of interest, rising product prices, product safety, distributor agreements, and direct-to-consumer advertising are becoming
- [Embedding a Focus on Real Strategic Marketing](https://nai-consulting.com/pharma-brief-5-embedding-a-focus-on-real-strategic-marketing/) - The pharmaceutical industry is in a critical period of transition. Business models that have proven remarkably successful over the past 20 years are now encountering major challenges. As companies grapple with the leading symptoms of these challenges -- pricing pressures, pipeline productivity concerns, a growing public distrust, and greater political scrutiny -- it’s becoming increasingly
- [Managing Key Physician Groups as Major Accounts  (Part 1)](https://nai-consulting.com/managing-key-physician-groups-as-major-accounts-part-1/) - Imagine a company with a limited number of major accounts that generate a majority of its revenues. The CEO is principally responsible for managing the relationship with those accounts, and he is the first one they call when operational issues arise. Does this sound like an effective way to do business? Yet it happens to
- [R&D Prioritization: Going Beyond Decision Analysis](https://nai-consulting.com/rd-prioritization-going-beyond-decision-analysis/) - One of the most critical processes for any R&D organization is project prioritization -- deciding which projects will be funded over the next period and which will not. Pharmaceutical companies, in particular, have to make big investment decisions about their drug pipelines. These decisions involve complex assessments of technical, clinical, regulatory, legal, and commercial risk,
- [Building Revenue Through Stronger Physician Relations](https://nai-consulting.com/building-revenue-through-stronger-physician-relations/) - For many healthcare systems, one of the most under-leveraged opportunities to drive revenue growth and improve strategic focus is the proactive management of physician relations. This is not to say that healthcare executives don’t take physician relations seriously. There is recognition in the industry that physicians are critical to a hospital’s success. Nevertheless, the reality
- [Practical Tools for Measuring Organizational Effectiveness](https://nai-consulting.com/practical-tools-for-measuring-organizational-effectiveness/) - We’re all familiar with the classic questions we need to answer to measure the impact of training – Donald Kirkpatrick laid them out for us in the mid 1970s, and they haven’t changed since then. Level 1: Did the trainees like the training? Level 2: Did the trainees learn what we wanted them to learn?
- [Guidelines for Optimizing Your Time-to-Market](https://nai-consulting.com/guidelines-for-optimizing-your-time-to-market/) - Time-to-market is one of the most crucial determinants of success in the pharmaceutical industry. The shorter the time between your competitors’ first hearing about your potential new drug and that drug’s introduction into the marketplace, the longer you will reap the rewards of sole ownership of the niche. Pharmaceutical companies have invested heavily in speeding
- [New Models of Physician Relations Management](https://nai-consulting.com/new-models-of-physician-relations-management/) - Over the last two decades, recognition of the importance of proactive relationship management and ongoing dialog for the maintenance of good relationships with physicians has grown significantly. The traditional model of physician relationship management is a reactive one. It puts hospital CEOs in a heroic "firefighter" role only after strained relationships result in angry calls
- [Strategies for Competing on Value](https://nai-consulting.com/strategies-for-competing-on-value/) - With healthcare costs for America’s aging population projected to rise dramatically over the next several decades, the pressure for controlling them will become enormous. Consumer-directed healthcare plans (such as high-deductible plans linked to HSAs) represent one of the latest initiatives targeting cost management, but they weren’t the first (remember HMOs?) and they won’t be the
- [Building a Leadership Infrastructure: A Road Map for Strategic Change](https://nai-consulting.com/building-a-leadership-infrastructure-a-road-map-for-strategic-change/) - The human resources function is at a defining moment in its evolution. Most organizations are developing bold new strategies to contend with rapidly changing market dynamics, presenting HR professionals with the challenge of translating these strategies into organizational structure, redefining roles, accountabilities, and competencies and aligning work processes. In the absence of strong HR leadership

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- [Home](https://nai-consulting.com/) - Numerof provides strategic management insight for the global healthcare sector and beyond. See how our consultants can help you succeed.
- [Our Clients](https://nai-consulting.com/management-consulting-clients/) - At Numerof, we focus on healthcare, but have more than 25 years of experience helping organizations with strategic management consulting services.
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- [Michael Abrams, MA](https://nai-consulting.com/michael-abrams-ma-2/) - Michael N. Abrams, Managing Partner, has served as an internal and external consultant to Fortune 50 corporations, major pharmaceutical and medical device companies, healthcare delivery institutions, the financial services industry, and government agencies for over 25 years. He has worked extensively in the areas of strategic planning and implementation; product strategy and portfolio development; market
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- [Jill Sackman](https://nai-consulting.com/jill-sackman/) - Dr. Jill E. Sackman is a Senior Consultant and head of the healthcare delivery practice at Numerof & Associates, Inc. An engaging, insightful speaker, Jill brings to her engagements deep experience as a surgeon, author and consultant. She’s worked for more than 25 years across healthcare, and understands the challenging issues facing healthcare today. Jill
- [cdmPhysician™](https://nai-consulting.com/cdmphysician-chronic-disease-practice-management/) - Proven techniques to help your team improve practice efficiency and outcomes In the new era of accountable care and at-risk payment, effective management of chronic conditions can make or break your cost and quality results. Patient interactions at the outpatient clinic represent your best opportunity to intervene. But without the knowledge, processes, and tools needed
- [Operationalizing Strategy](https://nai-consulting.com/what-we-do/strategic-management-consulting/operationalizing-strategy/) - Take a proactive approach to the road ahead by operationalizing your strategy for success with strategic consultation from Numerof.
- [Featured Posts](https://nai-consulting.com/news-and-insights/) - Read the latest insights on how to thrive during industry transitions from the strategic management consulting experts at Numerof.
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- [Competing on Differentiated Value](https://nai-consulting.com/what-we-do/strategic-management-consulting/compete-on-differentiated-value/) - Compete and win on differentiated value and strategic marketing. See how Numerof can help you use stakeholder insights to your advantage.
- [Delivering Global Growth](https://nai-consulting.com/what-we-do/strategic-management-consulting/deliver-global-growth/) - Deliver global growth by connecting to established and emerging markets with the help of strategic management consulting from Numerof.
- [Anticipating and Creating the Future](https://nai-consulting.com/what-we-do/strategic-management-consulting/anticipate-and-create-the-future/) - Build tomorrow’s model as you manage today’s. Numerof can help you adapt to changing market conditions. Learn more about our experience and solutions.
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- [Other Industries](https://nai-consulting.com/what-we-do/strategic-management-consulting/) - Numerof's strategic management consultants bring market insights to global companies in finance, IT, manufacturing, utilities and more.
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- [Portfolio Strategy](https://nai-consulting.com/what-we-do/medical-manufacturing-consulting/portfolio-strategy/) - Improve your portfolio, segmentation and positioning by capitalizing on strategic market insights from the management consultants at Numerof.
- [Strategic Planning and New Business Models](https://nai-consulting.com/what-we-do/medical-manufacturing-consulting/strategic-planning-and-new-business-models/) - See how Numerof brings strategic planning and insight to new business model development for the medical devices and diagnostics industry.
- [Strategic Approaches to Regulatory and Compliance](https://nai-consulting.com/what-we-do/medical-manufacturing-consulting/strategic-regulatory-and-compliance/) - Prepare for the latest regulatory and compliance mandates with help from the strategic management consultants at Numerof.
- [Selling to Complex, Evolving Customers](https://nai-consulting.com/what-we-do/medical-manufacturing-consulting/selling-to-complex-customers/) - Numerof can help you understand what medical device customers are facing to build a stronger value story and a more successful sales approach.
- [Reshaping R&D](https://nai-consulting.com/what-we-do/medical-manufacturing-consulting/reshaping-research-and-development/) - Keep your edge over the competition by reshaping research and development. Find your strategy with the consultants at Numerof.
- [M&A Strategy and Integration](https://nai-consulting.com/what-we-do/medical-manufacturing-consulting/mergers-and-acquisitions-strategy/) - Simplify M&As, or mergers & acquisitions, in medical device and diagnostics manufacturing with market insights from Numerof to provide strategic consulting and effective integration.
- [New Commercial Models](https://nai-consulting.com/what-we-do/medical-manufacturing-consulting/new-commercial-models/) - Achieve and maintain success in medical device and diagnostics manufacturing with new commercial models built on strategic insight from Numerof.
- [Modeling and Analytics](https://nai-consulting.com/what-we-do/medical-manufacturing-consulting/modeling-and-analytics/) - Data is everywhere. Use it to find opportunities in medical device manufacturing. See how Numerof helps with sophisticated modeling and analytics.
- [Managing Globally and Locally](https://nai-consulting.com/what-we-do/medical-manufacturing-consulting/manage-global-and-local/) - Meet the needs of local and global markets with a strong infrastructure and scalable processes. Numerof can help.
- [Making the Value Case](https://nai-consulting.com/what-we-do/medical-manufacturing-consulting/making-the-value-case/) - Learn how Numerof can help medical device and diagnostics manufacturers develop stronger economic and clinical value cases.
- [Developing a Robust Portfolio](https://nai-consulting.com/what-we-do/medical-manufacturing-consulting/develop-a-robust-portfolio/) - Drive stronger medical device and diagnostics product strategies with stakeholder insights and data from the team of Numerof consultants.
- [Delivering Global Growth](https://nai-consulting.com/what-we-do/medical-manufacturing-consulting/deliver-global-growth/) - Numerof strategic management consultants connect the dots across established and emerging medical device markets so you can deliver global growth.
- [Defining and Demonstrating Value](https://nai-consulting.com/what-we-do/medical-manufacturing-consulting/define-and-demonstrate-value/) - Compete and win in medical devices and diagnostics manufacturing by defining and demonstrating value with the help of Numerof.
- [Consolidation and Competition](https://nai-consulting.com/what-we-do/medical-manufacturing-consulting/consolidation-and-competition/) - Learn how to succeed with Numerof as consolidation and competition change the medical devices and diagnostics manufacturing market.
- [Strategic Planning and New Business Models](https://nai-consulting.com/what-we-do/healthcare-delivery-consulting/strategic-planning-new-business-models/) - It’s tempting to put off preparing for the future, but Numerof can offer clarity with strategic planning and insights on new business models.
- [Population Health Management](https://nai-consulting.com/what-we-do/healthcare-delivery-consulting/population-health-management/) - Numerof can help you deliver the right care, at the right time, in the right setting to manage population health and improve outcomes.
- [Patient-Centered Evidence-Based Care](https://nai-consulting.com/what-we-do/healthcare-delivery-consulting/patient-centered-evidence-based-care/) - Numerof can help you find the path to improved outcomes and reduced costs through patient-centered, evidence-based care delivery.
- [Organizational Infrastructure](https://nai-consulting.com/what-we-do/healthcare-delivery-consulting/organizational-infrastructure/) - It takes a strong organizational infrastructure to succeed in the new healthcare delivery landscape. Learn how Numerof can help your organization.
- [New Payment and Delivery Models](https://nai-consulting.com/what-we-do/healthcare-delivery-consulting/new-payment-delivery-models/) - Numerof has the strategic management consulting expertise you need to reduce costs and improve outcomes by preparing for tomorrow’s model.
- [Alliance Strategy and Implementation](https://nai-consulting.com/what-we-do/healthcare-delivery-consulting/alliance-strategy-implementation/) - Building successful partnerships and alliances takes strategic analysis and careful implementation. With more than 25 years of experience, Numerof can help.
- [Managing Variation in Cost and Quality](https://nai-consulting.com/what-we-do/healthcare-delivery-consulting/managing-variation-in-cost-quality/) - Numerof can help you manage variation in cost and quality by removing cultural and operational barriers to better outcomes at lower cost.
- [M&A Strategy and Integration](https://nai-consulting.com/what-we-do/healthcare-delivery-consulting/ma-strategy-and-integration/) - When it comes to mergers and acquisitions, Numerof uses deep market insights to provide strategic consulting and effective integration.
- [Financial Viability and Cost Improvement](https://nai-consulting.com/what-we-do/healthcare-delivery-consulting/financial-viability-cost-improvement/) - Improve your healthcare delivery margins and challenge historical norms with data, insights and strategic management consulting from Numerof.
- [Cost Improvement](https://nai-consulting.com/what-we-do/healthcare-delivery-consulting/cost-improvement/) - Reduce costs and improve outcomes. Take control of your financial viability with the help of Numerof strategic management consultants.
- [Competitive Differentiation](https://nai-consulting.com/what-we-do/healthcare-delivery-consulting/competitive-differentiation/) - Numerof can help you set yourself apart in a value-driven landscape by making healthcare delivery more cost-effective and safe with solid data.
- [Competition and Growth](https://nai-consulting.com/what-we-do/healthcare-delivery-consulting/competition-and-growth/) - Take the lead with new ideas for competition and growth in healthcare delivery with help from Numerof strategic management consultants.
- [Clinical Excellence, Quality, and Safety](https://nai-consulting.com/what-we-do/healthcare-delivery-consulting/clinical-excellence-quality-safety/) - Stay ahead of the competition by making clinical excellence, quality, and safety a key part of your strategy with Numerof’s healthcare consulting.
- [Bundled Pricing](https://nai-consulting.com/what-we-do/healthcare-delivery-consulting/bundled-pricing/) - If you’re ready, Numerof can help you implement bundled pricing to align incentives, keep costs in check and achieve better outcomes.
- [Pharmaceuticals](https://nai-consulting.com/what-we-do/pharmaceuticals-consulting/) - Bring Numerof's insight to your pharmaceutical company's strategic plans to stay ahead of your competitors. Learn how our management consultants can help.
- [Strategic Planning and New Business Models](https://nai-consulting.com/what-we-do/pharmaceuticals-consulting/strategic-planning-new-business-models-2/) - Build your success with Numerof's strategic planning and insight around new pharmaceutical business models.
- [Strategic Approaches to Regulatory and Compliance](https://nai-consulting.com/what-we-do/pharmaceuticals-consulting/strategic-approaches-to-regulatory-compliance/) - Regulatory and compliance mandates are constantly changing. Stay ahead of the curve with insight and strategy delivered by Numerof.
- [Selling to Complex, Evolving Customers](https://nai-consulting.com/what-we-do/pharmaceuticals-consulting/selling-to-complex-customers/) - As pharmaceutical customers become more complex and informed, Numerof can offer the strategic support you need to achieve and sustain success.
- [Reshaping R&D](https://nai-consulting.com/what-we-do/pharmaceuticals-consulting/reshaping-research-and-development/) - A robust research and development strategy is vital to your success. Plan for tomorrow by calling on Numerof’s strategic management consultants.
- [Managing Globally and Locally](https://nai-consulting.com/what-we-do/pharmaceuticals-consulting/manage-global-and-local/) - Manage your strategy across local and global markets with the support of Numerof strategic management consultants.
- [Making the Value Case](https://nai-consulting.com/what-we-do/pharmaceuticals-consulting/make-the-value-case/) - Build a value case that speaks to stakeholders and prospects with Numerof’s strategic management consultants and their decades of experience.
- [M&A Strategy and Integration](https://nai-consulting.com/what-we-do/pharmaceuticals-consulting/mergers-and-acquisitions-strategy/) - Make sense of mergers and acquisitions with market insights with Numerof's strategic consulting and effective integration that's built for success.
- [Developing a Robust Portfolio](https://nai-consulting.com/what-we-do/pharmaceuticals-consulting/develop-a-robust-portfolio/) - Put stakeholder insights to work. Develop a robust portfolio built on in-depth data from Numerof strategic managment consultants.
- [Delivering Global Growth](https://nai-consulting.com/what-we-do/pharmaceuticals-consulting/deliver-global-growth/) - Growth on a global scale requires a deep understanding of emerging markets around the world. See how Numerof can deliver the insight you need.
- [Defining and Demonstrating Value](https://nai-consulting.com/what-we-do/pharmaceuticals-consulting/define-and-demonstrate-value/) - Pharmaceutical companies can compete and win by clearly defining and demonstrating their value. See how Numerof consultants can help.
- [Achieving Market Access](https://nai-consulting.com/what-we-do/pharmaceuticals-consulting/achieve-market-access/) - Break into and achieve success in the most complex and rewarding markets with insights from Numerof's strategic management consultants.
- [Population Health and Risk-Based Models](https://nai-consulting.com/what-we-do/healthcare-payers-consulting/population-health-risk-based-models/) - Numerof strategic consultants have the insight healthcare payers need to bring change with population health and risk-based payment and delivery models.
- [Strategic Planning and New Business Models](https://nai-consulting.com/what-we-do/healthcare-payers-consulting/strategic-planning-new-business-models/) - During times of change, Numerof gives healthcare payers the strategic planning and new business models it takes to rise above competitors. Learn more.
- [New Payment and Delivery Models](https://nai-consulting.com/what-we-do/healthcare-payers-consulting/new-payment-delivery-models/) - Take the lead in changing incentives with consulting from Numerof. We guide healthcare payers through succeeding with new payment and delivery models.
- [Network Strategy and Provider Alignment](https://nai-consulting.com/what-we-do/healthcare-payers-consulting/network-strategy-provider-alignment/) - At Numerof, our consultants build better outcomes and lower costs for healthcare payers with network strategy and provider alignment. Learn more.
- [M&A Strategy and Integration](https://nai-consulting.com/what-we-do/healthcare-payers-consulting/mergers-and-acquisitions-strategy/) - Success in mergers & acquisitions for healthcare payers takes planning and strategic insight. The management consultants at Numerof are here to help.
- [Financial Viability and Cost Improvement](https://nai-consulting.com/what-we-do/healthcare-payers-consulting/financial-viability-cost-improvement/) - Healthcare payers are facing the need to prove financial viability and cost improvement. Let Numerof strategic management consultants help.
- [Clinical Excellence, Quality, and Safety](https://nai-consulting.com/what-we-do/healthcare-payers-consulting/clinical-excellence-quality-safety/) - For healthcare payers, improved outcomes and costs start with provider collaboration. See how Numerof improves clinical excellence, quality and safety.
- [Medical Devices and Diagnostics](https://nai-consulting.com/what-we-do/medical-manufacturing-consulting/) - Numerof provides market insight and strategy when it’s needed most in the medical devices and diagnostics manufacturing industry.
- [Achieving Market Access](https://nai-consulting.com/what-we-do/medical-manufacturing-consulting/achieve-market-access/) - Gaining ground in the medical devices and diagnostics manufacturing market is tough. Call on Numerof strategic management consultants for support.
- [Our Team](https://nai-consulting.com/management-consulting-team/) - Meet the talented Numerof consultants, analysts, and operations and marketing staff members who guide businesses to compete and win.
- [Other Industries](https://nai-consulting.com/consulting-case-studies/strategic-operational-success/) - Read how Numerof strategic management consultants help businesses thrive in transition across finance, IT utilities and more, on a global scale.
- [Medical Devices and Pharmaceuticals](https://nai-consulting.com/consulting-case-studies/medical-devices-pharmaceuticals/) - Read how Numerof strategic management consultants help medical device and pharmaceutical businesses thrive in transition on a global scale.
- [Healthcare Delivery and Payers](https://nai-consulting.com/consulting-case-studies/healthcare-delivery-payers/) - Read how Numerof strategic management consultants help healthcare delivery and payer businesses thrive in transition on a global scale.
- [Case Studies](https://nai-consulting.com/consulting-case-studies/) - At Numerof, our strategic management consultants help businesses thrive in industries of transition on a global scale. Read more about how we help.
- [Application](https://nai-consulting.com/management-consulting-careers/) - Apply to become a consultant, analyst, or operations and marketing team member at Numerof, a St. Louis-based healthcare management consulting firm.
- [Modeling and Analytics](https://nai-consulting.com/what-we-do/healthcare-payers-consulting/modeling-and-analytics/) - For healthcare payers, data is everywhere. Learn how Numerof strategic consultants bring modeling and analytics that improve decisions and performance.
- [Organizational Infrastructure](https://nai-consulting.com/what-we-do/healthcare-payers-consulting/organizational-infrastructure/) - To build sustained success healthcare payers have to lay a foundation that’s ready for it. Learn how insight from Numerof consultants can help.
- [Competitive Differentiation](https://nai-consulting.com/what-we-do/healthcare-payers-consulting/competitive-differentiation/) - The healthcare industry is changing dramatically for payers. Let Numerof consultants help you differentiate and win by building a new value story.
- [Consumer Engagement](https://nai-consulting.com/what-we-do/healthcare-payers-consulting/consumer-engagement/) - If you want to engage consumers, you have to earn their trust. See how Numerof gives healthcare payers the insight needed to build relationships.
- [Demands for Greater Transparency](https://nai-consulting.com/what-we-do/healthcare-payers-consulting/demands-for-greater-transparency/) - As the demand for greater transparency increases, Numerof consultants guide healthcare payers through the changes toward making transparency an asset.
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- [Organizational Alignment](https://nai-consulting.com/what-we-do/healthcare-payers-consulting/organizational-alignment/) - Numerof can help you realign your organization to succeed in tomorrow’s environment. See how we bring organizational alignment to healthcare payers.
- [Competition and Growth](https://nai-consulting.com/what-we-do/healthcare-payers-consulting/competition-and-growth/) - Healthcare industry changes are giving payers even more competition. Numerof gives you a compelling offering and value story to take on competitors.
- [What We Do](https://nai-consulting.com/what-we-do/) - Numerof provides strategic management insights for the global healthcare sector and beyond, from consumer goods to financial services. See how we can help.
- [Organizational Alignment](https://nai-consulting.com/what-we-do/healthcare-delivery-consulting/organizational-alignment/) - Work with Numerof to create organizational alignment by linking operations and strategy throughout your healthcare delivery organization.
- [Organizational Infrastructure](https://nai-consulting.com/what-we-do/pharmaceuticals-consulting/organizational-infrastructure/) - As you prepare to take new strategic steps, Numerof can help your pharmaceutical business build the required organizational infrastructure.
- [Portfolio Strategy](https://nai-consulting.com/what-we-do/pharmaceuticals-consulting/portfolio-strategy/) - Develop your pharmaceutical portfolio to position it for success. Numerof’s strategic management consultants and market insight are on your side.
- [Modeling and Analytics](https://nai-consulting.com/what-we-do/pharmaceuticals-consulting/modeling-and-analytics/) - Get the most from your data. Numerof will help you gain useful, strategic insights through sophisticated modeling and analytics.
- [New Commercial Models](https://nai-consulting.com/what-we-do/pharmaceuticals-consulting/new-commercial-models/) - "Find the strategic insight you need to implement successful new commercial models with Numerof’s decades of experience on your side. "
- [Consolidation and Competition](https://nai-consulting.com/what-we-do/pharmaceuticals-consulting/consolidation-and-competition/) - As consolidation and competition make the market even more complex, see how strategic management consulting from Numerof can help you succeed.

## News

- [Numerof Appoints Former Biopharma Market Access Leader Laurent Carter as Senior Advisor](https://nai-consulting.com/news/numerof-appoints-former-biopharma-market-access-leader-laurent-carter-as-senior-advisor/) - Former Bristol Myers Squibb senior executive brings more than 35 years of global pricing, market access and commercialization experience to Numerof clients Numerof & Associates, a healthcare strategy consulting firm advising organizations across the life sciences ecosystem, today announced that Laurent Carter, former BMS market access senior executive, has joined the firm as a Senior
- [<i>MedCity News</i> Interviews Numerof on Hinge Health Acquisition of Cylinder](https://nai-consulting.com/news/medcity-news-interviews-numerof-on-hinge-health-acquisition-of-cylinder/) - Hinge Health’s $105 million acquisition of Cylinder Health signals a major strategic shift as virtual care companies expand beyond single-condition offerings toward broader chronic care platforms. While consolidation can help employers address point-solution fatigue, true progress isn’t just about bundling single-condition services. Managing Partner Michael Abrams discussed the structural differences shaping digital health strategy in
- [Numerof Featured in <i>Medical Economics</i> on CMS’s WISeR Model](https://nai-consulting.com/news/numerof-featured-in-medical-economics-on-cmss-wiser-model/) - CMS is right to target wasteful spending in Medicare, but there has been much debate surrounding the new WISeR (Wasteful and Inappropriate Service Reduction) Model, and that it takes the wrong approach. By forcing prior authorization (PA) into traditional Medicare and outsourcing reviews to contractors incentivized by claim denials, WISeR threatens to replicate Medicare Advantage's
- [<i>PharmaVoice</i> Interviews Numerof on AstraZeneca-BMS Merger Talks](https://nai-consulting.com/news/pharmavoice-interviews-numerof-on-astrazeneca-bms-merger-talks/) - Recent reports of a potential $400 billion megamerger between AstraZeneca and Bristol Myers Squibb sent shockwaves through the biopharma sector. While the deal appears off, the underlying driver remains clear: Big Pharma’s urgent need to counter looming loss of exclusivity (LOE). In an interview with PharmaVoice, Managing Partner Michael Abrams explained that with a potential
- [Numerof Appoints Former Chief Commercial Officer Ronald Kierpa as Senior Advisor](https://nai-consulting.com/news/numerof-appoints-former-chief-commercial-officer-ronald-kierpa-as-senior-advisor/) - Veteran pharmaceutical and biotechnology leader brings decades of global commercial and launch expertise to Numerof clients Numerof & Associates, a healthcare strategy consulting firm advising organizations across the life sciences ecosystem, today announced that Ronald Kierpa, a highly respected global commercial leader in pharmaceuticals and biotechnology, has joined the firm as a Senior Consultant and
- [<i>Health Payer Specialist</i> Interviews Numerof on Cigna CEO’s Strategy](https://nai-consulting.com/news/health-payer-specialist-interviews-numerof-on-cigna-ceos-strategy/) - Cigna’s next chapter will depend on how effectively the company evaluates and optimizes the businesses and investments built over the past decade. David Cordani’s tenure was defined by building scale. New CEO Brian Evanko’s challenge will be determining how to best leverage that platform and answer a critical question: how will Cigna deploy its capital
- [Numerof Featured in <i>DC Journal</i> on Accountability in Healthcare](https://nai-consulting.com/news/numerof-featured-in-dc-journal-on-accountability-in-healthcare/) - Every few years, Washington finds a new healthcare villain – drug manufacturers, PBMs, insurers, or hospitals. Hearings are held, headlines are written, and promises of reform are made; yet the underlying problems persist. In his latest op-ed for DC Journal, Managing Partner Michael Abrams argues that healthcare's biggest challenge isn't cost – it's accountability. When
- [<i>MedCity News</i> Interviews Numerof on CMS’s WISeR Model](https://nai-consulting.com/news/medcity-news-interviews-numerof-on-cmss-wiser-model/) - The debate surrounding CMS's WISeR model raises an important question: How can we reduce wasteful spending in Medicare without creating new barriers to care? In an interview with MedCity News, Managing Partner Michael Abrams explained that the controversy stems largely from the model's reliance on prior authorization. While the tool has been used sparingly in
- [<I>BioSpace</I> Interviews Numerof on Commissioner’s National Priority Vouchers](https://nai-consulting.com/news/biospace-interviews-numerof-on-commissioners-national-priority-vouchers/) - The conversation around the FDA's Commissioner’s National Priority Voucher program isn't just about review speed. It’s about what the program signals about the FDA’s evolving role and a more ambitious effort to reshape how the pharmaceutical sector operates. In an interview with BioSpace, Managing Partner Michael Abrams explained the importance of understanding the CNPV program
- [<I>Fierce Biotech</I> Interviews Numerof on Clinical Trial Prediction Markets](https://nai-consulting.com/news/fierce-biotech-interviews-numerof-on-clinical-trial-prediction-markets/) - Prediction markets entering biotech may sound innovative on the surface, but they also introduce a new layer of risk to an industry already defined by uncertainty. Clinical trials influence investor confidence, patient enrollment, company valuations, and ultimately whether therapies ever reach the market. In an interview with Fierce Biotech, Managing Partner Michael Abrams warned of
- [<I>PharmaVoice</I> Interviews Numerof on Specialized R&D in Pharma](https://nai-consulting.com/news/pharmavoice-interviews-numerof-on-specialized-rd-in-pharma/) - Big Pharma’s shift toward specialization is ultimately a response to mounting pressure. Between looming patent cliffs, the IRA shortening the earning life of products, and increasing scientific complexity, many companies are concluding they can’t continue operating the way they have historically and expect the same results. In an interview with PharmaVoice, Managing Partner Michael Abrams
- [<I>Health Payer Specialist</I> Interviews Numerof on Cigna’s Evolving Strategy](https://nai-consulting.com/news/health-payer-specialist-interviews-numerof-on-cignas-evolving-strategy/) - Cigna’s evolution reflects a broader shift happening across healthcare: services businesses are increasingly viewed as more predictable, scalable, and strategically attractive than traditional insurance risk. David Cordani built Cigna into a national powerhouse through aggressive growth and acquisitions. But the next phase under incoming CEO Brian C. Evanko may be less about expansion and more
- [<I>PharmaVoice</I> Interviews Numerof on Purdue Pharma Settlement](https://nai-consulting.com/news/pharmavoice-interviews-numerof-on-purdue-pharma-settlement/) - More than 900,000 Americans died as a result of the opioid crisis, and the family behind Purdue Pharma made more than $10 billion marketing a drug they knew was addictive. Now, after years of litigation, the Sacklers will pay roughly $7 billion in settlements. The one bright spot is the creation of Knoa Pharma, a
- [<i>Chief Healthcare Executive</i> Interviews Numerof on Rising Healthcare Costs](https://nai-consulting.com/news/chief-healthcare-executive-interviews-numerof-on-rising-healthcare-costs/) - This week, hospital executives testified before lawmakers on rising healthcare costs. The hearing highlighted that it isn’t just individual decisions driving up costs but is a predictable result of misaligned incentives across the system. Managing Partner Michael Abrams told Chief Healthcare Executive that the hearing called attention to a number of problems. At the core,
- [<I>Virginia Economic Review</I> Interviews Numerof on Reshoring Drug Manufacturing](https://nai-consulting.com/news/virginia-economic-review-interviews-numerof-on-reshoring-drug-manufacturing/) - Recent policy changes have helped accelerate reshoring of drug manufacturing to the U.S., particularly in Virginia. However, most of the new investment is coming from branded drugmakers. Unfortunately, those same incentives won’t be sufficient for generic drug manufacturers. In an interview with Virginia Economic Development Partnership, Managing Partner Michael Abrams explained the challenges generics manufacturers
- [<I>BioPharma Dive</I> Interviews Numerof on Vinay Prasad's Departure from the FDA](https://nai-consulting.com/news/biopharma-dive-interviews-numerof-on-vinay-prasads-departure-from-the-fda/) - After a year marked by leadership turnover, shifting policies, and now the departure of Vinay Prasad, the question facing the FDA isn’t just about who’s in charge – it’s about whether the agency can provide the predictability biopharma companies need to operate. In an interview with BioPharma Dive, Managing Partner Michael Abrams explained that when
- [<I>PharmaVoice</I> Interviews Numerof on FDA’s CRL Push](https://nai-consulting.com/news/pharmavoice-interviews-numerof-on-fdas-crl-push/) - The FDA’s push for “radical transparency” is putting a spotlight on how – and when – information about drug development becomes public. In an interview with PharmaVoice, Managing Partner Michael Abrams explained that policy changes that make confidential information public aren’t new. Most significant will be manufacturers ceding some control over the new product narrative
- [<I> Healthcare Brew </I> Interviews Numerof on CVS Health's Agentic AI Platform](https://nai-consulting.com/news/healthcare-brew-interviews-numerof-on-cvs-healths-agentic-ai-platform/) - CVS Health’s announcement of its agentic AI platform is an interesting development in healthcare technology. The platform aims to unify pharmacy, medical, and digital health data to support more consistent patient engagement – a goal central to better outcomes. While the announcement presents a compelling vision, the specifics of how the platform will operate and
- [<i>MedCity News</i> Interviews Numerof on Hims & Hers – Novo Nordisk Partnership](https://nai-consulting.com/news/medcity-news-interviews-numerof-on-hims-hers-novo-nordisk-partnership/) - The rapid evolution of the GLP-1 market is reshaping how pharmaceutical manufacturers and digital health platforms work together. The recent agreement between Novo Nordisk and Hims & Hers is a striking example – turning a legal dispute over compounded GLP-1s into a distribution partnership. In an interview with MedCity News, Managing Partner Michael Abrams shared
- [<i>MedCity News</i> Interviews Numerof on Talkspace Acquisition](https://nai-consulting.com/news/medcity-news-interviews-numerof-on-talkspace-acquisition/) - The planned acquisition of Talkspace by UHS reflects the growing importance of a full behavioral health continuum. In an interview with MedCity News, Managing Partner Michael Abrams shared that platforms like Talkspace can serve as both a front door to care and a pathway to more intensive services when needed. At the same time, patients
- [<i>Financial Times</i> Interviews Numerof on Cigna's CEO Transition](https://nai-consulting.com/news/financial-times-interviews-numerof-on-cignas-ceo-transition/) - Brian C. Evanko has been a central part of The Cigna Group’s leadership team for decades and will now step into the CEO role, succeeding longtime leader David Cordani. Managing Partner Michael Abrams explained in an interview with Financial Times - Health Payer Specialist that after years of major strategic moves under Cordani, the focus
- [<i>MedCity News</i> Interviews Numerof on Hims & Hers Acquisition of Eucalyptus](https://nai-consulting.com/news/medcity-news-interviews-numerof-on-hims-hers-acquisition-of-eucalyptus/) - Hims & Hers recently announced its $1.15B acquisition of Eucalyptus, an Australian digital health company. In an interview with MedCity News, Managing Partner Michael Abrams shared his thoughts on the deal, noting that it’s a smart move, both financially and strategically. By bringing Eucalyptus into the fold, Hims & Hers is making a deliberate pivot
- [Numerof Appoints Former Chief Commercial Officer Mark C. Twyman as Senior Advisor](https://nai-consulting.com/news/numerof-associates-appoints-fmr-chief-commercial-officer-mark-c-twyman-as-senior-advisor/) - Veteran pharmaceutical and biotechnology leader brings decades of global commercial and launch expertise to Numerof clients Numerof & Associates, a healthcare strategy consulting firm advising organizations across the life sciences ecosystem, today announced that Mark C. Twyman, MBA, a highly respected global commercial leader in pharmaceuticals and biotechnology, has joined the firm as a Senior
- [<i>MedCity News</i> Interviews Numerof on Danaher Acquisition of Masimo](https://nai-consulting.com/news/medcity-news-interviews-numerof-on-danaher-acquisition-of-masimo/) - The Danaher Corporation acquisition of Masimo highlights a clear shift in healthcare: value is increasingly tied to continuous, integrated care within hospitals. In an interview with MedCity News, Managing Partner Michael Abrams shared that he sees the deal as both an offensive and defensive move for Danaher. Increasing value is placed on non‑invasive monitoring technologies
- [Numerof Featured in <i>Pharmaceutical Commerce</i> on Pharmacy Deserts](https://nai-consulting.com/news/numerof-featured-in-pharmaceutical-commerce-on-pharmacy-deserts/) - For nearly 60% of Americans, pharmacies are the first stop for non-emergency care—providing vaccinations, medication management, chronic disease screening, and public health support. When a community pharmacy closes, medication adherence drops, particularly for cardiovascular drugs, driving higher downstream costs across the system. The rise of “pharmacy deserts” is becoming a serious healthcare problem as community
- [<i>Chief Healthcare Executive</i> Interviews Numerof on Hospital M&A in 2026](https://nai-consulting.com/news/chief-healthcare-executive-interviews-numerof-on-hospital-ma-in-2026/) - Hospital mergers are picking up in 2026, but it’s important to look beyond the headlines. In an interview with Chief Healthcare Executive, Managing Partner Michael Abrams shared that many health systems were caught off guard last year by rapid federal policy changes, leading to a stagnant period for mergers and other initiatives. Said Abrams, I
- [<i>MedCity News</i> interviews Numerof on No Surprises Act](https://nai-consulting.com/news/medcity-news-interviews-numerof-on-no-surprises-act/) - The No Surprises Act was designed to protect patients from unexpected medical bills, and it has largely succeeded in that goal. But the Independent Dispute Resolution (IDR) process is beginning to show signs of strain. In cases like Anthem v. Prime Healthcare, some provider organizations appear to be submitting large numbers of ineligible claims, resulting
- [<i>PharmaVoice</i> Interviews Numerof on U.S. Biopharma M&A](https://nai-consulting.com/news/pharmavoice-interviews-numerof-on-u-s-biopharma-ma/) - Biopharma M&A slowed to a crawl in the first half of 2025, amid regulatory, pricing, and geopolitical uncertainties. In an interview with Michael Gibney, Managing Partner Michael Abrams discussed how multiple shocks in 2025 put a damper on potential deals and reshaped how pharma leaders are making long-term decisions. “Every day was another headline that
- [<i>BioWorld</i> Highlights Numerof 206 Global Pharma Outlook in Biopharma Forecast](https://nai-consulting.com/news/bioworld-highlights-numerof-206-global-pharma-outlook-in-biopharma-forecast/) - Heading into 2026, the biopharma industry faces heightened political, regulatory, and reimbursement uncertainty. This year, the level of policy activism is particularly impactful, shaping how companies approach manufacturing, commercialization, and portfolio strategy. Combined with ongoing patent cliffs and capital pressures, these forces highlight the need for organizations to rethink their business models and position themselves
- [<i>Healthcare Brew</i> interviews Numerof on Healthcare M&A Outlook for 2026](https://nai-consulting.com/news/healthcare-brew-interviews-numerof-on-healthcare-ma-outlook-for-2026/) - 2025 was a year of restraint for healthcare provider M&A. Hospital transactions slowed, while dental, behavioral health, and other practice specialties stayed active. Tight margins, labor pressures, and antitrust scrutiny pushed dealmakers toward mid-market and distress-driven transactions. Behavioral health and home/post-acute care drew consistent interest, while hospital systems prioritized financial stabilization, selective partnerships, and shedding
- [<i>Pharmaceutical Executive</i> interviews Numerof on Pharma and Biotech M&A](https://nai-consulting.com/news/pharmaceutical-executive-interviews-numerof-on-pharma-and-biotech-ma/) - After a quiet period in 2024, biopharma M&A activity is returning steadily, driven in part by strategic portfolio repositioning across Big Pharma. Buyers are prioritizing assets that fill pipeline gaps or add adjacent commercial revenue streams, particularly in areas such as oncology and precision medicine, obesity and metabolic disease, cardiovascular and renal disease, and CNS.
- [<i>PharmaVoice</i> interviews Numerof on the BIOSECURE Act](https://nai-consulting.com/news/pharmavoice-interviews-numerof-on-the-biosecure-act/) - After years of debate, the BIOSECURE Act is moving toward becoming law as part of the National Defense Authorization Act. While narrower than earlier proposals, it keeps the core idea intact: blocking U.S. federal funding from flowing to risky foreign-adversary biotech firms—while softening and restructuring how the policy works. Rather than naming specific Chinese companies,
- [<i>MedCity News</i> Interviews Numerof on the CMS’ New $50B Rural Health Fund](https://nai-consulting.com/news/medcity-news-interviews-numerof-on-the-cms-new-50b-rural-health-fund/) - During negotiations over passage of the One Big Beautiful Bill Act in July, 2025, a new, $50B Rural Health Fund was created to address concerns of some undecided legislators about the impact of the Act on rural hospitals. Managing Partner Michael Abrams spoke recently with MedCity News about the new fund and what’s needed to meaningfully change
- [Numerof & Associates’ 2026 Outlooks Highlight Mounting Pressures and Emerging Opportunities Across the Healthcare Industry](https://nai-consulting.com/news/numerof-associates-2026-outlooks-highlight-mounting-pressures-and-emerging-opportunities-across-the-healthcare-industry/) - The new administration’s policies are reshaping the healthcare landscape, driving renewed focus on value, evidence and operational agility. ST. LOUIS – NOV. 10, 2025 – Numerof & Associates, a leading strategy and implementation consultancy focused on healthcare organizations navigating industry-wide transition, today released its 2026 Healthcare Industry Outlooks, offering an integrated view of the challenges
- [<i>PharmaVoice</i> Interviews Numerof on Trump’s EO on Drug Pricing](https://nai-consulting.com/news/pharmavoice-interviews-numerof-on-trumps-eo-on-drug-pricing/) - Managing Partner Michael Abrams spoke with PharmaVoice about President Trump’s recent drug pricing executive order and the impact of potential tariffs. Whether any of the solutions generated are effective will depend on the creativity of those assigned to come up with potential solutions and the follow-through on those solutions deemed viable. Abrams added that branded
- [<i>Al Jazeera</i> Interviews Numerof on the Impacts of the Trade War on U.S. Healthcare](https://nai-consulting.com/news/al-jazeera-interviews-numerof-on-the-impacts-of-the-trade-war-on-u-s-healthcare/) - Managing Partner Michael Abrams spoke with Al Jazeera on the potential ramifications of the trade war between the U.S. and China on the healthcare sector and its supply chain. Healthcare has a very elaborate logistics chain, and obviously, it varies from product to product, but some of them are very complicated Abrams added that generic
- [<i>Healthcare Finance News</i> Interviews Numerof on Medicare Advantage Trends Heading into 2025](https://nai-consulting.com/news/healthcare-finance-news-interviews-numerof-on-medicare-advantage-trends-heading-into-2025/) - Managing Partner Michael Abrams spoke with Healthcare Finance News on the continued challenges Medicare Advantage will face in 2025, including rising utilization, and decreasing profitability. Utilization went up in 2024 unexpectedly, possibly reflecting pent-up demand carried over from the pandemic, or from people delaying their care. Abrams added that insurers may look to adjust their
- [<i>AIS Health</i> Interviews Numerof on Advanced Primary Care Initiative in Washington](https://nai-consulting.com/news/ais-health-interviews-numerof-on-advanced-primary-care-initiative-in-washington/) - Managing Partner Michael Abrams spoke with AIS Health on the announcement from the Purchasers Business Group on Health on an advanced primary care initiative in the state of Washington. While Abrams applauded PBGH’s initiative, he noted the challenge of convincing physicians to move away from the traditional fee-for-service model. As much as that makes sense,
- [<i>AIS Health</i> Interviews Numerof on Prior Authorization Practices](https://nai-consulting.com/news/ais-health-interviews-numerof-on-prior-authorization-practices/) - Managing Partner Michael Abrams spoke with AIS Health about the recent Senate report on Medicare Advantage prior authorization denials for post-acute care and its implications on future legislation. In response to the report, Abrams said: That is very simply what is wrong with our entire health care system — that the outcome and the experiences
- [<i>MedCity News</i> Interviews Numerof on Walgreens’ Potential Sale to Private Equity Firm](https://nai-consulting.com/news/medcity-news-interviews-numerof-on-walgreens-potential-sale-to-private-equity-firm/) - Managing Partner Michael Abrams spoke with MedCity News on reports of Walgreens exploring a potential sale to private equity firm Sycamore Partners, and the rationale behind a potential deal. Abrams pointed to multiple reasons Walgreens could be looking to sell, including increased pressure from pharmacy benefit managers, and a significant drop in market value. At
- [<i>MedCity News</i> Interviews Numerof on the Future of Prescription Drugs Under Trump](https://nai-consulting.com/news/medcity-news-interviews-numerof-on-the-future-of-prescription-drugs-under-trump/) - Managing Partner Michael Abrams spoke with MedCity News about potential changes to the pharma space in the upcoming Trump administration. Speaking on PBM reform, Abrams shared that Trump will likely replace Lina Khan, FTC Chair, which would impact its continued battle against PBMs. Read the full article on medcitynews.com.
- [<i>MedPage Today</i> Interviews Numerof on Trump’s Potential Cuts to Biden-Era Healthcare Policies](https://nai-consulting.com/news/medpage-today-interviews-numerof-on-trumps-potential-cuts-to-biden-era-healthcare-policies/) - Managing Partner Michael Abrams spoke with MedPage Today about what Biden-era healthcare policies Donald Trump may look to undo in the early days of his administration. Abrams pointed to Biden’s 2022 executive order on securing access to reproductive healthcare services as a frontrunner to be rescinded early in the administration: That's a goner -- that's
- [Rita Numerof Featured Guest on <i>The Business of Healthcare Podcast</i>](https://nai-consulting.com/news/rita-numerof-featured-guest-on-the-business-of-healthcare-podcast/) - President Dr. Rita Numerof returned for Episode 120 of The Business of Healthcare Podcast, joining host Dan Karnuta to discuss the challenges in transitioning to value-based pricing in healthcare. Rita previously appeared on Episode 27. A direct link to the podcast episode can be found here, or by searching for The Business of Healthcare Podcast
- [<i>Contract Pharma</i> Interviews Numerof on New Pharma vs Big Pharma, M&A](https://nai-consulting.com/news/contract-pharma-interviews-numerof-on-new-pharma-vs-big-pharma-ma/) - Managing Partner Michael Abrams spoke with Contract Pharma on the relationship between Big Pharma and smaller, technology-driven start-ups, and how it shapes development in the industry. The idea that new and big pharma are competitors in the same race is, by and large, myth…the relationship between such companies has typically been synergistic. Abrams also touched
- [<i>MedCity News</i> Interviews Numerof on Risant Health’s Acquisition of Cone Health](https://nai-consulting.com/news/medcity-news-interviews-numerof-on-risant-healths-acquisition-of-cone-health/) - Managing Partner Michael Abrams spoke with MedCity News about Risant’s recent acquisition of Cone Health, and what it could mean for parent-company Kaiser Permanente moving forward. Abrams shared that Cone has created a proactive culture about managing patients’ health, which makes the merger culturally compatible from his view. He also noted Cone’s 2023 financial results
- [<i>AIS Health</i> Interviews Numerof on FTC’s Reported Plan to Sue PBMs](https://nai-consulting.com/news/ais-health-interviews-numerof-on-ftcs-reported-plan-to-sue-pbms/) - Managing Partner Michael Abrams spoke with AIS Health about recent reports of the FTC’s plan to file a lawsuit against the country’s largest PBMs over how they negotiate rebates with manufacturers. Everybody has known for quite a long time that we have an oligopoly of six companies who control…access to outpatient drugs for the entire
- [<i>BioWorld</i> Interviews Numerof on the FTC’s Interim Report on PBMs](https://nai-consulting.com/news/bioworld-interviews-numerof-on-the-ftcs-interim-report-on-pbms/) - Managing Partner Michael Abrams spoke with BioWorld about the FTC’s recently released interim report on harmful PBM practices and its plans to sue the three largest PBMs. Abrams shared that the PBM conglomerates are self-dealing, and that targeting specific practices is a modest step and could be a challenge. Trying to understand, let alone untangle,
- [<i>Axios</i> Interviews Numerof on Retailers Pulling Out of Healthcare Investments](https://nai-consulting.com/news/axios-interviews-numerof-on-retailers-pulling-out-of-healthcare-investments/) - Managing Partner Michael Abrams spoke with Axios about strategic adjustments major retailers are making with their healthcare investments in response to the challenges of becoming primary care providers. In his interview, Abrams noted that national brands may be more likely to partner with community organizations to build up their patient volumes. The [One Medical] subscription
- [<i>Modern Healthcare</i> Interviews Numerof on CVS’ private equity search for Oak Street Health](https://nai-consulting.com/news/modern-healthcare-interviews-numerof-on-cvs-private-equity-search-for-oak-street-health/) - Managing Partner Michael Abrams spoke with Modern Healthcare about CVS Health’s search for private equity partners to fund Oak Street Health, a network of value-based primary care centers for adults on Medicare. Abrams noted that CVS is facing several economic factors, including rising inflation, decreasing reimbursement rates, and securing capital in a higher interest rate
- [<i>Modern Healthcare</i> Interviews Numerof on Increased Scrutiny of Healthcare M&A](https://nai-consulting.com/news/modern-healthcare-interviews-numerof-on-increased-scrutiny-of-healthcare-ma/) - Managing Partner Michael Abrams spoke with Modern Healthcare about how Washington’s increased scrutiny of healthcare M&A could affect future deals. The parties that are contemplating mergers at this point in time would have to be very sensitized to the politics of what's going on. Abrams also added if a merger is of the size that
- [Rita Numerof featured in <i>Authority Magazine's</i> Female Disruptor Series](https://nai-consulting.com/news/rita-numerof-featured-in-authority-magazines-female-disruptor-series/) - President Rita Numerof was featured in Authority Magazine as part of their female disruptor series. Her interview dove into the challenges of industry disruption in healthcare, being an advocate for a different business model, asking the bigger, strategic questions while remaining focused on the fundamentals, and much more. Believe in yourself, take the (calculated) risk,
- [<i>Axios</i> Interviews Numerof on Ozempic, Wegovy Prices](https://nai-consulting.com/news/axios-interviews-numerof-on-ozempic-wegovy-prices/) - Managing Partner Michael Abrams spoke with Axios about Bernie Sanders’ probe into the cost of Ozempic and Wegovy. ...right now, the world can't get enough of these products. This would not be the moment to expect the manufacturer to start lowering the price. Abrams also noted that private insurers aren’t likely to see a financial
- [<i>MedCity News</i> Interviews Numerof on Healthcare M&A Activity](https://nai-consulting.com/news/medcity-news-interviews-numerof-on-healthcare-ma-activity/) - Managing Partner Michael Abrams spoke with MedCity News about the rise in hospital M&A deals and what to expect in 2024. Abrams shared, We are witnessing “the later phases of consolidation” in the U.S. healthcare industry. He also noted that in addition to big players making opportunistic acquisitions, the industry has also seen new partnership
- [Numerof & Associates Population Health Study Findings Released: Hospitals’ Financial Concerns Well-Founded; Progress Towards Health Equity Stalled](https://nai-consulting.com/news/numerof-progress-towards-health-equity-stalled/) - Eighth annual study by Numerof & Associates highlights healthcare executives’ perspectives on population health and alternative payment models ST. LOUIS – APR 8, 2024 – Numerof & Associates, a leading healthcare strategy and implementation consultancy, today released The State of Population Health: Eighth Annual Numerof Survey Report, which provides the industry’s most comprehensive look at
- [DIA Partners with Numerof to Address Changing Dynamics of Healthcare Industry](https://nai-consulting.com/news/dia-partners-with-numerof-to-address-changing-dynamics-of-healthcare-industry/) - Organizations to chart course for life sciences professionals amid technology shifts WASHINGTON — DIA, a global organization of life science professionals, has engaged Numerof & Associates, a leading strategy and implementation consultancy focused on industries in transition, as an advisor to help it better identify and address the needs of the healthcare landscape. As artificial
- [Rita E. Numerof, PhD, announced as 2024 St. Louis Titan 100 recipient](https://nai-consulting.com/news/rita-e-numerof-phd-announced-as-2024-st-louis-titan-100-recipient/) - Titan CEO and headline sponsor Wipfli LLP are pleased to announce Rita E. Numerof, PhD, President & Co-founder of Numerof & Associates as a 2024 St. Louis Titan 100. The Titan 100 program recognizes the Top 100 CEOs & C-level executives in St. Louis. They are the area’s most accomplished business leaders in their industry
- [Numerof & Associates Welcomes Collaboration with Pharmaceutical, Healthcare Visionary Michael Ryan](https://nai-consulting.com/news/numerof-associates-welcomes-collaboration-with-pharmaceutical-healthcare-visionary-michael-ryan/) - Former Bristol-Myers Squibb, Amgen Senior Executive Will Partner with Strategy Consulting Firm in Support of its Pharma Client Portfolio Numerof & Associates announced today a Collaborative Services Agreement with Koios Enterprises and Consulting. As part of that agreement, Michael L. Ryan, PharmD, will serve as an executive advisor with the healthcare strategy firm. In this
- [Study: Threat of Financial Loss Continues to Impede Healthcare Organizations’ Transition to Population Health Management](https://nai-consulting.com/news/study-threat-of-financial-loss-continues-to-impede-healthcare-organizations-transition-to-population-health-management/) - Numerof & Associates 2022 “State of Population Health” Survey Report Finds Population Health Adoption Remains Marginal as Executives’ Expectations Fail to Materialize When it comes to the progress that healthcare delivery organizations are making on their journey from a traditional fee-for-service model to population health management, it is still very much a “Tale of Two
- [Despite Financial Vulnerability Seen in Pandemic, New Study Finds Providers Still Reluctant to Change](https://nai-consulting.com/news/despite-financial-vulnerability-seen-in-pandemic-new-study-finds-providers-still-reluctant-to-change/) - Sixth annual study by Numerof & Associates illuminates healthcare executives’ perspectives on population health and alternative payment models Most hospitals across the country suffered major financial damage when COVID-19 forced the shutdown of elective procedures. Despite this, a new report released today by healthcare strategy consultancy Numerof & Associates finds that few took away any
- [Numerof Published by <i>Pharmaceutical Executive</i> on the Role of Medical Affairs](https://nai-consulting.com/news/numerof-published-by-pharmaceutical-executive-on-the-role-of-medical-affairs/) - Commercial success now requires selling to a broader and more complex set of stakeholders with increasingly limited access. In order to effectively influence stakeholders, Medical Affairs teams must bring its capabilities to bear more proactively and effectively than what has been asked of them historically. In his article for Pharmaceutical Executive, It’s Time for Pharma
- [Numerof Presents on Managing Length of Stay at ACHE Congress](https://nai-consulting.com/news/american-college-of-healthcare-executives-ache-2010-5/) - Rita Numerof, Ph.D., President of Numerof & Associates, Inc. (NAI), presented to members of the American College of Healthcare Executives (ACHE) at the 2010 Congress on Healthcare Leadership, March 21-23, 2010. In her session, titled New Strategies For Reducing Length Of Stay, Dr. Numerof shared insights on managing patient throughput based on her extensive work
- [NAI Reacts To PDUFA V In <I>FierceBiotech</I>](https://nai-consulting.com/news/nai-reacts-to-pdufa-v-in-fiercebiotech-5/) - In a Congressional cycle paralyzed by partisan gridlock, early reauthorization of PDUFA -- the user fee act for drugs -- was hailed as a triumph for the current Congress. Not only did the law pass with bipartisan support, it passed ahead of schedule. So why was this particular piece of "must-pass" legislation able to garner
- [NAI Published in PM360 on Advisory Boards](https://nai-consulting.com/news/nai-published-in-pm360-on-advisory-boards-5/) - Physician advisory boards are being scrutinized more and more closely by regulatory agencies. OIG enforcement of anti-kickback statues has set new records over the last 18 months and the Patient Protection and Affordable Care Act signed into law in 2010 has made it easier for prosecutors to impose liability on medical product company management. But
- [NAI Published in Marketing Management on Global Branding](https://nai-consulting.com/news/why-global-brands-have-become-a-long-shot-6/) - The allure of the blockbuster global brand is irresistible -- but too often, plans for global dominance don’t work out, even when the company in question already has an established name. In their article Why Global Brands Have Become a Long Shot (published as Grow it Globally), which appeared in the Spring 2010 issue of Marketing
- [NAI Published in HFMA on Bundled Pricing](https://nai-consulting.com/news/nai-published-in-hfma-on-bundled-pricing-5/) - The U.S. healthcare industry is undergoing a radical transformation, driven in part by spiraling cost increases. In response, new ways of structuring service delivery and reimbursement intended to realign provider incentives are gaining momentum. One of these is "bundled pricing" -- providing a defined "package" of healthcare services to patients at a set price, quotable
- [NAI Published in <I>Trustee Magazine</I> on Bundled Pricing](https://nai-consulting.com/news/nai-published-in-trustee-magazine-on-bundled-pricing-5/) - In light of reform and demands for better health outcomes at lower cost, strategies that have sustained margin for healthcare organizations in the past are no longer viable. Alternative business models like bundled pricing are gaining momentum, but as hospitals begin implementing these new strategies, they face significant cultural barriers. In this month’s issue of
- [NAI Published in <I>Trustee Magazine</I> on a Market-Based Model for Healthcare](https://nai-consulting.com/news/nai-published-in-trustee-magazine-on-a-market-based-model-for-healthcare-5/) - "Better health outcomes at lower cost" has become the common theme for efforts to reform the healthcare system in this country. The billion dollar question is, how do we reach that goal? In the article titled, A Market-Based Model for Healthcare, published in Trustee Magazine, NAI Principal Michael N. Abrams discusses the perverse incentives in
- [NAI Published in <I>PM360</I> on Market Access](https://nai-consulting.com/news/nai-published-in-pm360-on-market-access-5/) - 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. As reimbursement rates for hospitals decrease, the way decisions about care are made is changing as well. Administrators' influence on
- [NAI Published in <I>PM360</I> on ACA’s Impact on Payers and Manufacturers](https://nai-consulting.com/news/nai-published-in-pm360-on-acas-impact-on-payers-and-manufacturers-4/) - Now that the Supreme Court has upheld the healthcare reform law, payers and manufacturers must be prepared to compete in this evolving market. Implementation of the legislation will significantly change the requirements and incentives for payers, and the rules governing market access for manufacturers. In the article How the New Healthcare Law Will Impact Payers
- [NAI Published in <I>Pharmaceutical Commerce</I> on ACOs](https://nai-consulting.com/news/nai-published-in-pharmaceutical-commerce-on-acos-5/) - CMS’s release of the final regulations for accountable care organizations in October created a buzz across the healthcare sector. Industry organizations, policy specialists, and other stakeholders were quick to note that the regulations were much less onerous than expected, and projections for participation in the Shared Savings Program grew. The final regulations did little to
- [NAI Published in <I>Medtech Executive</I> on Changes to the 510(K) Process](https://nai-consulting.com/news/nai-published-in-medtech-executive-on-changes-to-the-510k-process-5/) - The Institute of Medicine’s recent recommendation that the FDA should scrap the 510(k) process earlier this year sent shockwaves through the medical device industry. While the FDA has announced that it does not intend to end this approval process, device companies must expect additional, significant changes to the 510(k) process and post-market safety requirements. In
- [Nai Published in <I>MD&DI</I> on Post-Market Safety Surveillance](https://nai-consulting.com/news/nai-published-in-mddi-on-post-market-safety-surveillance-5/) - Medical device companies face an expanding set of legal and regulatory requirements to address risks and concerns around product safety. As product safety requirements increase, device companies must expand their approach to both post-market safety surveillance and managing product risks. In their article, Post-Market Safety Surveillance, published this month in MD&DI (Medical Device and Diagnostic
- [NAI Published in <I>LES Insights</I> on Changes to the 510(K) Process](https://nai-consulting.com/news/nai-published-in-les-insights-on-changes-to-the-510k-process-5/) - Tension in the medical device industry is building as the industry continues to speculate about what the FDA will unveil regarding changes to its premarket notification submission process, otherwise known as the 510(k) process. For years, the 510(k) process has been under intense scrutiny by the Senate and House, as well as by critics within
- [NAI Published in <I>FierceBiotech</I> on the Impact of the 2012 Election](https://nai-consulting.com/news/nai-published-in-fiercebiotech-on-the-impact-of-the-2012-election-5/) - The heated 2012 Presidential Campaign has finally come to an end and the focus has shifted from politics to policy. What effect will the outcome have on the future of pharmaceutical and medical device manufacturers? One thing is certain -- manufacturers will need to demonstrate economic and clinical value for their products. In the article
- [NAI Published in <I>eyeforpharma</I> on the State of the Pharmaceutical Business Model](https://nai-consulting.com/news/nai-published-in-eyeforpharma-on-the-state-of-the-pharmaceutical-business-model-5/) - The global pharmaceutical industry is in the midst of a business model transition. In the article Building a Foundation for the Future: Reflecting on the State of the Pharmaceutical Business Model, excerpted from Healthcare at a Turning Point: A Roadmap for Change, President Rita E. Numerof, Ph.D. explains how the current pharmaceutical business model is
- [NAI Published in <I>eyeforpharma</I> on the Need for a New Approach to Sales](https://nai-consulting.com/news/nai-published-in-eyeforpharma-on-the-need-for-a-new-approach-to-sales-5/) - NAI President, Rita E. Numerof, Ph.D., explains why pharmaceutical companies will need a more nuanced sales approach in her latest column for eyeforpharma, Retooling Your Sales Function to Ensure Market Access. Check it out here.
- [NAI Published in <I>eyeforpharma</I> on the Impact of the Supreme Court Ruling on Healthcare Reform](https://nai-consulting.com/news/nai-published-in-eyeforpharma-on-the-impact-of-the-supreme-court-ruling-on-healthcare-reform-5/) - Since the Supreme Court has upheld the healthcare reform law, payers and manufacturers must be prepared to compete in this evolving market. So what do manufacturers need to know about the Court’s ruling? In the article What Payers Value: Understanding the Impact of the Supreme Court Ruling, published in eyeforpharma September 2012, NAI president Rita
- [NAI Published in <I>eyeforpharma</I> on Market Access](https://nai-consulting.com/news/nai-published-in-eyeforpharma-on-market-access-5/) - Around the globe, government and private payers are increasingly requiring economic and clinical evidence to justify product pricing as cost containment becomes a central issue. Individual physicians remain important, but the power of payers and organized provider groups to impact market access, product uptake and profitability is rapidly growing. In this environment, pharmaceutical companies will
- [NAI Published in <I>eyeforpharma</I> on Late-Stage Clinical Trials](https://nai-consulting.com/news/nai-published-in-eyeforpharma-on-late-stage-clinical-trials-5/) - Increasing globalization of the pharmaceutical industry has fueled changes in the regulatory environment, including increased data requirements at the various stages of product development, validation, approval, and production. In particular, regulatory agencies around the world are requiring additional data about the long-term safety and efficacy of new products. In this environment, late-phase studies constitute a
- [NAI Published in <I>BioPharm International</I> on Orphan Drugs](https://nai-consulting.com/news/nai-published-in-biopharm-international-on-orphan-drugs-10/) - In 1988, the Orphan Drug Act was barely five years old and still coming of age in the industry, but even then, manufacturers were starting to see the potential competitive advantage of orphan drug status. Currently, the future of orphan drug development looks likely to be increasingly active, as the pharmaceutical industry advances toward personalized
- [NAI Published in <I>BioPharm International</I> on Orphan Drugs](https://nai-consulting.com/news/nai-published-in-biopharm-international-on-orphan-drugs-9/) - While historically on the margins of R&D spend, orphan drug development increasingly looks like a strategy whose time has arrived for delivering value in drug development. The benefits of shifting focus to orphan drugs are numerous, but as competition moves into these niche spaces, the need to demonstrate the economic and clinical value of drugs
- [NAI Published in <I>Becker’s Spine Review</I> on Refocusing on Value in Spine Care](https://nai-consulting.com/news/nai-published-in-beckers-spine-review-on-refocusing-on-value-in-spine-care-4/) - In recent years, growing concern about the overuse of certain spinal procedures, especially spinal fusion, has led to growing restrictions by payers on such interventions. To counter payer resistance, the spine surgery community needs to stay ahead of the curve by adopting nonsurgical treatment as a bigger part of their practice. In Incorporating Nonsurgical Procedures
- [NAI Published in <I>Becker’s Spine & Ortho Review</I> on Improving Diagnostic Specificity in Spine Care](https://nai-consulting.com/news/nai-published-in-beckers-spine-ortho-review-on-improving-diagnostic-specificity-in-spine-care-4/) - Over the past 15 years, the number of spinal fusion surgeries has drastically increased, but unfortunately, the rate of success hasn’t been commensurate with that growth. As payers focus more on outcomes and cost management, surgeons will increasingly need to demonstrate the value of performing these complex procedures. One aspect of this is the need
- [NAI Published in <I>Becker’s Hospital Review</I> on Value in Healthcare Delivery](https://nai-consulting.com/news/nai-published-in-beckers-hospital-review-on-value-in-healthcare-delivery-4/) - As hospitals learn to compete in an environment characterized by increasing pushback on the cost of care, they’ll need to rethink the value they bring to market. In 3 Steps to Build Your Hospital’s Value Case, published February 14, 2013 in Becker’s Hospital Review, NAI Managing Partner Michael N. Abrams describes the steps hospitals must
- [NAI Published in <I>Becker’s Hospital Review</I> on Service Line Strategy](https://nai-consulting.com/news/nai-published-in-beckers-hospital-review-on-service-line-strategy-4/) - Regardless of the way in which legal challenges to recent legislation are resolved, healthcare is an industry confronting dramatic change. Delivery organizations face growing pressure to raise quality, reduce costs and increase revenues. Survivors in this market will need to adapt and implement new care models … models that provide evidence-based economic and clinical value
- [NAI Published in <I>Becker’s Hospital Review</I> on Bundled Pricing](https://nai-consulting.com/news/nai-published-in-beckers-hospital-review-on-bundled-pricing-8/) - As healthcare insurers and providers grapple with how to better manage costs and quality, bundled pricing is gaining momentum as a potential way forward. But the challenges associated with implementing the approach can seem daunting. There are steps providers can take to overcome these hurdles. Rita E. Numerof, Ph.D., President, and Michael N. Abrams, M.A.,
- [NAI Published in <I>Becker’s Hospital Review</I> on Bundled Pricing](https://nai-consulting.com/news/nai-published-in-beckers-hospital-review-on-bundled-pricing-7/) - Most hospitals have learned to manage financially with the discounted fee-for-service model that’s been in place, but that’s history. In light of reform and demands for better health outcomes at lower cost, alternative payment models -- specifically bundled payment -- are gaining momentum. In, Bundled Pricing: Strategies for Success, published by Becker’s Hospital Review, Eric
- [NAI Published in <I>Becker’s Hospital Review</I> on Accountability for Care](https://nai-consulting.com/news/nai-published-in-beckers-hospital-review-on-accountability-for-care-4/) - One consequence of reform is that it has shown a spotlight on what’s missing in the current business model of healthcare: accountability -- for care coordination, outcomes, and decision-making -- in short, accountability for better care at lower cost. In their article, 7 Ways to Improve Accountability for Care, recently published by Becker’s Hospital Review,
- [NAI Published in <em>Trustee Magazine</em> on New Ways to Reduce Costs](https://nai-consulting.com/news/nai-published-in-trustee-magazine-on-new-ways-to-reduce-costs-5/) - Multiple factors are rapidly converging to push the US health care delivery to the brink of insolvency, and even Congress is growing concerned about being at the wheel. Better care at lower cost is quickly becoming the mantra that guides policy makers in their implementation of healthcare reform legislation, and will need to become a
- [NAI Published in <em>MD&DI</em> on Managing Clinical Investigator Relationships](https://nai-consulting.com/news/putting-value-at-the-center-of-healthcare-professional-partnerships-6/) - Healthcare manufacturers find themselves on the horns of a dilemma regarding their relationships with physicians. Those relationships -- particularly with clinical investigators -- are essential to continued innovation. On the other hand, they’ve been specifically targeted by FDA and the Department of Justice (DOJ) for heightened scrutiny to root out abuse in rewarding product purchase
- [NAI Published in <em>MD&DI</em> on Compliance Strategy](https://nai-consulting.com/news/the-need-for-compliance-as-a-business-strategy-5/) - Compliance demands continue to intensify for healthcare industry manufacturers. With top FDA administrators promising more executive accountability and more serious financial penalties, NAI’s March 2010 publication in MD&DI Magazine proposes that manufacturers recognize The Need for Compliance as Business Strategy. According to authors Stephen E. Rothenberg, J.D., Business Analyst, Michael N. Abrams, Managing Partner, and
- [NAI Published in <em>Managed Healthcare Executive</em> on Disease State Modeling](https://nai-consulting.com/news/nai-published-in-managed-healthcare-executive-on-disease-state-modeling-5/) - Our healthcare system puts payers in a key position to drive change because they structure the financial incentives that shape provider behavior. In their recently published article, Comprehensive Disease State Modeling Adds Value, which appeared in the March, 2010 issue of Managed Healthcare Executive, authors Michael Abrams, M.A., Managing Partner, and Mark Morgan, M.S.(R), Senior Business
- [NAI Published in <em>HealthLeaders Media</em> on Length of Stay](https://nai-consulting.com/news/length-of-stay-the-management-headache-that-wont-go-away-5/) - Like antibiotic-resistant bacteria, the challenge to reduce length of stay (LOS) persists...despite the best efforts of most healthcare organizations. And this uncomfortable reality comes at a time when more stringent reimbursement promises to put even more pressure on hospital revenues. In their article Length of Stay: The Management Headache That Won’t Go Away, published February
- [NAI Published in <em>eyeforpharma</em> on New Commercial Models](https://nai-consulting.com/news/nai-published-in-eye-for-pharma-on-new-commercial-models-5/) - As healthcare manufacturers struggle to adapt to the evolving requirements imposed by healthcare reform, one of the more broadly recognized needs is change to the industry’s commercial model. In their article How to Build a Post-Reform Commercial Model, published March 2, 2010 in Eye for Pharma, authors Michael Abrams, M.A., Managing Partner, and Bill Ott,
- [NAI Published in <em>Corporate Compliance Insights</em> on Ensuring Compliance Program Success](https://nai-consulting.com/news/nai-published-in-corporate-compliance-insights-on-ensuring-compliance-program-success-5/) - For companies trying to read the enforcement ‘tea leaves’ of the OIG, recent settlements and corporate integrity agreements often provide insight. In their article Compliance, Commercial Risk, and Pfizer: Lessons Learned, published April 20, 2010 by Corporate Compliance Insights, authors Stephen Rothenberg, Business Analyst, and Michael Abrams, Managing Partner, review the lessons to be drawn by
- [NAI Published in <em>Applied Clinical Trials</em> on Strategic Uses of Safety Monitoring Data](https://nai-consulting.com/news/nai-published-in-applied-clinical-trials-on-strategic-uses-of-safety-monitoring-data-5/) - Growing public concern about adverse consequences of FDA-approved drugs and devices has led to new regulatory focus on safety monitoring. Going forward, the FDA has made clear its intent to require more rigorous efforts in this realm. In their just-published article Using Compliance Data for Strategic Advantage, (appearing in this month’s issue of Applied Clinical
- [NAI Published by <em>HFMA</em> on Bundled Pricing](https://nai-consulting.com/news/nai-published-by-hfma-on-bundled-pricing-5/) - Spiraling cost inflation and lagging quality outcomes have fueled reforms that are rewriting the rules for the entire healthcare sector. As a result, concepts like bundled pricing are gaining momentum -- but these efforts require physician input and buy-in to succeed. In NAI’s article Engaging Physicians in Bundled Pricing, published by HFMA’s Strategic Financial Planning,
- [NAI Provides Guidance on Choosing a Chief Compliance Officer in <I>Pharmaceutical Compliance Monitor</I>](https://nai-consulting.com/news/nai-provides-guidance-on-choosing-a-chief-compliance-officer-in-pharmaceutical-compliance-monitor-5/) - As pharmaceutical companies struggle to meet increasing legal and regulatory requirements, what’s really critical in a chief compliance officer? NAI Consultant Stephen Rothenberg, J.D., discusses the characteristics this executive should have in his article, Choosing the Right Chief Compliance Officer, published September 25, 2012 in Pharmaceutical Compliance Monitor. The article describes the key considerations for
- [Managed Care As Customer](https://nai-consulting.com/news/managed-care-as-customer-6/) - NAI PUBLISHED IN PM360 ON SELLING TO MANAGED CARE While 'physician-as-customer' has historically been a key to success for pharmaceutical marketers, the shift in power to insurers calls for re-thinking of this approach. In her article Managed Care as Customer, published April 2009 in PM360, author Rita E. Numerof, Ph.D., President offers up advice for
- [Building A Strategic Market Claims Strategy](https://nai-consulting.com/news/building-a-strategic-market-claims-strategy-5/) - NAI PUBLISHED IN MX: BUSINESS STRATEGIES FOR MEDICAL DEVICE PROFESSIONALS Even the most successful medical device companies are finding today’s rapidly changing and increasingly competitive global market a challenge. To be successful requires not only flawless execution of traditional marketing activities, but a critical evaluation of a product’s economic and clinical value proposition. Customers expect
- [Regulation’s Impact On Innovation: A Two-Edged Sword](https://nai-consulting.com/news/regulations-impact-on-innovation-a-two-edged-sword-5/) - NAI PUBLISHED IN MEDICAL PROGRESS TODAY ON THE IMPACT OF REGULATION ON INNOVATION Many proponents of healthcare reform point to the need for comparative effectiveness research (CER) to guide practice in more cost effective ways. Certainly the potential is there for reducing the overall cost of treatment through more prudent use of resources. And the
- [NAI Published in <I>Becker’s Hospital Review</I> on Physician Alignment](https://nai-consulting.com/news/nai-published-in-beckers-hospital-review-on-physician-alignment-4/) - Many providers have started to explore bundled pricing as a mechanism to address concerns about the cost and quality of healthcare, and to provide differentiation in the marketplace. But it’s increasingly clear that one of the biggest barriers these providers face is getting physicians on board. This month in Becker’s Hospital Review, NAI Partners Michael
- [National Media Coverage of Numerof’s Population Health Survey](https://nai-consulting.com/news/national-media-coverage-of-numerofs-population-health-survey-3/) - Population health management has become a national topic of conversation, but to date little effort has been devoted to tracking the actual progress that’s been made toward this new model of care. Now in its fifth year, Numerof’s State of Population Health survey provides an in-depth, national look at the pace of change from fee-for-service.
- [Coupled with Covid-19, Benchmark Study Reveals What Could Be the Last Report of Nominal Population Health Progress](https://nai-consulting.com/news/coupled-with-covid-19-benchmark-study-reveals-what-could-be-the-last-report-of-nominal-population-health-progress/) - Conducted before the Covid-19 pandemic, fifth annual study by Numerof & Associates finds providers are still falling short of making a meaningful commitment to population health Progress in implementing population health has remained limited, according to the fifth annual State of Population Health survey by healthcare strategy consultancy Numerof & Associates. But lessons learned from
- [Numerof Interviewed on Facebook’s New Blood Donation Feature](https://nai-consulting.com/news/numerof-interviewed-on-facebooks-new-blood-donation-feature/) - Managing Partner Michael Abrams spoke to FierceHealthcare about Facebook’s launch of its blood donation tool in the U.S., alerting users to blood drives and shortages in their local area. It’s a public health service that could have important benefits, by saving lives that might otherwise have been lost. Abrams also noted the potential for Facebook’s
- [Numerof Interviewed on CVS Health’s Expansion of HealthHUBs](https://nai-consulting.com/news/numerof-interviewed-on-cvs-healths-expansion-of-healthhubs/) - President Dr. Rita Numerof and Managing Partner Michael Abrams both spoke to media outlets about CVS’s plans to expand their healthcare services. Abrams shared with Modern Healthcare why simply adding these “HealthHUBs” may not be enough: The way they run their operations now, in general, their culture is not one of deep individual personal engagement.
- [Numerof Interviewed on Best Buy's Move into the Healthcare Business](https://nai-consulting.com/news/numerof-interviewed-on-best-buys-move-into-the-healthcare-business/) - Managing Partner Michael Abrams spoke with Managed Healthcare Executive about Best Buy's foray into the healthcare space and what can be learned from nontraditional companies thinking strategically about healthcare. Health execs looking for a safe template—a plan of action that has been tried over and over by others—will likely miss the opportunity. Every organization comes
- [Numerof Interviewed on JPMorgan's Acquisition of InstaMed](https://nai-consulting.com/news/numerof-interviewed-on-jpmorgans-acquisition-of-instamed/) - President Dr. Rita Numerof and Managing Partner Michael Abrams were both interviewed by media outlets on JPMorgan's acquisition of InstaMed. Abrams shared with FierceHealthcare what the purchase could mean for Haven, the joint venture the company shares with Amazon and Berkshire Hathaway. Haven is more likely to be the recipient of what the individual partners do
- [Numerof Interviewed on Departure of Haven COO](https://nai-consulting.com/news/numerof-interviewed-on-departure-of-haven-coo/) - Managing Partner Michael Abrams spoke with Modern Healthcare about the recent departure of Haven's COO, Jack Stoddard, and its implications on the joint-venture. Abrams shared that it shouldn't be a major stumbling block for Haven. The Haven partners are pursuing opportunities that are most closely aligned with their strategic capabilities. They are also each focused
- [Numerof Interviewed on Surprise Medical Bills](https://nai-consulting.com/news/numerof-interviewed-on-surprise-medical-bills/) - President Dr. Rita Numerof spoke with CBS News on surprise medical billing and ideas being proposed by Congress to eliminate surprise bills. Critics of current laws say they don't prevent providers from billing the consumers directly and new legislation is needed to protect patients. Read the full story at cbsnews.com. A local CBS affilitate in
- [Numerof Interviewed on Medicare Spending](https://nai-consulting.com/news/numerof-interviewed-on-medicare-spending/) - Managing Partner Michael Abrams spoke with reporters at Modern Healthcare and FierceHealthcare about the newly released report from the Social Security and Medicare boards of trustees and why it should be of concern to hospitals. The writing is on the wall that healthcare providers need to figure out how to make money at Medicare rates.
- [Numerof Published in <i>AJMC</i> on Market-Based Models](https://nai-consulting.com/news/numerof-published-in-ajmc-on-market-based-models/) - Rising consumerism, new competition, and payment models designed to keep patients out of acute care are forcing hospital-centric enterprises to rethink their delivery models.If they don’t, technology innovators and deep pocketed consumer-centric companies like Amazon and Walmart will become patients’ providers of choice. Michael Abrams' and Rita Numerof's article for AJMC, The Future of Care
- [Numerof Interviewed on Population Health Survey Report](https://nai-consulting.com/news/numerof-interviewed-on-population-health-survey-report/) - Managing Partner Michael Abrams spoke with AJMC on the results of the fourth annual State of Population Health survey. Michael and reporter Wallace Stephens took a deep-dive into the report and discussed why population health management progress has stalled. Population health management represents a different business model, a different way of looking at the mandates
- [Numerof Interviewed on Centene's Acquisition of WellCare Health Plans](https://nai-consulting.com/news/numerof-interviewed-on-centenes-acquisition-of-wellcare-health-plans/) - Dr. Rita Numerof spoke with MedCity News about Centene's acquisition of WellCare Health Plans and the impact of consolidation within the payer industry. Centene’s decision to acquire WellCare reflects a common belief among horizontally merging healthcare organizations that size is protective. However, payers must realize this is not the case. Read the full story at
- [Numerof Interviewed on Statewide ACOs](https://nai-consulting.com/news/numerof-interviewed-on-statewide-acos/) - Managing Partner Michael Abrams talked with Healthcare Dive about the implementation of state-wide ACOs in some areas of the nation. At the end of the day, success or failure is based on success in managing the quality of care. Read the full story at healthcaredive.com
- [National Media Coverage of Numerof’s Population Health Survey](https://nai-consulting.com/news/national-media-coverage-of-numerofs-population-health-survey-2/) - Population health management has become a national topic of conversation, but to date little effort has been devoted to tracking the actual progress that’s been made toward this new model of care. Now in its fourth year, Numerof’s State of Population Health survey provides an in-depth, national look at the pace of change from fee-for-service.
- [Numerof Presents at the 19th Annual Population Health Colloquium](https://nai-consulting.com/news/numerof-presents-at-the-19th-annual-population-health-colloquium/) - Dr. Rita Numerof participated in a discussion with the Health Leaders panel at the 19th Population Health Colloquium in Philadelphia, Pennsylvania. The panel was moderated by Dr. David Nash, Dean, Jefferson College of Population Health, and recapped the dominant themes of the conference and what to expect in the future in population health. Speakers included:
- [Numerof Published by <i>AJMC</i> on Hospital Megamergers](https://nai-consulting.com/news/numerof-published-by-ajmc-on-hospital-megamergers/) - In February, Dallas-based health systems Baylor Scott & White and Memorial Hermann decided to call off a proposed merger, claiming they were “capable of achieving [their] visions for the future without merging at this time.” In her article for AJMC, As Business and Payment Models Evolve, Nimbleness Trumps Scale, Dr. Rita Numerof discusses why healthcare
- [Numerof Interviewed on Insurers' Strategic Affiliation](https://nai-consulting.com/news/numerof-interviewed-on-insurers-strategic-affiliation/) - Managing Partner Michael Abrams talked with MedCity News about the strategic affiliation between Blue Cross Blue Shield of North Carolina and Cambia Health Solutions. Michael noted that BCBS of NC will gain access to Cambia's technology and experience and Cambia will gain scale where technology can be applied. The skill and determination of management, and
- [Numerof Published in <i>AJMC</i> on Migration of Care](https://nai-consulting.com/news/numerof-published-in-ajmc-on-migration-of-care/) - The migration of care from inpatient to outpatient settings and ambulatory surgery centers promises to lower the cost of care, improve convenience and access, and deliver better outcomes. That's good news for consumers and employers. For payers, it's an opportunity to provide better care at lower cost - a clear competitive advantage. In his article
- [Numerof Published by <i>Fierce Healthcare</i> on Social Determinants of Health](https://nai-consulting.com/news/numerof-published-by-fierce-healthcare-on-social-determinants-of-health/) - As providers struggle to succeed with evolving payment models that hold them accountable for health outcomes, they face the impact of social determinants of health. With more covered lives moving to capitated contracts, bundled payments and other risk-based payment models, shrinking reimbursement, rising charity care, and growing Medicare populations, margins are on the line. These
- [Numerof Interview on 2019 Outlook for Payers](https://nai-consulting.com/news/numerof-interview-on-2019-outlook-for-payers/) - Managing Partner Michael Abrams spoke with Healthcare Dive about the outlook for payers in 2019 and the challenges they face in the next year. It's probably going to be a good year for the payer segment, but they need to be very diligent in preparing for what comes next, because I think the challenges will
- [Numerof Interviewed on Authorized Generics](https://nai-consulting.com/news/numerof-interviewed-on-authorized-generics/) - Dr. Rita Numerof spoke with BioPharma Dive about drug manufacturers launching authorized generics of their own branded drugs, and the strategy behind making this unconventional move. Holding onto customers via a lower list price is preferable, even if authorized generics essentially "cannibalize your own products before your competition does." Read the full story at biopharmadive.com
- [Benchmark Study Finds Progress Toward Population Health Finance Models Has Stalled in Absence of External Pressure](https://nai-consulting.com/news/benchmark-study-finds-progress-toward-population-health-finance-models-has-stalled-in-absence-of-external-pressure/) - Fourth annual study by Numerof & Associates finds concerns over financial risk and cultural complacency still outweighing incentives to move forward Progress toward implementation of population health as a model for organizing healthcare delivery appears to have stalled in 2018, according to the fourth annual State of Population Health survey by Numerof & Associates, a
- [Numerof Interviewed on Biosimilars Adoption](https://nai-consulting.com/news/numerof-interviewed-on-biosimilars-adoption/) - Senior Research Analyst Mike Kuchenreuther recently spoke with Drug Store News about biosimilars and the challenges manufacturers face when they go through the approval process. In order to be deemed interchangeable, the manufacturer must demonstrate the biosimilar is sufficiently similar to the reference product and is expected to produce the same clinical result. Read the
- [Numerof Interviewed on Prescription Drug Rebates](https://nai-consulting.com/news/numerof-interviews-on-prescription-drug-rebates/) - Dr. Rita Numerof spoke with BioWorld about HHS' proposal to modify the current drug rebate system and its implications for pharmacy benefits managers. If Congress is serious about taming drug prices, it needs to look at the PBM business model and consider fundamental changes. The value they create today is really questionable... rebates are a
- [Numerof Interviewed on HHS Alternative Payment Model for Ambulance Providers](https://nai-consulting.com/news/numerof-interviewed-on-hhs-alternative-payment-model-for-ambulance-providers/) - Dr. Rita Numerof spoke with RevCycleIntelligence about HHS' new alternative payment model for ambulance providers and how it could impact patient treatment in emergency situations. Key to the success of this new model will be the identification of ‘appropriate’ care options and the ability to accurately diagnose needs, matching those needs to the right setting and
- [Numerof Interviewed on Baylor Scott & White-Memorial Hermann Cancelled Merger](https://nai-consulting.com/news/numerof-interviewed-on-baylor-scott-white-memorial-hermann-cancelled-merger-2/) - Dr. Rita Numerof spoke with RevCycle Intelligence about the cancelled consolidation between Baylor Scott & White and Memorial Hermann, and explained that bigger isn't always better when it comes to mergers. BSW and Memorial Hermann’s decision not to merge may signal a beginning realization that ‘bigger isn’t necessarily better’—especially if it means more of the same."
- [Numerof Interviewed on Baylor Scott & White-Memorial Hermann Cancelled Merger](https://nai-consulting.com/news/numerof-interviewed-on-baylor-scott-white-memorial-hermann-cancelled-merger/) - Dr. Rita Numerof spoke with Modern Healthcare about Baylor Scott & White Health and Memorial Hermann Health System's decision to halt their proposed merger. Numerof noted that walking away from their merger may be a sign of people beginning to understand that bigger isn't necessarily better. We need these organizations, but we need them to
- [Numerof Published by <i>Becker's Hospital Review</i> on Hospital Acceditation](https://nai-consulting.com/news/numerof-published-by-beckers-hospital-review-on-hospital-acceditation/) - The Centers for Medicare & Medicaid Services (CMS) has recently taken the first steps to increase hospital accreditation and oversight and regulation through their December request for information. The decision to do so has not come lightly - while the government is pushing for more regulation and oversight, other organizations want less so hospitals can
- [Numerof Interviewed on HHS Drug Rebate Proposal](https://nai-consulting.com/news/numerof-interviewed-on-hhs-drug-rebate-proposal/) - Managing Partner Michael Abrams talked with MedCity News about the recent proposal by US Health and Human Services to eliminate drug kickbacks and rebates. If administration costs are eliminated and base costs are lower as a result, this change does not need to translate into premium increases. Read the full story at medcitynews.com
- [Numerof Interviewed on CMS' New "What's Covered" App](https://nai-consulting.com/news/numerof-interviewed-on-cms-new-whats-covered-app/) - Managing Partner Michael Abrams spoke with The Daily Caller about CMS' new app, What's Covered, designed to help seniors engage with Original Medicare, and how it can be further developed as a health tool. Abrams noted that it may take some adjusting on both the developer side and beneficiary side for the app to be most
- [Numerof Interviewed on Walmart-CVS Caremark Pricing Dispute](https://nai-consulting.com/news/numerof-interviewed-on-walmart-cvs-caremark-pricing-dispute/) - Dr. Rita Numerof talked with The Daily Caller about Walmart and CVS Caremark's temporary split over prescription drug prices and what the resolution means for consumers. Those that rely on Walmart’s convenient accessibility – especially in rural areas where other reasonable options may not exist – are the most notable winners. Quickly resolving this roadblock
- [Numerof Interviewed on Non-Traditional Players in Healthcare](https://nai-consulting.com/news/numerof-interviewed-on-non-traditional-players-in-healthcare/) - Managing Partner Michael Abrams talked with Healthcare Informatics about non-traditional players in healthcare and how they are shaking up the sector. Michael shared that much of healthcare delivery is obsessed with "big data," but they have hardly scratched the surface using the data they already own. This is a very strategic move for Amazon because
- [Numerof Interviewed on CMS' New Price Transparency Rule](https://nai-consulting.com/news/numerof-interviewed-on-cms-new-price-transparency-rule/) - Managing Partner Michael Abrams talked with MedCityNews on the CMS' rule requiring the disclosure of hospital prices and how it could be the catalyst to a bigger conversation about transparency in healthcare. I think putting those prices out there – even with the acknowledgement that these aren’t the prices anyone pays unless they’re uninsured –
- [Numerof Interviewed on CMS Accreditation Reform](https://nai-consulting.com/news/numerof-interviewed-on-cms-accreditation-reform/) - Dr. Rita Numerof spoke with Modern Healthcare about CMS' investigation into Medicare accreditors and conflicts-of-interest. Numerof shared that greater enforcement in how accreditors set up consultancy relationships could level the playing field, but also noted that any changes could face fierce opposition from industry stakeholders. Read the full story at modernhealthcare.com
- [Numerof Interviewed on Price Transparency Rule](https://nai-consulting.com/news/numerof-interviewed-on-price-transparency-rule/) - Managing Partner Michael Abrams talked to FierceHealthcare about the CMS Inpatient Prospective Payment System (IPPS) rule that went into effect on January 1 and how market players can help further advance transparency in healthcare. Quite frankly, it’s going to put providers on the back foot. I think it will force the industry to behave more like other market-based
- [Numerof Interviewed on the Biggest Payer Stories of 2018](https://nai-consulting.com/news/numerof-interviewed-on-the-biggest-payer-stories-of-2018/) - Dr. Rita Numerof spoke with MedCity News about market disruption and what 2018's most notable changes could mean for how care is delivered in the future. There’s a lot of interest from insurers to move care to an appropriate setting for a given patient. If a procedure can be done safely in an outpatient or
- [Numerof Interviewed on Glaxosmithkline-Pfizer Joint Venture](https://nai-consulting.com/news/numerof-interviewed-on-glaxosmithkline-pfizer-joint-venture/) - Rita Numerof talked with MedCity News about GlaxoSmithKline and Pfizer forming a joint venture to market over-the-counter drug products. Numerof shared that the consumer health space tends to be more competitive, including competition from store brands, and has shorter product cycles. If a company really wants to focus on their core business, this kind of move
- [Rita Numerof Interviewed on The Business of Healthcare Podcast](https://nai-consulting.com/news/rita-numerof-interviewed-on-the-business-of-healthcare-podcast/) - Dr. Rita Numerof recently joined The Business of Healthcare podcast host Dr. Bob Kaiser to talk about healthcare disruption, moving away from fee-for-service, and getting to a market-based model. Listen to the episode here: The Business of Healthcare Podcast, Episode 27: Market-Based Models in Healthcare
- [Numerof Interviewed on Allscripts' Sale of Netsmart](https://nai-consulting.com/news/numerof-interviewed-on-allscripts-sale-of-netsmart/) - Dr. Rita Numerof spoke with Modern Healthcare about Allscripts selling its stake in Netsmart Technologies to GI Partners. The two companies both acquired stakes in Netsmart in 2016. Numerof noted the acquisition "could further advance Netsmart's push for better, more accessible treatment." Read the full story on modernhealthcare.com
- [Numerof Published by <i>AJMC</i> on Megamergers](https://nai-consulting.com/news/numerof-published-by-ajmc-on-megamergers/) - Of late, announcements of megamergers between hospital systems, insurers and private companies have been dominating the healthcare news cycle. Despite good intentions—lower costs, better care for consumers—mergers and acquisitions rarely live up to expectations. In her column for The American Journal of Managed Care, Megamergers Continue, but Some are Better than Others, Dr. Rita Numerof discusses
- [Numerof Interviewed on Apple's Medical Clinics](https://nai-consulting.com/news/numerof-interviewed-on-apples-medical-clinics/) - Managing Partner Michael Abrams spoke with MedCityNews on Apple operating its own medical clinics. What makes Apple’s initiative unique, however, is that the company owns and operates the clinics itself as opposed to outsourcing the operation. The latter has been the norm with big tech companies historically. Michael also shared that hospitals should commit to transparency and accountability for cost
- [Numerof Interviewed on Walgreens-FedEx Pharmacy Delivery Partnership](https://nai-consulting.com/news/numerof-interviewed-on-walgreens-fedex-pharmacy-delivery-partnership/) - Dr. Rita Numerof spoke with MedCityNews about Walgreens' partnership with FedEx to offer nationwide next-day prescription delivery service. With emerging competition posing a threat, Walgreens was forced to step up to the plate, resulting in consumers from a variety of cities being able to get next-day and same-day deliveries of medications they need. It’s all
- [Numerof Interviewed on CMS Star Ratings](https://nai-consulting.com/news/numerof-interview-on-cms-star-ratings/) - Dr. Rita Numerof spoke with Modern Healthcare about the latest preview report of the upcoming release of star ratings in February. "I think continually changing things in material ways and having things that are often at odds with one another, that is not a good way of engaging in meaningful measurement," said Rita, in regards
- [Numerof Interviewed by <i>Healthcare Finance News</i> on Mergers and Acquisitions](https://nai-consulting.com/news/numerof-interviewed-by-healthcare-finance-news-on-mergers-and-acquisitions/) - Dr. Rita Numerof spoke with Healthcare Finance News on hospital mergers and acquisitions, and the challenges to make mega-mergers successful. The reality is that around 40 percent of M&A in general, across industries, fail to deliver on the financial performance that the parents coming together in the first place wanted to achieve. The fact that
- [Numerof Interviewed on Healthcare Dive's Executive of the Year](https://nai-consulting.com/news/numerof-interviewed-on-healthcare-dives-executive-of-the-year/) - Dr. Rita Numerof spoke with Healthcare Dive about David Feinberg, named Healthcare Dive's Executive of the Year, and his recent move to Google to lead the company's health efforts. He brings a unique perspective to innovation, which is what Google is all about. He's used innovation to drive improvement in healthcare quality and patient satisfaction,
- [Numerof Interviewed on CVS-Aetna Acquisition](https://nai-consulting.com/news/numerof-interviewed-on-cvs-aetna-acquisition-2/) - Dr. Rita Numerof spoke with The Daily Caller on the approved CVS-Aetna merger and what it means for the healthcare marketplace. “The merger can accelerate the efforts to change the fundamental business model of health care,” Numerof said. “It’s very attractive to employers who might want to sign up with Aetna.” Read the full story
- [Numerof Interviewed on CVS-Aetna Acquisition](https://nai-consulting.com/news/numerof-interviewed-on-cvs-aetna-acquisition/) - Dr. Rita Numerof spoke with MedCity News about the future plans of CVS as its acquisition of Aetna nears completion. By driving patients to CVS retail spaces through pharmacy and clinical outpatient services, CVS can reinforce and grow its front end over-the-counter business which is substantially private label. Read the full story on medcitynews.com
- [Numerof Interviewed on Walgreens-Humana Partnership](https://nai-consulting.com/news/numerof-interviewed-on-walgreens-humana-partnership/) - Dr. Rita Numerof spoke with MedCity News about Walgreens and Humana’s new partnership to take equity stakes in each other. Walgreens has been looking to acquire an insurer for some time. Humana represents an attractive partner. Its largely Medicare Advantage book of business offers the opportunity to steer cost sensitive seniors to Walgreens and its
- [Numerof Published by <i>MedCity News</i> on Site-Neutral Payments](https://nai-consulting.com/news/numerof-published-by-medcity-news-on-site-neutral-payments/) - Just before the elections, the Centers for Medicare and Medicaid Services (CMS) released a final rule extending changes to their 340B drug reimbursement policy to include hospital outpatient departments, and also expanded the application of site-neutral payment policies. The rule changes, though expected, were not warmly welcomed by the hospital industry. In her post for
- [Numerof Interviewed on Google hiring Geisinger CEO](https://nai-consulting.com/news/numerof-interviewed-on-google-hiring-geisinger-ceo/) - Dr. Rita Numerof spoke with Modern Healthcare on Google’s hiring of Geisinger Health System CEO David Feinberg. Rita shared, “David is of a mindset that we need a different model, so philosophically, this gives him a platform to have an enormous impact on healthcare services and outcomes in nontraditional ways." “David has an ability and
- [Numerof Interviewed on the Impacts of the Midterm Elections on Healthcare](https://nai-consulting.com/news/numerof-interviewed-on-the-impacts-of-the-midterm-elections-on-healthcare/) - Managing Partner Michael Abrams spoke with reporters at Modern Healthcare and Fierce Healthcare about the impacts on healthcare following the midterm elections. “If we just talk about partisan advantage we will continue to spin our wheels and two years from now we will not be any closer to a solution. We will be closer to
- [Numerof Interviewed on Health Literacy in Hospitals](https://nai-consulting.com/news/numerof-interviewed-on-health-literacy-in-hospitals/) - Managing Partner Michael Abrams spoke with Modern Healthcare on health literacy in hospitals. “When hospitals were being paid to fix their mistakes, the lack of health literacy was a profit generator… hospitals did not, by and large, own the issue.” “This is a cultural thing, and cultures change slowly,” Abrams said. “It's a process that
- [Numerof Interviewed on Mandatory Price Disclosures in DTC ads](https://nai-consulting.com/news/numerof-interviewed-on-mandatory-price-disclosures-in-dtc-ads/) - Managing Partner Michael Abrams spoke with FierceHealthcare on the Trump Administration requiring drug prices to be in consumer advertisements. He told Fierce that list prices could even deter patients from filling prescriptions entirely. “People who misunderstand those commercials, who think the list price is what they will pay, may be less inclined to have those scripts
- [Numerof Presents at BIO 2018 on An Investor’s Perspective on Value](https://nai-consulting.com/news/numerof-presents-at-bio-2018-on-an-investors-perspective-on-value/) - One of the challenges manufacturers face is ensuring sufficient evidence to support not only product approval, but also reimbursement and market adoption. This is particularly relevant for early stage biotech companies that tend to focus on regulatory submission and not on how the product will be reimbursed and ultimately adopted. Michael Abrams and fellow experts
- [Numerof Presents at BIO on Strategies for Selling Value](https://nai-consulting.com/news/numerof-presents-at-bio-on-strategies-for-selling-value/) - Kim White moderated a discussion on Strategies for Selling Value in a Dynamic Environment on June 4th. Kim and fellow experts from Amgen, Ferring Pharmaceuticals, and Sunovion provided insight into the strategies they are using to meet growing demands for a data-based value narrative. Speakers included: Dr. Nicole Yurgin, Executive Director, Cardiovascular/Metabolic Therapeutic Area Head,
- [Numerof Presents at 18th Population Health Colloquium](https://nai-consulting.com/news/numerof-presents-at-18th-population-health-colloquium/) - What are leaders in population health doing today? Dr. Rita Numerof participated in a discussion with the Health Leaders panel at the 18th Population Health Colloquium in Philadelphia, Pennsylvania. Rita joined Senior Advisor at Leavitt Partners, Dr. Brent James, Former Professional Baseball Player, Darryl Strawberry, and experts from Ariadne Labs and Evidation Health for a dynamic conversation on
- [Population Health Leaders Leaving Lagging Providers Even Further Behind](https://nai-consulting.com/news/numerof-releases-third-annual-state-of-population-health-survey-report/) - Third annual study by Numerof & Associates finds growing gap between intentions and progress for provider adoption of value-based practices A growing number of healthcare delivery organizations are failing to keep pace with their population health objectives and falling even further behind the leaders in this space, according to the third annual State of Population Health
- [Numerof Presents at Hospital Association of Pennsylvania](https://nai-consulting.com/news/numerof-presents-at-hospital-association-of-pennsylvania/) - Numerof Consultant Gordon Phillips presented to members of the Hospital Association of Pennsylvania in Lancaster, PA on Creating High Value Partnerships Across the Continuum. Gordon discussed the growing importance of post-acute networks in a value-based market and walked through the stages of establishing and managing strategic partnerships with post-acute providers. The session was held on Tuesday,
- [Numerof Published by the Heritage Foundation on ACOs](https://nai-consulting.com/news/nai-published-by-the-heritage-foundation-on-acos-5/) - The Heritage Foundation has released its policy guidance for Congress on ACOs, titled Why Accountable Care Organizations Won't Deliver Better Health Care - and Market Innovation Will, authored by Rita E. Numerof, Ph.D., President of Numerof & Associates, Inc. In theory, ACOs provide financial incentives to health care organizations to reduce costs and improve quality.
- [Numerof Presents at Illinois Hospital Association Leadership Summit](https://nai-consulting.com/news/numerof-presents-at-illinois-hospital-association-leadership-summit/) - Numerof Consultant Gordon Phillips presented to members of the Illinois Hospital Association at their Leadership Conference in Chicago on Creating High Value Partnerships Across the Continuum. Gordon discussed why and how organizations are moving to value and walked through stages of establishing and managing strategic partnerships with post-acute providers. The session was held on Wednesday,
- [Numerof Presents at Georgia Hospital Association Summer Meeting](https://nai-consulting.com/news/numerof-presents-at-georgia-hospital-association-summer-meeting/) - President Dr. Rita Numerof moderated an insightful discussion for members of the Georgia Hospital Association in Amelia Island, Florida on Corporate Decision Making in Healthcare. Experts from UPS, Southern Company, and Mohawk Industries shared their companies’ health care purchasing strategies, providing perspective on how they define value in health care and the steps they’re taking
- [Numerof Presents at 17th Population Health Colloquium](https://nai-consulting.com/news/numerof-presents-at-17th-population-health-colloquium/) - What are leaders in population health doing today? Dr. Rita Numerof participated in a discussion with the Health Leaders panel at the 17th Population Health Colloquium in Philadelphia, Pennsylvania. Rita and fellow experts from TeamHealth, California Association of Physician Groups, Livongo and Castlight Health highlighted challenges and opportunities related to population health. The panel was
- [Numerof Presents at NAMCP 2017 Spring Managed Care Forum](https://nai-consulting.com/news/numerof-presents-at-namcp-2017-spring-managed-care-forum/) - Numerof Vice President Kim White spoke at the National Association of Managed Care Physicians Spring Forum in Orlando, Florida on Getting to Population Health: Learning from Success. Based on Numerof’s 2nd annual national State of Population Health Survey, Kim characterized progress in the industry, and shared what executives see as their biggest challenges. She also provided examples
- [Numerof Presents at California Hospital Association Post-Acute Care Conference](https://nai-consulting.com/news/numerof-presents-at-california-hospital-association-post-acute-care-conference/) - Numerof Consultant Gordon Phillips spoke to members of the California Hospital Association in Huntington Beach, California on creating high value partnerships across the continuum of care. With the rise of value-based payment models, providers are increasingly responsible for factors beyond their immediate control, and building relationships with trusted partners is crucial for minimizing risk and
- [Numerof Published by <i>eyeforpharma</i> on Economic and Clinical Value](https://nai-consulting.com/news/numerof-published-by-eyeforpharma-on-economic-and-clinical-value/) - Historically, the R&D function has been focused on generating the safety and efficacy data required for regulatory approval. But in today’s value-based marketplace, R&D must also ensure their organizations have the data required not only to get their product approved, but also to get it reimbursed and adopted. In Rita Numerof’s latest Industry Insights column
- [Numerof Presents at NAMCP 2016 Fall Managed Care Forum](https://nai-consulting.com/news/numerof-presents-at-namcp-2016-fall-managed-care-forum/) - Vice President Kim White moderated a panel on payer-provider partnerships at the National Association of Managed Care Physicians’ Fall Managed Care Forum in Las Vegas, Nevada. As payers and providers work toward better health outcomes at lower cost, they’re experimenting with a number of models and partnerships to achieve these goals. Kim led a discussion
- [Numerof Presents at European Confederation of Pharmaceutical Entrepreneurs](https://nai-consulting.com/news/numerof-presents-at-european-confederation-of-pharmaceutical-entrepreneurs/) - Managing Partner Michael Abrams presented to members of the European Confederation of Pharmaceutical Entrepreneurs (EUCOPE) in Brussels, Belgium. EUCOPE is Europe’s principal trade body for mid-tier innovative organizations in the pharmaceutical and medical devices industries. Michael’s presentation, Changing Dynamics in the U.S. Market, provided a high level background on key dynamics and drivers in the
- [Numerof Presents at AMCP Nexus 2016](https://nai-consulting.com/news/numerof-presents-at-amcp-nexus-2016/) - Vice President Kim White moderated a panel on risk-sharing at this year’s AMCP Nexus in National Harbor, Maryland. Risk-sharing agreements between payers and manufacturers have long been used outside the U.S. to manage the cost of medical products and to link cost to outcomes achieved. However, uptake in the U.S. has been slower than in
- [National Media Coverage of Numerof’s Population Health Survey](https://nai-consulting.com/news/national-media-coverage-of-numerofs-population-health-survey/) - Population health management has become a national topic of conversation, but to date little effort has been devoted to tracking the actual progress that’s been made towards value-based models of care. Numerof partnered with Dr. David Nash, Dean of the Jefferson College of Population Health, for our second annual in-depth, national look at the pace
- [Numerof Published by <i>PM360</i> on the New Administration](https://nai-consulting.com/news/numerof-published-by-pm360-on-the-new-administration/) - The results of the recent presidential election caught many by surprise, including much of the healthcare industry. As Trump continues to build his cabinet and set priorities for his administration, many are asking what they should anticipate from a new administration. In their recent article for PM360, Healthcare 2017: A New Day is Dawning, Kim White and
- [Numerof Study Finds Population Health Important but Challenging; Policy Shifts Could Threaten Progress](https://nai-consulting.com/news/numerof-releases-second-annual-state-of-population-health-survey-report/) - Second annual study by Numerof & Associates provides national snapshot of transition from fee-for-service to fixed payments linked to outcomes Healthcare delivery organizations remain committed to population health management but have lowered expectations for the pace of change. This finding from the second annual State of Population Health survey by Numerof & Associates, a healthcare
- [Numerof Staff Interviewed on Healthcare Reform](https://nai-consulting.com/news/numerof-staff-interviewed-on-healthcare-reform/) - Multiple leading publications have recently featured Numerof staff perspectives on healthcare reform, including FierceHealthcare, Healthcare Finance News, Becker's Hospital Review, and CNBC. In an interview with FierceHealthcare, President Rita Numerof shared perspectives on the recent Trump executive order and healthcare reform more broadly. “We didn’t get here overnight,” Numerof told FierceHealthcare in an exclusive interview, “and
- [Numerof Published by <i>PM360</i> on Specialty Drugs](https://nai-consulting.com/news/numerof-published-by-pm360-on-specialty-drugs/) - Specialty drugs have become the growth engine in the pharmaceutical industry worldwide. In the U.S. alone, spending on specialty medicines has nearly doubled in the past five years. Against this backdrop, many traditional big pharma companies are creating specialty divisions and a growing number of smaller companies are solely focused on these products. As interest
- [NAI Published in <I>HFM Magazine</I> on Bundled Pricing](https://nai-consulting.com/news/nai-published-in-hfm-magazine-on-bundled-pricing-5/) - Bundled pricing represents a significant departure from the current fee-for-service model -- a model that has been widely criticized as motivating providers to drive up utilization, rather than focusing on healthcare quality. By changing utilization incentives and shifting some financial risk from payers to providers, bundled payment presents an opportunity for providers and physicians to
- [Numerof Published in <em>Trustee Magazine</em> on Population Health Management](https://nai-consulting.com/news/numerof-published-in-trustee-magazine-on-population-health-management/) - As payers, providers and employers struggle to come up with new approaches to deliver better, cheaper care, the idea of population health management is gaining ground. Consultant Kim White, M.B.A. and Research Analyst Christen Buseman, Ph.D., M.P.H., identify specific steps healthcare delivery organizations need to take to make population health a reality in their article
- [Numerof Published in <i>Trustee Magazine</i> on Transparency](https://nai-consulting.com/news/numerof-published-in-trustee-magazine-on-transparency/) - The focus on transparency springs from a convergence of trends toward shifting the burden of costs and expanding the ability of consumers to make health care decisions. Increasingly, consumers want to know how much a procedure will cost, and they want to compare the quality, safety, and outcomes of providers. In Trustee Magazine’s Web Exclusive,
- [Numerof Published in <i>Trustee Magazine</i> on Risk-Based Payment Structures](https://nai-consulting.com/news/numerof-published-in-trustee-magazine-on-risk-based-payment-structures/) - Hospitals and health systems in the United States are facing unprecedented pressure for change. In the near future, hospital boards and c-suite executives will have a major strategic decision to make: Should they go at-risk? Risk-based payment structures take on various forms. Numerof’s Michael Abrams, Rita Numerof, and Christen Buseman outline what risk looks like
- [Numerof Interviewed by <i>Home Health Care New</i>s on the Challenges Facing Home Health Agencies](https://nai-consulting.com/news/numerof-interviewed-by-home-health-care-news-on-the-challenges-facing-home-health-agencies/) - In an interview for Home Health Care News, President Rita Numerof discusses the evolving home healthcare business in an uncertain regulatory environment. “If we are serious as a country about health and moving care, it has to be in the home. Hospitals were never meant to be destinations of choice. We should be able to
- [Numerof Published by <i>Becker’s Hospital Review</i> on Transparency](https://nai-consulting.com/news/numerof-published-by-beckers-hospital-review-on-transparency/) - The challenges posed by the growing demand for transparency will require advanced planning, new investments, and new ways of conducting the business of caring for patients. Eric Abrams outlines the key areas hospitals and systems should consider for investment and constant improvement in his article for Becker’s Hospital Review, Six Actions to Prepare for a
- [Numerof Published by <i>PM360</i> on the Future of Biosimilars](https://nai-consulting.com/news/numerof-published-by-pm360-on-the-future-of-biosimilars/) - For quite some time, providers, public and private payers, policy-makers, pharmacy benefit managers and patients have hoped the arrival of biosimilars would usher in a new era of competitive drug prices. However, as the U.S. market prepares to welcome its second biosimilar, Celltrion’s Inflectra, the future of biosimilars in this country remains unclear. In his
- [Numerof Published by <i>MD&DI</i> on Value-Based Payment Models](https://nai-consulting.com/news/numerof-published-by-mddi-on-value-based-payment-models/) - Device manufacturers are operating in a rapidly changing healthcare environment that is shifting risk and accountability to providers through value-based payment models. Companies that quickly develop the capabilities to operate in a value-based marketplace will be prepared to win in this evolving environment. In their recently published article for MD&DI, Value-Based Payment Models: Implications for
- [Numerof Published by <i>hfm</i> on Managing Variation in Cost and Quality](https://nai-consulting.com/news/numerof-published-by-hfm-on-managing-variation-in-cost-and-quality/) - As the healthcare industry moves toward value-based care, collaboration between finance and clinicians has never been more important. Addressing the cultural divide that has existed between the two functions is the first step toward being able to identify those variations that add value, and those that don’t. Michael Abrams and Rita Numerof explore critical steps
- [Numerof Interviewed by <i>Becker’s</i> on Pharma Price Hikes](https://nai-consulting.com/news/numerof-interviewed-by-beckers-on-pharma-price-hikes/) - In an interview for Becker’s Hospital Review, President Rita Numerof discusses the controversy surrounding the price of EpiPens and why Mylan may not deserve all the backlash it's endured. “It's not about putting in price controls; it's about stimulating good competition. The pharmaceutical industry needs a more market-sensitive regulatory apparatus in the FDA, which will
- [Numerof Interviewed by <i>Healthcare Informatics</i> on CMS Star Ratings](https://nai-consulting.com/news/numerof-interviewed-by-healthcare-informatics-on-cms-star-ratings/) - In an interview for Healthcare Informatics, President Rita Numerof discusses how, despite some flaws, the latest CMS star ratings represent a significant step toward greater transparency and accountability for health outcomes. While there are significant methodology issues that should be addressed, “…these ratings are a first step in seeing that the consumer is informed, has
- [Numerof Published by <i>RealClearHealth</i> on Hospital Star Ratings](https://nai-consulting.com/news/numerof-published-by-realclearhealth-on-hospital-star-ratings/) - On July 27, CMS published one-to-five-star ratings of the overall quality of hospitals, designed to help patients and their loved ones compare hospitals side-by-side. While the rating system does have its flaws, it’s a step in the right direction to increase transparency and accountability. President Rita Numerof discusses what these ratings mean for healthcare executives
- [Numerof Interviewed by <i>Managed Healthcare Executive</i> on Diabetes Drug Spending](https://nai-consulting.com/news/numerof-interviewed-by-managed-healthcare-executive-on-diabetes-drug-spending/) - Senior Consultant Kim White discussed cost implications and future considerations in Diabetes drug spending on the rise, as seen in Managed Healthcare Executive. “It will take patients, providers and payers working together to ensure that the patient gets the right intervention at the right time to minimize the long-term cost impact of the disease,” she
- [Numerof Interviewed by <i>Medical Group Management Association</i> on Risk-Based Partnerships](https://nai-consulting.com/news/numerof-interviewed-by-medical-group-management-association-on-risk-based-partnerships/) - In an interview for MGMA Connect, Senior Consultant Kim White discusses the implications of going into “at-risk” relationships and steps providers can take to enhance a successful partnership in Risk-based contracting requires new relationships, innovation. “It’s important to emphasize that it’s not just data that organizations need to succeed in at-risk models. Organizations tend to
- [Numerof Published by <i>eyeforpharma</i> on IDNs](https://nai-consulting.com/news/numerof-published-by-eyeforpharma-on-idns/) - The accelerating consolidation of healthcare delivery organizations into integrated delivery networks (IDNs) shows no sign of slowing down. Future commercial success will depend on manufacturers’ ability to rapidly align marketing and sales with the evolving purchasing decision processes of IDNs. In her latest column for eyeforpharma, Planning for Success in an IDN Environment, President Rita
- [Numerof Featured in <i>U.S. News</i> on Rural Hospital Closures](https://nai-consulting.com/news/numerof-featured-in-u-s-news-on-rural-hospital-closures/) - Recent years have seen a string of rural hospitals ending operations, citing the continuing fiscal challenges of the current hospital environment. Not every small town needs a world-class facility to conduct complex surgeries and rare treatments, but each does need a facility that can stabilize emergency cases and serve as a medical resource. The consequences
- [Numerof Published by The Governance Institute on Population Health Survey](https://nai-consulting.com/news/numerof-published-by-the-governance-institute-on-population-health-survey/) - Population health has gained traction as an important solution to addressing the issues inherent in the current healthcare system. However, a study released by Numerof & Associates finds most healthcare providers continue to lag in actually implementing population health management. In their article, Survey Finds Critical Gaps in Progress Toward Population Health and Value-Based Models
- [Numerof Interviewed by <i>Managed Healthcare Executive</i> on Payer Consolidation](https://nai-consulting.com/news/numerof-interviewed-by-managed-healthcare-executive-on-payer-consolidation/) - In an interview for Managed Healthcare Executive, Managing Partner Michael Abrams discusses his reactions to the Department of Justice’s lawsuits to block the Aetna-Humana and Anthem-Cigna mergers in Payer mega mergers in question: Industry expert weighs in. “Consolidation in any already concentrated industry that would reduce the top five providers to just three should attract
- [Numerof Interviewed by <i>American Journal of Managed Care</i> on Payment Reform](https://nai-consulting.com/news/numerof-interviewed-by-american-journal-of-managed-care-on-payment-reform/) - In an interview for AJMC, Managing Partner Michael Abrams discusses the impact on providers as a result of CMS’ recent proposal to mandate bundled payments for cardiac care in Getting Ready for Bundled Payments in Cardiac Care. “… the changes involved in adapting to value-based care models are extensive, but I don’t think we have
- [Numerof Interviewed by <i>FierceHealthcare</i> on CMS Star Ratings](https://nai-consulting.com/news/numerof-interviewed-by-fiercehealthcare-on-cms-star-ratings/) - In an interview for FierceHealthcare, President Rita Numerof offers advice for hospitals, whether they’re celebrating success or must acknowledge their failures, in CMS star ratings: Response plan for high- and low-ranking hospitals. “… it’s important that all organizations regardless of the score and how they view the scoring mechanism take this seriously," Numerof said. Click
- [Numerof Published by <i>BioPharm International</i> on Immuno-oncology Drugs](https://nai-consulting.com/news/numerof-published-by-biopharm-international-on-immuno-oncology-drugs/) - The war on drug prices continues to intensify. Recent formulary decisions demonstrated the willingness of payers to take a hard line against perceived pricing excesses. Moving forward, pricing pressure will only increase. One therapeutic area that’s a proxy for where this drug price war is headed is oncology, and more specifically, immuno-oncology (I-O). While only
- [Numerof Presents to Society of Cardiovascular Patient Care's 19th Congress](https://nai-consulting.com/news/numerof-presents-to-society-of-cardiovascular-patient-cares-19th-congress/) - Vice President Kim White presented to the Society of Cardiovascular Patient Care at their annual Congress in May on The State of Population Health. Kim discussed the elements of a macro-level roadmap for system-wide population health management and identified critical organizational requirements to improve alignment and accountability of partners and ensure a successful population health
- [Numerof Published by <i>STAT</i> on Risk-Sharing](https://nai-consulting.com/news/numerof-published-by-stat-on-risk-sharing/) - In most realms of commerce, if a product fails to deliver what’s been promised, consumers are financially covered through refunds and warranties. This has never been the case with pharmaceuticals and medical devices. Increasingly, however, that’s going to change. In her recent article for STAT, Money-Back Guarantee: The New Trend in Drug and Device Marketing,
- [Numerof Published by <i>RealClearHealth</i> on Hospital Safety](https://nai-consulting.com/news/numerof-published-by-realclearhealth-on-hospital-safety/) - Hospital safety and quality performance has been in the news a great deal recently. Regardless of anyone’s views on the various methodologies and measures, there’s one thing we can agree on – increasing transparency in healthcare can’t be ignored. President Rita Numerof outlines steps that hospitals receiving unfavorable ratings need to take, and shares a
- [Numerof Published by <i>MD&DI</i> on Bundled Payment in Orthopedics](https://nai-consulting.com/news/numerof-published-by-mddi-on-bundled-payment-in-orthopedics/) - Bundled payment in orthopedics represents an opportunity for smart medical device firms that are not afraid to change how they do business. With CJR and other bundled payment programs, not only are hospitals challenged with getting their own house in order, but they must also pay greater attention to managing cost and quality across the
- [Numerof Published on What Population Health Means for Manufacturers](https://nai-consulting.com/news/numerof-published-on-what-population-health-means-for-manufacturers/) - Population health has been defined many ways by different groups, but is typically focused on managing the health of a defined population by providing the earliest and least costly intervention for each patient at a predictable price with quality guarantees. There’s been growing consensus that population health is the goal. What has been unclear is
- [Numerof Published by <i>H&HN</i> on Post-Acute Care Partnerships](https://nai-consulting.com/news/numerof-published-by-hhn-on-post-acute-care-partnerships/) - As payers shift more risk to providers - which can extend well beyond the acute care discharge - identifying and selecting post-acute partners has become critical. Post-acute providers are no longer simply a downstream referral partner. They’ve become an extension of the hospital’s care delivery model and have a more direct impact on a hospital’s
- [<i>Bringing Value to Healthcare</i> Excerpted in <i>Managed Care Magazine</i>](https://nai-consulting.com/news/bringing-value-to-healthcare-excerpted-in-managed-care-magazine/) - Changing the basis for reimbursement is the only path to achieving the kind of behavior change that will improve quality and reduce cost in a sustainable way. Working closely with providers, payers need to lead the efforts that will make different models for care delivery and payment a reality. In an excerpt from Bringing Value to
- [NAI Published by <i>H&HN</i> on Bundled Pricing](https://nai-consulting.com/news/nai-published-by-hhn-daily-on-bundled-pricing-9/) - Spiraling cost increases, coupled with lagging quality outcomes and a chronic lack of transparency have gotten the attention of payers, patients, and policymakers. Healthcare delivery organizations face growing pressure to address these issues. Bundled pricing is an innovation being implemented by market leaders that promises to do so. Deceptively simple sounding, this radically different approach
- [NAI Published by <i>H&HN</i> on Bundled Pricing](https://nai-consulting.com/news/nai-published-by-hhn-daily-on-bundled-pricing-10/) - The healthcare industry is in the midst of a revolutionary upheaval reflecting the concerns of patients, payers, providers, and policymakers over spiraling costs, lagging quality, and a lack of transparency. Healthcare providers are experimenting with a variety of approaches to address these issues, including offering "bundled prices" for episodes of care. This approach realigns provider
- [NAI Published in <i>H&HN</i> on ACOs](https://nai-consulting.com/news/nai-published-in-hhn-daily-on-acos-5/) - For all the debate, virtually all stakeholders agree with the overall objective of healthcare reform ... achieving better health outcomes at lower cost. Different views have emerged as to how best achieve this objective. One model appearing in reform legislation is the Accountable Care Organization (ACO). In their March 10, 2011 article, The Essence of
- [NAI Published in <i>H&HN</i> on Bundled Payments](https://nai-consulting.com/news/nai-published-in-hhn-weekly-on-bundled-payments-5/) - From the healthcare buyer’s perspective, the reform objective of "better health outcomes at lower cost" can be more simply expressed as "we’re not receiving commensurate value for our healthcare dollar." In this environment the concept of "bundled" pricing has enormous potential as a mechanism for differentiation in an increasingly commoditized and price sensitive market. In
- [NAI Published in <i>H&HN</i> on Business Model Redesign](https://nai-consulting.com/news/competing-for-patients-5/) - Growing local and global competition, major shifts in the power of payers and consumers, shrinking margins, increased regulation and costs make the point -- healthcare as it’s traditionally been defined is history. In their article Competing for Patients, published February 16, 2010 in H&HN, authors Rita E. Numerof, Ph.D., President and Bill Ott, M.B.A., Senior
- [NAI Published in <i>H&HN</i> on Physician Engagement](https://nai-consulting.com/news/nai-published-in-hhn-daily-on-physician-engagement-5/) - Reform is driving an industry redefinition of "value" that challenges traditional healthcare business models. Several solutions to move healthcare delivery organizations toward evidence-based value orientations have been proposed, including accountable care organizations and new payment models like bundled pricing. Any new business model that acknowledges the critical role of clinical decision making in determining cost
- [Numerof Published in <i>H&HN</i> on Transparency in Healthcare](https://nai-consulting.com/news/numerof-published-in-hhn-on-transparency-in-healthcare/) - Managing Partner Michael Abrams, M.A., and Business Analyst Daniel King, Ph.D., examine the ever growing demand for transparency in the healthcare marketplace. Converging trends are shifting hospitals to transparent pricing and competition on cost and quality. Transparency in Healthcare: Coming to your Hospital Soon, published February 20, 2014, in H&HN, examines how patients are confronting
- [Numerof Published by <i>H&HN</i> on Value-Based Models](https://nai-consulting.com/news/numerof-published-by-hhn-daily-on-value-based-models/) - With a lot of uncertainty about the future, many hospital leaders are asking, “How do I succeed today while getting ready for value-based payment?” Fortunately, there are steps hospitals can take that will help improve performance now while preparing them to assume risk in value-based payment models. Numerof President Rita Numerof, PhD outlines these initial
- [New Book <i>Bringing Value to Healthcare</i> Excerpted in <i>H&HN</i>](https://nai-consulting.com/news/new-book-bringing-value-to-healthcare-excerpted-in-hhn-daily/) - For more than a decade, as payers have increasingly squeezed revenues, much of health care delivery has defined its strategic response as doing what it’s always done, but for less. To get off the “spend and borrow treadmill,” hospitals need to redefine the business they are in. While there is no single solution or model
- [Numerof Featured by <i>CNBC</i> on Health Care Reform](https://nai-consulting.com/news/numerof-featured-by-cnbc-on-health-care-reform/) - For the last eight years, far too much of the national debate on health care reform has focused on health coverage and not health care. For those leading the charge back in March 2010, the Affordable Care Act was predominantly framed as a reform of the insurance sector. Fast forward to today and Republicans and
- [Numerof Presents at SEMDA 2016](https://nai-consulting.com/news/numerof-presents-at-semda-2016/) - Vice President Kim White served as a panelist at this year’s SEMDA conference in Nashville on the implications of new payment models for manufacturers. The healthcare delivery and reimbursement landscape is in flux. Providers and practices are being acquired by delivery systems, and pressure to deliver better health outcomes at lower cost continues to grow. New payment
- [Numerof Presents at NAMCP's Spring Managed Care Forum](https://nai-consulting.com/news/numerof-presents-at-namcps-spring-managed-care-forum/) - Vice President Kim White presented at the 2016 Spring Managed Care Forum sponsored by the National Association of Managed Care Physicians (NAMCP) on Getting to Population Health: Identifying Leaders & Laggards. Based on Numerof’s national State of Population Health Survey, Kim characterized the continuum of implementation, summarized what executives see as their biggest challenges, provided examples of
- [Numerof Published in ISPOR’s <i>Value & Outcomes</i> Spotlight on IDNs](https://nai-consulting.com/news/numerof-published-in-ispors-value-outcomes-spotlight-on-idns/) - As pressure for “better outcomes at lower cost” continues to mount, manufacturers must understand that they face a future in which they may be asked – or even required – to take on more of the risks related to the performance and cost of their products. However, before entering into risk sharing agreements, manufacturers must
- [Numerof Interviewed by <i>Managed Healthcare Executive</i> on Drug Pricing](https://nai-consulting.com/news/numerof-interviewed-by-managed-healthcare-executive-on-drug-pricing/) - President Dr. Rita Numerof shared insights on a prominent dispute between two industry powerhouses in Anthem, Express Scripts battle over drug prices, as seen in Managed Healthcare Executive. Numerof explained that “in order to stay relevant, PBMs will need to be able to demonstrate that they deliver on their promise of reduced drug pricing for
- [Numerof Interviewed by <i>HealthPayerIntelligence</i> on Value-Based Care Reimbursement](https://nai-consulting.com/news/numerof-interviewed-by-healthpayerintelligence-on-value-based-care-reimbursement/) - President Dr. Rita Numerof discussed trends in the health insurance market and the focus on value-based care reimbursement in 5 Elements Essential for Value-based Care Reimbursement, as seen in HealthPayerIntelligence. “Cost transparency is really critical in terms of a market-based model, which is at the core of bringing value to healthcare. If you think about
- [Numerof Presents at The 16th Population Health Colloquium](https://nai-consulting.com/news/numerof-presents-at-the-16th-population-health-colloquium/) - Dr. Rita Numerof chaired the Innovative Population Health Programs track on March 8th at The 16th Population Health Colloquium in Philadelphia. Rita and fellow experts from Mass. General Hospital, SRG Technology, Health Economy LLC, US Preventive Medicine, and EviCore discussed challenges and opportunities related to population health. Speakers included: Dr. Adrian Zai, Clinical Director, SRG Technology;
- [Numerof and Abrams Release New Book <i>Bringing Value to Healthcare: Practical Steps for Getting to a Market-Based Model</i>](https://nai-consulting.com/news/numerof-and-abrams-release-new-book-bringing-value-to-healthcare-practical-steps-for-getting-to-a-market-based-model/) - How can we create a healthcare system that is accountable for delivering optimal patient outcomes at sustainable cost? In their latest book, Bringing Value to Healthcare: Practical Steps for Getting to a Market-Based Model, Rita Numerof and Michael Abrams lay out the roadmap to a healthcare system that is truly accountable for delivering optimal patient outcomes
- [Numerof Presents to North Carolina Hospital Association](https://nai-consulting.com/news/numerof-presents-to-north-carolina-hospital-association/) - President Dr. Rita Numerof delivered a keynote to member hospital senior executives at NCHA’s Winter Membership Meeting. Rita spoke to the forces reshaping healthcare, the evolving focus on value, and the challenges of moving from fee-for-service to a value-based model that is more transparent and more closely linked to quality and outcomes. She also discussed
- [Numerof’s State of Population Health Survey Covered in Multiple National Media Outlets](https://nai-consulting.com/news/numerofs-state-of-population-health-survey-covered-in-multiple-national-media-outlets/) - Numerof’s recently released State of Population Health Survey report has attracted attention nationwide in multiple publications: FierceHealthcare: Population health management: survey finds too many hospitals drag their feet Becker’s Hospital Review: Most health providers lag in implementing population health management: 5 findings MedCity News: In absence of mandates, adoption of population health lags HealthITAnalytics: Is
- [Numerof Published in <i>Becker’s Hospital Review</i> on CJR and Relationships with Downstream Providers](https://nai-consulting.com/news/numerof-published-in-beckers-hospital-review-on-cjr-and-relationships-with-downstream-providers/) - The pending implementation of the Comprehensive Care for Joint Replacement (CJR) model is just the latest push by CMS for healthcare delivery organizations to take on more accountability for the quality and cost of care they provide. As industry momentum continues to build toward bundled payments, at-risk contracting and population health, the need to collaborate
- [Numerof Published in <i>FierceHealthPayer</i> on Payer-Provider Collaboration](https://nai-consulting.com/news/numerof-published-in-fiercehealthpayer-on-payer-provider-collaboration/) - In the healthcare industry, the relationship between payers and providers has long been adversarial - and it’s become counterproductively so. The longstanding distrust has put a major roadblock in the way of profitable changes and hampers efforts to improve care on both sides. In FierceHealthPayer’s Industry Voices, Dr. Rita Numerof describes the need for both payers
- [National Survey by Numerof & Associates Finds Critical Gaps in Progress Toward Population Health and Value-Based Models of Care](https://nai-consulting.com/news/national-survey-by-numerof-associates-finds-critical-gaps-in-progress-toward-population-health-and-value-based-models-of-care/) - ‘State of Population Health’ study provides first national look at pace of transition from fee-for-service to fixed payments linked to outcomes A national study released today by Numerof & Associates, a healthcare strategy consultancy, finds most healthcare providers continue to lag in implementing population health management despite broad agreement that it will be important for
- [Numerof Published in <i>Pharmaceutical Technology</i> on Canada’s Pharma Market](https://nai-consulting.com/news/numerof-published-in-pharmaceutical-technology-on-canadas-pharma-market/) - In Market Access Outlook for Canada, published by Pharmaceutical Technology, Research Analyst Mike Kuchenreuther, Ph.D., provides an overview of the key aspects of the current Canadian pharmaceutical market and highlights some recent developments as well as their implications for pharmaceutical manufacturers.
- [Numerof Interviewed by <i>Managed Healthcare Executive</i> on New Psoriasis Therapies](https://nai-consulting.com/news/numerof-interviewed-by-managed-healthcare-executive-on-new-psoriasis-therapies/) - Senior Consultant Kim White discussed how to reduce treatment costs in, New Psoriasis Therapies Must Demonstrate Value, as seen in Managed Healthcare Executive. “Further studies need to be done to demonstrate both the economic and clinical value these products bring to the market—and the rationale for why payers and consumers should pay for them,” she
- [Numerof Published by <i>PM360</i> on New Commercial Models](https://nai-consulting.com/news/numerof-published-by-pm360-on-new-commercial-models/) - Driven by new reimbursement requirements from CMS and private payers, healthcare delivery organizations are facing an unprecedented increase in their accountability for the quality and cost of care. This has profound implications for the commercial approach that manufacturers take to the market. Numerof & Associates’ Kim White and Michael Abrams discuss the steps manufacturers must
- [Numerof Presents at MedTech World's MD&M Florida 2015](https://nai-consulting.com/news/numerof-presents-at-medtech-worlds-mdm-florida-2015/) - As healthcare delivery organizations make the transition to value-based care, they’re experimenting with new models for payment and care delivery like ACOs, PCMH, bundled payments, and population health. They’re increasingly scrutinizing treatment protocols and products used with the objective of lowering cost, improving quality, and potentially, shifting risk to suppliers. Navigating these changes requires manufacturers
- [Numerof Presents at The Governance Institute Chairperson, CEO, and Physician Leader Conference](https://nai-consulting.com/news/numerof-presents-at-the-governance-institute-chairperson-ceo-and-physician-leader-conference/) - With growing scrutiny of healthcare cost and quality, the question of “why should anyone come to your hospital?” is becoming much more common. Numerof President Dr. Rita Numerof, Dr. Stephen Klasko, President and CEO of Thomas Jefferson University Hospital, and Dr. Peggy Naas, Chief Medical Officer at Healthcare Performance Improvement, highlighted challenges and opportunities related
- [Numerof Published in <i>FierceHealthPayer</i> on Business Model Change](https://nai-consulting.com/news/numerof-published-in-fiercehealthpayer-on-business-model-change/) - In the face of demand for lower costs, private health insurance is increasingly becoming a commoditized business. Payers understand that they are vulnerable to market changes, but they aren’t sure how to prepare for what comes next. In FierceHealthPayer’s Industry Voices, Dr. Rita Numerof provides actionable strategies for payers in implementing business model change. Building a
- [Numerof Interviewed in <i>Louisville Courier-Journal</i> on Kindred’s Declining Stock](https://nai-consulting.com/news/numerof-interviewed-in-louisville-courier-journal-on-kindreds-declining-stock/) - President Dr. Rita Numerof explored reimbursement pressures and its impact on long-term acute care in Why has Kindred's Stock Nosedived, as seen in the Louisville Courier-Journal. “… they will be required to demonstrate health outcomes and effective management of clinical issues as a condition of referral and payment,” said Numerof. To read Grace Schneider’s full article, click here.
- [Numerof Published by <i>Pharmaceutical Technology Europe</i> on Risk-Sharing Agreements](https://nai-consulting.com/news/numerof-published-by-pharmaceutical-technology-europe-on-risk-sharing-agreements/) - Payers across the globe are becoming increasingly assertive regarding products whose costs aren’t in line with perceived performance—a trend that shows no signs of slowing down. Financial and performance-based RSAs (PBRSAs) have been widely employed throughout Europe to reduce drug expenditures. While these agreements may not be universally applicable or without challenge, they are gaining momentum
- [Numerof Published by <i>eyeforpharma</i> on Population Health Management](https://nai-consulting.com/news/numerof-published-by-eyeforpharma-on-population-health-management/) - The U.S. healthcare system is currently in the midst of seismic change, largely characterized by the shift from volume to value-based medicine. Driven by this shift, population health management has gained considerable traction in recent years, with significant implications for pharma. In her latest column for eyeforpharma, Preparing for Population Health Management, President Rita Numerof
- [Numerof Presents at Population Health and the Role of Nursing Conference](https://nai-consulting.com/news/numerof-presents-at-population-health-and-the-role-of-nursing-conference/) - At the Population Health and the Role of Nursing Conference, presented by the Maryland Healthcare Education Institute (MHEI) and the Maryland Organization of Nurse Executives (MONE), Senior Consultant Kim White presented on The State of Population Health. She reviewed preliminary findings from the national State of Population Health Survey that Numerof is conducting in collaboration with the
- [Numerof Presents at Bowers Pharmaceutical Conference at Rutgers](https://nai-consulting.com/news/numerof-presents-at-bowers-pharmaceutical-conference-at-rutgers/) - At the 65th Annual Roy A. Bowers Pharmaceutical Conference, Senior Consultant Kim White presented, The State of Population Health: How New Jersey Compares to the Nation. She reviewed preliminary findings from the national State of Population Health Survey that Numerof is conducting in collaboration with the Jefferson School of Population Health. This survey is the
- [Numerof Published by <i>Physician Leadership Journal</i> on Chronic Care Models](https://nai-consulting.com/news/numerof-published-by-physician-leadership-journal-on-chronic-care-models/) - The Affordable Care Act, rising expenses of Medicare, and the increasing cost of healthcare to employers and employees have led to renewed efforts to control health expenditures. Most care models are organized for treatment of acute illness, while chronic disease treatment is often continuous rather than a short-term event. Numerof’s Dr. David Horwitz covers four
- [Numerof Published by <i>eyeforpharma</i> on Reference Pricing](https://nai-consulting.com/news/numerof-published-by-eyeforpharma-on-reference-pricing/) - Reference pricing shines a spotlight on the importance of demonstrating economic and clinical value in a way that resonates with payers, providers, and consumers. In her recent Industry Insights column for eyeforpharma, Reference Pricing on the Horizon, Rita Numerof discusses the distinct opportunities pharma companies have to be proactive in clearly defining how their products
- [Numerof Published by <i>BioPharm International</i> on the Pharma Market in China](https://nai-consulting.com/news/9115-numerof-published-by-biopharm-international-on-the-pharma-market-in-china/) - Research Analyst Mike Kuchenreuther, Ph.D., provides insights into the significant growth opportunities for global manufacturers in China, the world’s second largest pharmaceutical market, in his recent article for BioPharm International, Market Access in China. Mike identifies regulatory and pricing challenges, and discusses strategies manufacturers should consider for sustainable success. Global manufacturers remain well-positioned to leverage
- [Numerof Published by <i>Becker’s Hospital Review</i> on Population Health Management](https://nai-consulting.com/news/numerof-published-by-beckers-hospital-review-on-population-health-management/) - As provider organizations begin to tackle the challenge of managing population health, they’ll need to develop a systematic approach to quality improvement and how it’s measured across the continuum of care. The practical demands of managing population health are huge – and require underlying cultural and operational shifts. Numerof’s Michael Abrams, Rita Numerof, and Christen
- [Numerof Published by <i>MD&DI</i> on Commercial Models](https://nai-consulting.com/news/numerof-published-by-mddi-on-commercial-models/) - As healthcare delivery organizations make the transition to value-based care, they’re experimenting with new models for payment and care delivery like ACOs, PCMH, bundled payments, and population health. In order to ensure they’re delivering the best outcomes at lower cost, they’ll look closely at treatment protocols and products used, and make decisions that are in
- [Numerof Presents at Health Forum/AHA Leadership Summit](https://nai-consulting.com/news/numerof-presents-at-health-forumaha-leadership-summit/) - At the 23rd Annual Health Forum/AHA Leadership Summit in San Francisco, Senior Consultant Kim White presented Provider/Payer Partnerships: Collaborating on Care and Cost where she examined the elements of a successful partnership, from design to details, beginning with the operational requirements for taking on risk at the provider level.
- [Numerof Published in <i>Population Health News</i> on Cultural Implications of Population Health](https://nai-consulting.com/news/numerof-published-in-population-health-news-on-cultural-implications-of-population-health/) - Preparing to take on population health management is increasingly on the agenda as providers are challenged to provide better quality at lower cost. To do so successfully will require many delivery organizations to make significant changes that run counter to cultural norms established over many years. Numerof & Associates’ Michael Abrams, Kim White and Christen
- [Numerof Interviewed in <i>HealthLeaders</i> on Transparency, Cost, and Quality](https://nai-consulting.com/news/numerof-interviewed-in-healthleaders-on-transparency-cost-and-quality/) - President Dr. Rita Numerof was recently interviewed for a series of HealthLeaders stories on transparency, cost, and quality in healthcare by senior leadership editor Philip Betbeze, including May’s cover story and a follow-up commentary published today. “We need to look at transparency as more than just price,” said Numerof, describing that a focus on cost
- [Numerof Published in <i>Pharmaceutical Technology Europe</i> on the Pharma Market in France](https://nai-consulting.com/news/numerof-published-in-pharmaceutical-technology-europe-on-the-pharma-market-in-france/) - Research Analyst Mike Kuchenreuther, Ph.D., provides an in-depth look at recent developments in the French pharmaceutical market in Market Access Outlook in France, published by Pharmaceutical Technology Europe. Mike identifies pricing and reimbursement challenges, and the implications for manufacturers and their market strategy. Innovative pricing mechanisms, such as risk sharing, outcomes-based contracting and agreements are
- [NAI Published in <em>MD&DI</em> on New Poduct Development Strategy](https://nai-consulting.com/news/a-seat-at-the-strategy-table-6/) - The growing pressure for "better care at lower cost" is changing the fundamental rules of the medical device and diagnostics business. New rules call for new strategies, and that’s the case made by authors Rita E. Numerof, Ph.D., President and Bill Ott, M.B.A., Senior Consultant, in their article, A Seat at the Strategy Table , published
- [Numerof Presents at 2015 BIO International Convention](https://nai-consulting.com/news/numerof-presents-at-2015-bio-international-convention/) - At this year's BIO International Convention, Managing Partner Michael Abrams led the panel, How EU Reimbursement Hurdles Will Become the Norm in the U.S., with panelists Stefan Seliger, Head of Pricing and Reimbursement at Roche Pharmaceuticals, Alexander Natz, Secretary General of the European Confederation of Pharmaceutical Entrepreneurs, and Laura Spiegel, Group Marketing Manager, Strategy and Innovation at Roche Diagnostics.
- [Numerof Interviewed in <i>Louisville Courier-Journal</i> on Humana Acquisition](https://nai-consulting.com/news/numerof-interviewed-in-louisville-courier-journal-on-humana-acquisition/) - President Dr. Rita Numerof explored what Aetna’s acquisition of Humana could mean for employees in Humana workers could face a rough ride, as seen in the Louisville Courier-Journal. "I would expect there would be fairly dramatic reductions in jobs" overall at Humana, said Numerof. To read Grace Schneider’s full article, click here.
- [Numerof Published by <i>Applied Clinical Trials</i> on Economic and Clinical Value](https://nai-consulting.com/news/numerof-published-by-applied-clinical-trials-on-economic-and-clinical-value/) - Innovations such as biologics and personalized medicine promise new levels of clinical effectiveness. However, willingness to pay is not limitless, especially in the context of soaring drug prices and an increasing focus among payers, providers, and policymakers on lowering healthcare costs. Total product value, both economic and clinical, has become the essential basis for differentiation
- [Numerof Published by <i>eyeforpharma</i> on Risk Sharing Agreements](https://nai-consulting.com/news/numerof-published-by-eyeforpharma-on-risk-sharing-agreements/) - With greater focus on improving outcomes and reducing cost in healthcare, there has been a significant push across the sector to link payment with performance through risk sharing or similar value-based agreements. Although manufacturers have been largely unaffected by these agreements thus far, recent trends suggest a shift. In light of mounting drug prices, payers
- [Numerof Presents at ISPOR 20th Annual International Meeting](https://nai-consulting.com/news/numerof-presents-at-ispor-20th-annual-international-meeting/) - At the ISPOR 20th Annual International Meeting in Philadelphia, Senior Consultant Kim White led a discussion on how different manufacturers are approaching risk sharing agreements with panelists Bryan Gilpin, Director of Customer Solutions and International Operations at Boston Scientific, Sherry Thornton, Vice President of Healthcare Alliances at Medtronic, and Don Liss, Vice President of Clinical Programs and
- [Numerof Published in <i>Texas Healthcare Trustees Bulletin</i> on Population Health](https://nai-consulting.com/news/numerof-published-in-texas-healthcare-trustees-bulletin-on-population-health/) - Population health management reflects a new care delivery model that emphasizes wellness and prevention, and requires new payment models that support that goal. As provider organizations begin to tackle the challenge of managing this new initiative, they’ll need to develop a systematic approach to quality improvement and how it’s measured across the continuum of care.
- [Numerof Published by <i>Pharmaceutical Executive</i> on IDNs](https://nai-consulting.com/news/numerof-published-by-pharmaceutical-executive-on-idns/) - Healthcare companies are being challenged to reduce costs while delivering innovative, quality care. Shrinking reimbursement, penalties for quality shortfalls, and increasing transparency of pricing are challenging traditional operating assumptions. For pharmaceutical manufacturers, navigating these changes requires understanding how to effectively engage healthcare delivery customers that look and behave differently. As providers become more integrated and
- [Numerof Published in <i>BioPharm International</i> on Biosimilars](https://nai-consulting.com/news/numerof-published-in-biopharm-international-on-biosimilars/) - While the pace of global biosimilar adoption has been uneven, the opening of the U.S. market marks a major turning point. Global sales are expected to grow to $35B by 2020 (from only $1.3B in 2013) as more than $69B of biologics go off patent by 2018. For a closer look at global biosimilar markets,
- [Numerof Published in <i>eyeforpharma</i> on IDNs](https://nai-consulting.com/news/numerof-published-in-eyeforpharma-on-idns/) - In her recent Industry Insights Columns for eyeforpharma, President Rita Numerof, Ph.D., addresses one of the most rapidly emerging trends in healthcare: the formation of integrated delivery networks (IDNs). It’s no secret that healthcare delivery is consolidating. But many manufacturers haven’t adapted their commercial models to keep pace with their changing customers. While IDNs share the
- [Numerof Presents at Becker’s Hospital Review 6th Annual Meeting](https://nai-consulting.com/news/numerof-presents-at-beckers-hospital-review-6th-annual-meeting/) - To succeed in the new healthcare, delivery organizations will need to redefine key roles, upgrade staff capabilities, and sustain new behaviors. Senior Consultant Dr. Jill Sackman and Gundersen Health System’s Director of Organizational Development Janine Luz presented Building a Leadership Infrastructure for the New Healthcare Millennium at Becker's Hospital Review Annual Meeting in Chicago. They outlined the
- [Numerof Published by <i>eyeforpharma</i> on Market Segmentation](https://nai-consulting.com/news/numerof-published-by-eyeforpharma-on-market-segmentation/) - The enablers of the “one-size-fits-many” blockbuster model are eroding. Payers are pushing back more aggressively on “me-too” treatments where value can’t be demonstrated. With consolidation and greater pressure to manage cost and quality, hospital administrators now exert greater influence over clinicians’ prescribing decisions. There’s great value in smaller, more targeted patient populations – but finding
- [Numerof Published in <i>H&HN</i> on Monetizing the Value of Your Care](https://nai-consulting.com/news/numerof-published-in-hhn-on-monetizing-the-value-of-your-care/) - Increasingly pressed by lower reimbursements and tougher competition, delivery organizations are struggling to maintain and grow margins in today’s challenging environment. In particular, those organizations that have built care processes that deliver consistent, high quality results are wondering why they should settle for a commodity price when the care they provide is exceptional. According to
- [Numerof Published in <i>hfm Magazine</i> on New Payment Models](https://nai-consulting.com/news/numerof-published-in-hfm-magazine-on-new-payment-models/) - Operating at-risk represents a major (and daunting) shift for healthcare delivery organizations of all types. However, whether the model is bundled payment, population health, or accountable care, many of the key requirements are the same. Providers that invest now in developing the capabilities and infrastructure needed to take on risk will position themselves for success.
- [Numerof Presents at NAMCP Spring Managed Care Forum 2015](https://nai-consulting.com/news/numerof-presents-at-namcp-spring-managed-care-forum-2015/) - At NAMCP Spring Managed Care Forum 2015 in Orlando, Managing Partner Michael Abrams reviewed preliminary findings from the national State of Population Health Survey that Numerof is conducting in collaboration with the Jefferson School of Population Health. This survey is the most comprehensive effort yet to compile a “snapshot” of the progress of healthcare delivery
- [Numerof Presents at AAPL 2015 Annual Meeting and Spring Institute](https://nai-consulting.com/news/numerof-presents-at-aapl-2015-annual-meeting-and-spring-institute/) - Bundled pricing upends fee-for-service incentives, and demands a whole wide range of new processes and capabilities for success. Senior Consultant Dr. David Horwitz presented on Building a Bundled Price for the Treatment of Chronic Disease at the AAPL Annual Meeting in Las Vegas where he outlined a methodology for building the infrastructure and providing the technical
- [Numerof Presents at ACHE 2015 Congress on Leadership](https://nai-consulting.com/news/numerof-presents-at-ache-2015-congress-on-leadership/) - Mounting pressure on cost is driving profound structural change across healthcare. These changes demand new strategic and operational skills from healthcare management. If they are going to succeed in the new healthcare millennium, delivery organizations will need to redefine key roles, upgrade staff capabilities, and sustain new behaviors. Senior Consultant Dr. Jill Sackman and Gundersen
- [Numerof Presents at 13th Annual eyeforpharma Philadelphia Conference](https://nai-consulting.com/news/numerof-presents-at-13th-annual-eyeforpharma-philadelphia-conference/) - In today’s healthcare environment, price pressure is tough and only getting tougher. At the 13th Annual eyeforpharma Philadelphia Conference, Senior Consultant Jill Sackman led a discussion on strategies you can use to succeed and win, with panelists Bruce Taylor, Director of Government Strategy and Relations at Roche Diagnostics Corporation, and Dr. David Horwitz, Former Global Chief
- [Numerof Published in <em>Pharmaceutical Compliance Monitor</em> on Integrating Real World Evidence and Investigator Initiated Trials](https://nai-consulting.com/news/numerof-published-in-pharmaceutical-compliance-monitor-on-integrating-real-world-evidence-and-investigator-initiated-trials/) - Investigator initiated trials (IIT) continue to play a critical role for pharma and medical device companies. IITs further research in areas of interest and help develop insights into product effectiveness with patient populations. In addition, more efforts are incorporating real-world evidence (RWE) into strategic planning to meet regulatory requirements and support the value propositions for
- [NAI Announces the Release of New Book, <I>Healthcare At A Turning Point: A Roadmap For Change</I></B>](https://nai-consulting.com/news/nai-announces-the-release-of-new-book-healthcare-at-a-turning-point-a-roadmap-for-change-5/) - Based on more than 25 years of consulting experience across the healthcare delivery, insurance, pharma and device sectors, NAI President Rita E. Numerof, Ph.D. and Managing Partner, Michael N. Abrams, M.A. offer a fresh perspective in their latest book, Healthcare at a Turning Point: A Roadmap for Change. In Healthcare at a Turning Point, the
- [Numerof Interviewed in <i>HealthLeaders</i> on Knowing Costs](https://nai-consulting.com/news/numerof-interviewed-in-healthleaders-on-knowing-costs/) - With the approach of value-based payment, hospitals will need to know what it costs to deliver care before they can offer competitive capitated and bundled prices. In Why Understanding Your Costs is Vital, Philip Betbeze, senior leadership editor with HealthLeaders, interviews President Rita Numerof, Ph.D. on why knowing your hospital or health system’s underlying costs
- [Numerof Published in <i>PharmTech</i> on Value Based Healthcare in the UK](https://nai-consulting.com/news/numerof-published-in-pharmtech-on-value-based-healthcare-in-the-u-k/) - Value based pricing (VBP) and value based assessments (VBA) models are becoming more prominent in the UK pharma market. Accordingly, manufacturers must have clear strategic direction, goals, and objectives when conveying their value propositions to Clinical Commissioning Groups. In particular, manufacturers need to shift from being product centric to patient centric. Senior Consultant Jill E.
- [Numerof Published in <i>PM360</i> on Value Added Services](https://nai-consulting.com/news/numerof-published-in-pm360-on-value-added-services/) - Pharmaceutical and medical device organizations are looking to value-added services as a means to create new revenue streams. To succeed with value-added services in the global marketplace, a dual focus on strategy and implementation are required to ensure quality and alignment. In the article titled, Capturing Value from Value-Added Services, Consultant Christopher de Wolff addresses
- [Numerof Published in <i>MD&DI</i> on New Commercial Models](https://nai-consulting.com/news/numerof-published-in-mddi-on-new-commercial-models/) - Managing partner Michael Abrams and President Rita Numerof discuss how manufacturers must understand how their entire portfolios fit across relationships with their hospital customers and how they impact hospital bottom lines. Manufactures should diagnose their customers and communicate value, with supporting evidence, in terms that resonate with their customers. In the article, New Commercial Models
- [Numerof Presents at National Association of Managed Care Physicians ](https://nai-consulting.com/news/numerof-presents-at-national-association-of-managed-care-physicians/) - President Rita Numerof, Ph.D. gave a keynote presentation to healthcare and managed care providers at the NAMCP Fall Forum, on November 14 in Las Vegas, NV. Rita’s session, Healthcare at a Turning Point: A Roadmap for Change, discussed the rapidly evolving healthcare landscape and the outlook for an increase in payer/provider collaborations. She also shared the consequences
- [Michael Abrams Interviewed by <em>Strategic Health Care Marketing</em> on Retail Based Medicine](https://nai-consulting.com/news/michael-abrams-interviewed-by-strategic-health-care-marketing-on-retail-based-medicine/) - Managing Partner Michael Abrams discusses Schnuck Markets' new outpatient infusion center and the growing opportunities to bring more health care services into the retail setting in Supermarket Chain Offers Infusion Services, as seen in Strategic Health Care Marketing. While most consumers think first of a physician office or hospital as a place to go, “the challenge for
- [Numerof Published in <em>BioPharm International</em> on Germany's Pharma Market](https://nai-consulting.com/news/numerof-published-in-biopharm-international-on-germanys-pharma-market/) - Senior Consultant Jill E. Sackman, D.V.M., Ph.D., and Research Analyst Mike Kuchenreuther, Ph.D., provide an in-depth look at recent developments in the German pharmaceutical market in Germany Post AMNOG: Insights for BioPharma, published November 2014, by BioPharm International. Jill and Mike identify pricing and reimbursement challenges and discuss strategies manufacturers should consider for sustainable success. Manufacturers prepared
- [Numerof Published in <em>PM360</em> on Oncology Drug Market Access ](https://nai-consulting.com/news/nai-published-in-pm360-on-oncology-drug-market-access/) - NAI Senior Consultant Jill E. Sackman, D.V.M., Ph.D., and Consultant Stephen Rothenberg, J.D., discuss the challenges that oncology companies face as they introduce new products to the market in their article, Market Access—Global Challenges for Oncology Drugs. Published May 13, 2014 in PM360, the authors focus on the growing cost sensitivity of the provider and
- [Numerof Published in <em>eyeforpharma</em> on Value Added Services](https://nai-consulting.com/news/4925-2/) - In June’s installment of her Industry Insights column with eyeforpharma, NAI President, Rita Numerof, Ph.D., discusses the variety of initiatives pharmaceutical companies are focusing on to create value added services for drugs and medical devices. Value Added Services: The Second Wave of Disease Management, published June 19, 2014, highlights the range of approaches being taken
- [NAI Published in <em>BioPharm International</em> on the Emerging Markets of Southeast Asia](https://nai-consulting.com/news/nai-published-in-biopharm-international-on-the-emerging-markets-of-southeast-asia/) - NAI Senior Consultant, Jill E. Sackman, D.V.M., Ph.D., explores the opportunities for pharmaceutical R&D and market entry in Southeast Asia in the latest installment of her emerging markets series, featured in BioPharm International. Jill provides insight and guidance regarding trends in regulatory harmonization and pharmacovigilance, reimbursement, and regional considerations across the ASEAN countries that directly influence
- [NAI Published in <em>eyeforpharma</em> on Limitations of Big Data](https://nai-consulting.com/news/nai-published-in-eyeforpharma-on-limitations-of-big-data/) - As part of her ongoing Industry Insights column for eyeforpharma, NAI President, Rita E. Numerof, Ph.D., looks at the shortcomings of big data, suggesting that far from being an all-encompassing cure, it’s simply one of many solutions to pharma’s growth problems. Her article, In Search of the Silver Bullet: The Illusion of Big Data describes the potential pitfalls that come
- [NAI Published in <em>BioPharm International</em> on the Emerging Latin American Market](https://nai-consulting.com/news/nai-published-in-biopharm-international-on-the-emerging-latin-american-market/) - NAI Senior Consultant, Jill E. Sackman, D.V.M., Ph.D., focuses on the contemporary challenges and opportunities of the Latin American market in the latest installment of her column on emerging markets for BioPharm International. Jill notes many of the significant regulatory and market access considerations that must be evaluated before venturing into the quickly growing Latin American
- [NAI Published in <em>BioPharm International</em> on Key Regulatory Challenges in Eastern Europe](https://nai-consulting.com/news/nai-published-in-biopharm-international-on-key-regulatory-challenges-in-eastern-europe/) - In the second article of her “Navigating Emerging Markets” series seen in BioPharm International, NAI Senior Consultant Jill E. Sackman, D.V.M., Ph.D., tackles the region-specific challenges of Eastern Europe, and the implications for successful market entry and partnerships. Jill highlights critical information about regulatory harmonization with the EU, differential progress and political dynamics by country
- [NAI Published in <em>Pharmaceutical Commerce</em> on Pharma’s Stake in CER](https://nai-consulting.com/news/nai-published-in-pharmaceutical-commerce-on-pharmas-stake-in-cer/) - In the article, Pharma’s Stake in CER, adapted from the book Healthcare at a Turning Point: A Roadmap for Change, NAI Managing Partner, Michael N. Abrams, M.A., spotlights comparative effectiveness research (CER) as a new reality for the pharmaceutical industry that demands radical revision of its business model. Michael previews the implications of increased CER application, making
- [NAI Published in <em>Pharmaceutical Compliance Monitor</em> on the Role of the Board in Compliance](https://nai-consulting.com/news/nai-published-in-pharmaceutical-compliance-monitor-on-the-role-of-the-board-in-compliance/) - The size and number of recent settlements for regulatory compliance failures raise a key question for board members: how should the board’s fiduciary responsibility translate into concrete action? NAI Consultant Stephen Rothenberg, J.D., addresses this topic in his article, The Board's Role in Pharmaceutical Compliance. Stephen also offers a structured approach to evaluating progress toward
- [Numerof Published in <em>eyeforpharma</em> on Commercial Models](https://nai-consulting.com/news/numerof-published-in-eyeforpharma-on-commercial-models/) - In her latest Industry Insights Column for eyeforpharma, President Rita Numerof, Ph.D., addresses the commercial model changes organizations need to make in adapting to the evolving healthcare delivery market. Pharma’s delivery organization customers are adjusting to survive in a much tougher business climate we call Healthcare 2.0. This should prompt pharma companies to reevaluate the assumptions on which
- [Numerof Published in <em>Pharmaceutical Commerce</em> on the Future of Cancer Care](https://nai-consulting.com/news/numerof-published-in-pharmaceutical-commerce-on-the-future-of-cancer-care/) - Major transition in cancer care is underway, where much more will be expected of cancer therapies and factored into care paths. In Economic and clinical value: the future of cancer care, President Rita Numerof, Ph.D. discusses the major changes occurring in the cancer care landscape. Pharmaceutical companies will need to focus on evidence based care, patient
- [Numerof Presents at Governance Institute Leadership Conference](https://nai-consulting.com/news/numerof-presents-at-governance-institute-leadership-conference/) - President Rita Numerof, Ph.D. presented to healthcare industry leaders at the Governance Institute Leadership Conference, on October 21 in White Sulphur Springs, WV. Rita’s general session, Healthcare at a Turning Point: A Roadmap for Change, reviewed the challenges of moving from fee-for-service to a value-based model that is more transparent and closely linked to quality and outcomes.
- [Numerof Presents at <em>eyeforpharma</em> Real World Evidence (RWE) Conference](https://nai-consulting.com/news/numerof-presents-at-eyeforpharma-real-world-evidence-rwe-conference/) - Numerof Consultant Christopher de Wolff led a session on Using RWE to Kickstart Innovation at the 2014 eyeforpharma Real World Evidence & Data Partnerships Summit on October 15. Executives from Christiana Care Health System, National Health Council, and Actavis joined Christopher in examining how RWE can be used to improve understanding of treatment pathways; better
- [Numerof Published in the <em>Palm Beach Post</em> on Transparency in Healthcare](https://nai-consulting.com/news/numerof-published-in-the-palm-beach-post-on-transparency-in-healthcare/) - President Rita Numerof calls for greater transparency from hospitals to provide price and quality information in a Palm Beach Post commentary. She also suggests tools consumers can use to research hospitals and procedures as a way to make better informed choices and steps hospitals can take to improve transparency.
- [Numerof Presents at Advamed Conference](https://nai-consulting.com/news/numerof-presents-at-advamed-conference/) - Numerof Consultant Christopher de Wolff led a session entitled Planning for Market Entry in Developing Economies at the 2014 AdvaMed Conference on October 6. Executives from Baxter, Stryker, and the U.S. Department of Commerce joined Christopher in sharing perspectives on common regulatory steps that play an integral role in shaping each stage of the product development, approval,
- [Numerof Published in <em>eyeforpharma</em> on Patient Centricity](https://nai-consulting.com/news/numerof-published-in-eyeforpharma-on-patient-centricity/) - As healthcare evolves, manufacturers are engaging patients as partners earlier in product research and development. This inclusion of a patient-centric perspective helps in generating data for a value story, which resonates with these increasingly important stakeholders. In her latest Industry Insights Column for eyeforpharma, Numerof President Rita Numerof, Ph.D., outlines what manufacturers must consider to
- [Numerof Presents at CreateHealth Workshop](https://nai-consulting.com/news/numerof-presents-at-createhealth-workshop/) - Senior Consultant Dr. Jill Sackman reviewed how healthcare stakeholders are looking at novel data sharing approaches and population health management during her session, Value Creation Through Data-driven Approaches, at a Value Creation in Cardio Obstructive Pulmonary Disease (COPD) workshop hosted by CreateHealth.
- [Numerof Presents at American Medical Rehabilitation Providers Association](https://nai-consulting.com/news/numerof-presents-at-american-medical-rehabilitation-providers-association/) - Senior Consultant Dr. Jill Sackman discussed the pivotal role of rehabilitation medicine in the continuum of care during her session, Healthcare at a Turning Point: A Roadmap for Change for Rehabilitation Medicine, at the AMRPA 12th Annual Education Conference on September 17. Jill shared insights on industry challenges, the forces driving a focus on value
- [NAI Published in <em>HFMA</em>: Strategic Financial Planning on Changing Healthcare Delivery](https://nai-consulting.com/news/nai-published-in-hfma-strategic-finaicial-planning-on-changing-healthcare-delivery-5/) - Healthcare providers hoping to meet the better-care-at-lower-cost mandate of healthcare reform are going to have to develop a new business model, rethinking assumptions about the care they provide and how it is managed. In their article Kick-Start Your Management Team to Achieve Transformational Change, published February 16, 2010 in HFMA's online newsletter, Strategic Financial Planning,
- [Numerof Provides Expert Commentary on Obama Administration’s Healthcare Summit](https://nai-consulting.com/news/numerof-provides-expert-commentary-on-obama-administrations-healthcare-summit-4/) - Rita E. Numerof, Ph.D., President of Numerof & Associates, Inc. (NAI), joined a distinguished panel of experts contributing to the Center for Healthcare Transformation’s American People's Online Health Summit, February 25, 2010. CHT sponsored the live online session concurrently with the Administration’s Healthcare Summit, hosting key members of both parties to discuss healthcare reform. While
- [NAI Introduces Pharma Industry Column in <em>Pharma Philos</em>](https://nai-consulting.com/news/nai-introduces-pharma-industry-column-in-pharma-philos-5/) - NAI announces the first of a series of monthly columns on the pharmaceutical industry written by Rita E. Numerof, Ph.D., President, and published by Pharma Philos starting April 15, 2010. In her ongoing column, titled In the Eye of the Storm: Insights for an Industry in Transition, Rita will examine the multitude of critical issues
- [NAI Published in <em>Pharmaceutical Commerce</em> on Fair Market Value Fees](https://nai-consulting.com/news/nai-published-in-pharmaceutical-commerce-on-fair-market-value-fees-5/) - Pharmaceutical and medical device companies' financial relationships with physicians are a large and growing focus of OIG and DOJ enforcement activity, which makes it more important than ever to ensure that these arrangements can withstand critical examination. In his article Defending Fair Market Value (FMV) Assessments published June 28, 2010 in Pharmaceutical Commerce author Stephen
- [NAI Published in <em>PM360</em> on Growth Strategies for Healthcare](https://nai-consulting.com/news/nai-published-in-pm360-on-growth-strategies-for-healthcare-5/) - In a reform environment mandating "better care outcomes at lower cost", a new basis of competition for healthcare product manufacturers has emerged -- economic and clinical value (ECV). This change has profound implications for even the most successful companies, requiring a re-thinking of fundamental business models and go-to-market strategies. In their June 2010 article published
- [Numerof Co-Presents Podcast on the Effects of 'Obamacare'](https://nai-consulting.com/news/numerof-co-presents-podcast-on-the-effects-of-obamacare-5/) - Rita E. Numerof, Ph.D., President of Numerof & Associates, Inc. (NAI) joined Paul Howard, Ph.D. of The Manhattan Institute in a podcast discussion of reform legislation effects on the healthcare industry. As Dr. Numerof noted in the discussion, "The legislation that was passed earlier this year only addressed … the issue of insurance reform, and
- [NAI and AHA Collaborate on Action Guide for Managing Cost & Quality Variation](https://nai-consulting.com/news/nai-and-aha-collaborate-on-action-guide-for-managing-cost-quality-variation-5/) - Sometimes patients with the same medical needs receive different courses of treatment, with different outcomes. Why? Because even within the same hospital, lack of appropriate metrics and analytics allow variation in treatment decisions and resulting unpredictability in cost and quality outcomes. If hospital administrators hope to deliver better quality at lower cost, they will need
- [NAI and the Center for Health Transformation Release Recommendations for Payment Reform](https://nai-consulting.com/news/nai-and-the-center-for-health-transformation-release-recommendations-for-payment-reform-5/) - The historical fee-for-service payment model in healthcare does not provide incentives to support progress toward the reform goals of better care at lower cost. An unintended consequence of the model is that it doesn't reward physicians and hospitals for improving quality or lowering costs. In fact, it often encourages the maximum use of resources and
- [NAI Published by <I>Eyeforpharma</I>](https://nai-consulting.com/news/nai-published-by-eyeforpharma-5/) - NAI announces the first of a series of monthly columns on the pharmaceutical industry written by Rita E. Numerof, Ph.D., President, and published by eyeforpharma starting September 25, 2011. In her ongoing column -- called In the Eye of the Storm -- Rita will examine the multitude of critical issues the pharma industry currently faces,
- [NAI Published in <U>Defining The Value Of Spine Care</U>](https://nai-consulting.com/news/nai-published-in-defining-the-value-of-spine-care-5/) - Rita E. Numerof, Ph.D., President, and Stephen R. Rothenberg, J.D., Consultant, at Numerof & Associates, Inc. (NAI), contributed chapters to the ground-breaking new book, Defining the Value of Spine Care, edited by Jeffrey A. Rihn, M.D., Alexander R. Vaccaro M.D., Ph.D., Todd J. Albert, M.D. and David B. Nash, M.D. and available at Amazon.com today.
- [NAI Contributes to <I>BIOtechNOW</I> on Product Development Infrastructure](https://nai-consulting.com/news/nai-contributes-to-biotechnow-on-product-development-infrastructure-5/) - The pharmaceutical industry has entered a critical period of transition. With the management of healthcare costs reaching crisis proportions, payers are raising the bar...insisting on hard evidence of clinical and economic value in comparison to therapies that already exist. In this environment, sustainable market leadership requires a radically different development engine. Managing in a Cost-Constrained
- [NAI Presents to the Council for Value in Spine Care on ACOs](https://nai-consulting.com/news/nai-presents-to-the-council-for-value-in-spine-care-on-acos-9/) - NAI PRESENTS TO THE COUNCIL FOR VALUE IN SPINE CARE ON ACOs Rita E. Numerof, Ph.D., President of Numerof & Associates, Inc. (NAI), joined other healthcare experts including David Nash, Professor of Health Policy and Medicine at Jefferson Medical College, as a speaker at the Council for Value in Spine Care on February 25, 2012.
- [NAI Presents to the Council for Value in Spine Care on ACOs](https://nai-consulting.com/news/nai-presents-to-the-council-for-value-in-spine-care-on-acos-10/) - Rita E. Numerof, Ph.D., President of Numerof & Associates, Inc. (NAI) will join other healthcare experts including David Nash, Professor of Health Policy and Medicine at Jefferson Medical College, as a speaker at the Council for Value in Spine Care on February 25, 2012. Drawing on her 30 years of experience working with major providers,
- [Michael Abrams Interviewed on Change Management Challenges in Healthcare Boardrooms](https://nai-consulting.com/news/michael-abrams-interviewed-on-change-management-challenges-in-healthcare-boardrooms/) - Hospitals face profound operational and cultural challenges in meeting the demands of value based reimbursement, reference pricing and transparency. As they take on more risk and focus on outcomes based performance, Boards as well will struggle with the need for transformational change -- what it means for their organization and for their own governance practices.
- [NAI Interviewed on ACOs](https://nai-consulting.com/news/nai-interviewed-on-acos-5/) - Rita Numerof, Ph.D., President of Numerof & Associates, Inc. (NAI), was interviewed on accountable care organizations in this month’s issue of St. Louis Medical News. During her interview, she described ways that providers can improve accountability for healthcare cost and quality with or without an ACO. She explains that "[S]hared (administrative and clinical) accountability is
- [NAI Contributes to <I>BIOtechNOW</I> on Parallel Review](https://nai-consulting.com/news/nai-contributes-to-biotechnow-on-parallel-review-5/) - Last year, CMS and the FDA launched a pilot program for concurrent regulatory and reimbursement review of medical products. While manufacturers may like the idea of reducing the cycle time between FDA and CMS reviews, there are downside risks -- for example, that CMS' reimbursement concerns may become an element in the FDA's determination of
- [NAI Featured in the <I>Washington Examiner</I> on Obamacare](https://nai-consulting.com/news/nai-featured-in-the-washington-examiner-on-obamacare-5/) - This month marks the two year anniversary of the Patient Protection and Affordable Care Act of 2010 (PPACA) -- otherwise known as ‘Obamacare’. While we eagerly await the U.S. Supreme Court decision on the constitutionality of the act, the reality is that regardless of the court’s decision, PPACA has heralded a new level of bureaucracy,
- [NAI Interviewed by <I>Des Moines Register</I> on Accountable Care Organizations](https://nai-consulting.com/news/nai-interviewed-by-des-moines-register-on-accountable-care-organizations-5/) - NAI INTERVIEWED BY DES MOINES REGISTER ON ACCOUNTABLE CARE ORGANIZATIONS Rita Numerof, Ph.D., President of Numerof & Associates, Inc. (NAI), was interviewed for an article on accountable care organizations (ACOs) by the Des Moines Register’s Tony Leys. In the article, titled New Health Care Payment System Links Costs, Patients' Outcomes, Dr. Numerof expressed concern that
- [Numerof Predicts the Supreme Court Ruling](https://nai-consulting.com/news/numerof-predicts-the-supreme-court-ruling-5/) - NAI's President, Rita E. Numerof, Ph.D., gave her opinion to the St. Louis Business Journal on this month's Supreme Court Ruling on the Patient Protection and Affordable Care Act (PPACA). In her interview, she explains why the Supreme Court would likely either uphold or strike down the bill in its entirety. She describes how the
- [Numerof Reacts to the Supreme Court Ruling](https://nai-consulting.com/news/numerof-reacts-to-the-supreme-court-ruling-5/) - NUMEROF REACTS TO THE SUPREME COURT RULING NAI President, Rita E. Numerof, Ph.D. joins other leading healthcare executives representing BJC, SSM, and Express Scripts in reacting to the Supreme Court's ruling on the Patient Protection and Affordable Care Act in the St. Louis Business Journal. In her interview, she explains the implications for employers and
- [NAI Interviewed by <I>Becker’s ASC Review</I> on How Providers Can Hire the Best Talent](https://nai-consulting.com/news/nai-interviewed-by-beckers-asc-review-on-how-providers-can-hire-the-best-talent-4/) - Recruiting in healthcare has been a challenge for some time, but with the waves of consolidation across the industry, it’s tougher now than ever. One of NAI’s senior consultants, Dr. Jill E. Sackman, described how organizations can ensure they are asking the right questions this month in Becker’s ASC Review. In her interview, Jill breaks
- [NAI Interviewed by <I>Becker’s ASC Review</I> on Strategies to Maximize Reimbursement](https://nai-consulting.com/news/nai-interviewed-by-beckers-asc-review-on-strategies-to-maximize-reimbursement-8/) - How can ambulatory surgery centers (ASCs) maximize reimbursement for procedures like total joint replacement? One of NAI’s consultants, Kim White, M.B.A., offered her insights this month in Becker’s ASC Review. Since costs in ASCs are significantly lower than acute care settings, migration of such procedures is attractive. On the other hand, because such migration is
- [NAI Interviewed by <I>Becker’s ASC Review</I> on Lowering Costs Per Case](https://nai-consulting.com/news/nai-interviewed-by-beckers-asc-review-on-lowering-costs-per-case-4/) - Lowering costs is an essential, on-going focus among most delivery organizations. From materials management to revenue cycle review, there are many ways to tackle cost control. However, one critical area has been neglected -- cost differences between physicians in the operating room. In the article, Lowering Costs per Case, published by Becker’s ASC Review on
- [Nai Interviewed by <I>Becker’s ASC Review</I> on Payor Network Strategies](https://nai-consulting.com/news/nai-interviewed-by-beckers-asc-review-on-payor-network-strategies-4/) - With all the noise about lowering healthcare costs, what will health plans actually do, and how will that impact coverage? NAI President Rita E. Numerof, Ph.D. was interviewed on strategies health insurers are using to rein in costs -- and the implications for providers, employers and patients -- this month in Becker’s ASC Review. "Having
- [NAI Interviewed by <I>Becker’s ASC Review</I> on Reducing Cost Per Case](https://nai-consulting.com/news/nai-interviewed-by-beckers-asc-review-on-reducing-cost-per-case-4/) - In spite of the growing public consensus on the need to bring healthcare costs under control, many in the industry are struggling to truly streamline their operations. NAI’s Managing Partner, Michael N. Abrams, M.A., drawing on more than 25 years of experience in this space, offered his suggestions this month in Becker’s ASC Review: "The
- [Nai Interviewed by <I>Becker’S Hospital Review</I> on Spiraling Healthcare Costs](https://nai-consulting.com/news/nai-interviewed-by-beckers-hospital-review-on-spiraling-healthcare-costs-4/) - U.S. healthcare expenditures are on track to rise from 17.9 percent in 2010 to 19.6 percent by 2021, and have been described as a threat to national security by many. Yet there is relatively little consensus on the dynamics behind this continuing trend. NAI consultant Stephen Rothenberg, J.D. was one of several healthcare professionals, including
- [NAI Interviewed on Creating an Adaptable Culture by <I>Becker’s ASC Review</I>](https://nai-consulting.com/news/nai-interviewed-on-creating-an-adaptable-culture-by-beckers-asc-review-4/) - NAI Senior Consultant Jill E. Sackman, D.V.M., Ph.D., was interviewed on strategies to encourage adaptability this month in Becker’s ASC Review. In the article, titled 7 Steps to Create a Culture of Adaptability at Surgery Centers (September 20, 2012), Dr. Sackman provides a brief checklist of critical strategies and tactics that medical executives should focus
- [NAI Interviewed by <I>eyeforpharma</I> on Real World Data](https://nai-consulting.com/news/nai-interviewed-by-eyeforpharma-on-real-world-data-5/) - What is real world evidence (RWE), and why has it become a hot topic for pharmaceutical companies? One of NAI’s Senior Consultants, Jill E. Sackman, D.V.M., Ph.D., explained why RWE is suddenly on everyone’s mind, and what manufacturers can do to ensure they are meeting the growing demand for it to eyeforpharma’s Craig Sharp. In
- [NAI Interviewed by <I>Becker’s ASC Review</I> on Strategies to Maximize Reimbursement](https://nai-consulting.com/news/nai-interviewed-by-beckers-asc-review-on-strategies-to-maximize-reimbursement-7/) - How can ambulatory surgery centers (ASCs) drive more revenue? One of NAI’s consultants, Kim White, M.B.A., offered her insights into how ASCs can maximize reimbursement this month in Becker’s ASC Review. According to Kim, having the data to demonstrate the value an ASC offers, translated into terms that stakeholders like insurers and patients care about,
- [<I>Dallas Business Journal</I> Covers NAI’s Healthcare Renaissance Presentation](https://nai-consulting.com/news/dallas-business-journal-covers-nais-healthcare-renaissance-presentation-4/) - NAI President, Rita E. Numerof, Ph.D., moderated a panel discussion for the Dallas business community, entitled Healthcare Renaissance: Moving Toward a Market-Driven Model of Care. Joining her was Cancer Treatment Centers of America President and CEO, Steve Bonner, who was recently named one of Modern Healthcare’s "100 Most Influential People in Healthcare." During the session,
- [NAI Interviewed by <I>The Wall Street Journal’s MarketWatch</I> on Employer Wellness Programs](https://nai-consulting.com/news/nai-interviewed-by-the-wall-street-journals-marketwatch-on-employer-wellness-programs-4/) - NAI President, Rita E. Numerof, Ph.D., was interviewed by The Wall Street Journal’s MarketWatch on the value of employer wellness programs. In Getting Paid to Stay Healthy, reporter Jonnelle Marte delves into incentives employers are offering employees for getting healthy: "Unless you have a results component ...it’s difficult to see whether or not you have
- [NAI Interviewed by <I>Becker’s ASC Review</I> on Healthcare Innovation](https://nai-consulting.com/news/nai-interviewed-by-beckers-asc-review-on-healthcare-innovation-4/) - NAI Managing Partner Michael N. Abrams, M.A., was interviewed this month in Becker’s ASC Review on strategies to encourage innovation in healthcare settings. "The ASC is an optimal environment for testing new processes and procedures because they do a limited set of procedures with a patient base that is less complicated than in a hospital
- [NAI Interviewed by <I>Biotechnology Healthcare</I> on Specialty Drug Combinations](https://nai-consulting.com/news/nai-interviewed-by-biotechnology-healthcare-on-specialty-drug-combinations-5/) - This year’s meeting of the American Society of Clinical Oncology (ASCO), focused as usual on new breakthroughs in oncology -- especially in immunotherapy and specialty drug combinations. But behind the glittering scientific developments, there was a growing shadow. As clinicians proudly spoke of the results achieved by combining expensive specialty drugs, those with a practical
- [NAI Presents at the Center for Healthcare Governance](https://nai-consulting.com/news/nai-presents-at-the-center-for-healthcare-governance-5/) - Rita E. Numerof, Ph.D., President of Numerof & Associates, Inc., presented to healthcare industry leaders at the Center for Healthcare Governance Winter Symposium, February 18, 2013. Drawing on her 25 years of experience working with major providers, payers, and manufacturers, Rita shared key considerations for healthcare delivery leaders as they address demands for better health
- [NAI Presents at the AHA/Health Forum Annual Leadership Summit on Bundled Payment](https://nai-consulting.com/news/nai-presents-at-the-ahahealth-forum-annual-leadership-summit-on-bundled-payment-5/) - Rita E. Numerof, Ph.D., will present to healthcare industry leaders at the annual AHA/Health Forum Annual Leadership Summit in San Diego, July 19, 2011. Drawing on her 30 years of experience working with major providers, payers, and manufacturers, Dr. Numerof’s session, Bundled Payment: The Next Step in Improving Quality and Reducing Cost, will describe the
- [NAI Presents at the 4th Annual Orphan Drug Conference](https://nai-consulting.com/news/nai-presents-at-the-4th-annual-orphan-drug-conference-5/) - NAI President Rita E. Numerof, Ph.D., and Senior Consultant Jill Sackman, Ph.D., D.V.M. will join industry leaders in a panel at the 4th Annual Ultra Orphan Drug Conference on September 19th, 2011, sponsored by Centric Health Resources. Drawing on their extensive industry experience, Drs. Numerof and Sackman will join the session titled Addressing the Needs
- [NAI Presents to the Society for Healthcare Strategy and Market Development on Accountable Care](https://nai-consulting.com/news/nai-presents-to-the-society-for-healthcare-strategy-and-market-development-on-accountable-care-5/) - NAI Consultant Stephen Rothenberg, J.D. presented a webinar on ACOs, titled The Essence of Accountable Care, to the Society for Healthcare Strategy and Market Development on October 12, 2011. In theory, the ACO model will provide financial incentives to health care organizations to reduce costs and improve quality. In reality, given the dynamics and complexity
- [Numerof Presents on Market-Based Healthcare](https://nai-consulting.com/news/numerof-presents-on-market-based-healthcare-5/) - NAI President, Rita E. Numerof, Ph.D. joins Steve Bonner, President and CEO, Cancer Treatment Centers of America, in a panel discussing the future of the U.S. healthcare system, in St. Louis on Wednesday, November 16. Produced by the St. Louis Business Journal, the session is entitled Healthcare Renaissance: Moving Toward a Market-Driven Model of Healthcare.
- [NAI Presents at the BIO International Convention](https://nai-consulting.com/news/nai-presents-at-the-bio-international-convention/) - Rita E. Numerof, Ph.D., President of Numerof & Associates, Inc., joined other industry experts as a panelist at the Orphan Disease Forum - Innovations in Supply Chain Economics and Value Creation in U.S. Orphan Markets at the BIO International Convention on June 19. Because orphan drug products carry a higher per-patient cost than other drugs,
- [NAI Published by the Galen Institute on Health Insurance Exchanges](https://nai-consulting.com/news/nai-published-by-the-galen-institute-on-health-insurance-exchanges-5/) - The Galen Institute has released its policy paper on health insurance exchanges, titled What’s Wrong with Health Insurance Exchanges, authored by Rita E. Numerof, Ph.D., President of Numerof & Associates, Inc. The paper describes why health insurance exchanges as defined by PPACA are unlikely to increase access or improve health outcomes. It explains the problems
- [NAI Presents at the 10th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference](https://nai-consulting.com/news/nai-presents-at-the-10th-annual-orthopedic-spine-and-pain-management-driven-asc-conference/) - NAI Consultant Stephen Rothenberg, J.D. presented a session, Building a Robust Value Case for Spinal Surgery at the 10th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference: Improving Profitability and Business and Legal Issues on June 16. In recent years, growing concern about the overuse of certain spinal procedures has led to increasing pushback from
- [NAI Published in <em>eyeforpharma</em> on the Effects of Healthcare Consolidation](https://nai-consulting.com/news/nai-published-in-eyeforpharma-over-the-effects-of-health-consoldiation/) - NAI President, Rita E. Numerof, Ph.D., discusses the challenges that manufacturers face in the current trend of healthcare consolidation, and how they should adapt, in her article, Healthcare Consolidation and What It Means for Manufacturers, published in eyeforpharma November 28, 2012.
- [NAI Presents to the Voluntary Health Action Committee on Value in Healthcare](https://nai-consulting.com/news/nai-presents-to-the-voluntary-health-action-committee-on-value-in-healthcare/) - Rita E. Numerof, Ph.D., President of Numerof & Associates, Inc. (NAI), presented to the National Health Council on June 12 at the Voluntary Health Agency Committee Meeting. Speaking as an expert with more than 25 years of experience working across the entire healthcare industry -- from payers and providers to manufacturers -- Dr. Numerof discussed
- [NAI Published in <em>Pharmaceutical Compliance Monitor</em> on Effective Field-Based Monitoring](https://nai-consulting.com/news/nai-published-in-pharmaceutical-compliance-monitor-on-effective-field-based-monitoring/) - With relationships between manufacturers and physicians under increasing scrutiny, pharma and device compliance staff need to be able to demonstrate results. They must be able to show that their efforts are actually resulting in interactions with physicians that are compliant and ethical. NAI Consultant, Stephen Rothenberg, J.D., describes how an effective field-based monitoring plan can
- [NAI Published in <em>MD&DI</em> on the Impact of Comparative Effectiveness Research on Spine Care Device Companies](https://nai-consulting.com/news/4539-2/) - Adapted from the author’s contributed chapter in Defining the Value of Spine Care (Rihn, Vaccaro, Albert, and Nash, eds., 2012), NAI President Rita E. Numerof, Ph.D. discusses the progress of comparative effectiveness research (CER) with regard to spine care, what manufacturers can expect and what they should do now to mitigate market access threats inherent
- [NAI Published in <em>eyeforpharma</em> on the Implications of the 2012 Election on Global Pharmaceuticals](https://nai-consulting.com/news/nai-published-in-eyeforpharma-on-the-implications-of-the-2012-election-on-global-pharmaceuticals/) - NAI President, Rita E. Numerof, Ph.D., reflects on the recent election and the impact on future healthcare policy, answering the question: “So what can pharmaceutical manufacturers expect to happen next?” See the full article, Healthcare Policy Impact -- What the 2012 Elections Mean for the Global Pharmaceutical Industry, published in eyeforpharma, Februrary 7, 2013.
- [NAI Interviewed by <em>Health Data Management Magazine</em> on Healthcare Consolidation](https://nai-consulting.com/news/nai-interviewed-by-health-data-management-magazine-on-healthcare-consolidation/) - We’ve heard a lot about consolidation in the healthcare industry in recent months. But what’s behind this trend? One of NAI’s consultants, Kim White, M.B.A., offered her insights this month in Health Data Management. According to Kim, "Health systems are seeking safety in size," but they shouldn’t overlook the challenges of integration. "A health system
- [Dr. Jill Sackman Interviewed by <em>OR Manager</em> Magazine on the Impact of ACA](https://nai-consulting.com/news/dr-jill-sackman-interviewed-by-or-manager-magazine-on-the-impact-of-aca/) - Senior Consultant Dr. Jill Sackman was interviewed on the impact the Patient Protection and Affordable Care Act is having on every part of the healthcare system, including ambulatory surgery centers. Her comments were published in the February 2014 issue of OR Manager in ACA will bring more patients to ASCs - but will profits follow? According to
- [NAI Published in <em>Becker’s Hospital Review</em> on Cultural Challenges of Bundled Pricing](https://nai-consulting.com/news/nai-published-in-beckers-hospital-review-on-cultural-challenges-of-bundled-pricing-4/) - As healthcare organizations respond to current cost and quality pressures by making pricing more transparent through bundling of services, cultural norms that have historically separated clinical and financial concerns must be reexamined. NAI Managing Partner Michael N. Abrams, M.A., examines four key challenges that providers face in 4 Cultural Challenges of Bundled Pricing, published April
- [NAI Published in <em>PM360</em> on Positioning Products for Payers](https://nai-consulting.com/news/nai-published-in-pm360-on-positioning-products-for-payers/) - To ensure that pharmaceutical and medical device companies can meet the evolving requirements for economic and clinical value evidence and ensure reimbursement, manufacturers need to understand what payers want. NAI Consultant, Kim White, unpacks those needs in her recent article in PM360, The New Wave of Product Positioning, published April 1, 2013.
- [NAI Published in <em>eyeforpharma</em> on Using Big Data to Anticipate the Market](https://nai-consulting.com/news/nai-published-in-eyeforpharma-on-using-big-data-to-anticipate-the-market/) - NAI President, Rita E. Numerof, Ph.D., explores the potential for manufacturers to use big data in providing critical insights into patient behavior, and the healthcare market, in June’s installment of her Industry Insights column with eyeforpharma. Published June 7, 2013, Using Big Data to Anticipate Where the Market Is Going presents Rita’s perspective on big data:
- [NAI Published in <em>eyeforphama</em> on How Manufacturers Can Demonstrate Value Through Patient Adherence](https://nai-consulting.com/news/4516-2/) - NAI President Rita E. Numerof, Ph.D., examines the link between an increased focus on patient adherence and improved results with industry payers in her eyeforpharma Industry Insights column article, How Better Patient Adherence Can Serve as a Competitive Differentiator, published July 4, 2013.
- [Dr. Rita Numerof Speaks on Big Data in Healthcare](https://nai-consulting.com/news/rita-speaks-on-big-data-in-healthcare/) - Dr. Rita Numerof discusses big data in the healthcare industry with the Manhattan Institute’s Dr. Paul Howard in his latest podcast on Medical Progress Today.com. To listen to the podcast, click here. "Data aggregation matters a whole lot less to me than how the data is used… we need to look at the data that
- [NAI Published in <em>BioPharm International</em> on the Emerging Market of South Korea](https://nai-consulting.com/news/nai-published-in-biopharm-international-on-the-emerging-market-of-south-korea/) - NAI Senior Consultant, Jill E. Sackman, D.V.M., Ph.D., continues her “Navigating Emerging Markets” column with BioPharm International in her piece concerning the regulatory trends in South Korea, published August 1, 2013. Jill provides insight and guidance regarding trends in regulatory harmonization and pharmacovigilance, reimbursement, and regional considerations of South Korea that will directly influence successful
- [NAI Published in <em>eyeforpharma</em> on Impact of Healthcare Consolidation for Manufacturers](https://nai-consulting.com/news/nai-published-in-eyeforpharma-on-impact-of-healthcare-consolidation-for-manufacturers/) - As payers and providers consolidate and use their market share to influence negotiations with manufacturers, what can pharma do to protect their business and capture value for their products? This month, NAI President Rita E. Numerof, Ph.D., clarifies the serious implications associated with this trend in her Industry Insights column with eyeforpharma, Implications of Massive
- [NAI Published in <em>eyeforpharma</em> on Product Lifecycle Management](https://nai-consulting.com/news/nai-published-in-eyeforpharma-on-product-lifecycle-management/) - In her recent Industry Insights column piece with eyeforpharma, NAI President Rita E. Numerof, Ph.D., highlights the importance of integrating multiple lifecycle management strategies into manufacturer organizations to prolong the protection given to existing products and to manage competition from generic manufacturers. See the full article, published September 5, 2013: Tighten Up Your Product Lifecycle
- [NAI Published on Product Value and Price](https://nai-consulting.com/news/nai-published-on-product-value-and-price/) - In her most recent Industry Insights column published October 10, 2013, NAI President Rita Numerof, Ph.D., explores how manufacturers need to broaden the dialogue they have with payers about the level of reimbursement they receive for their products. Titled Using Data to Link Product Value and Price, Rita’s column explores the need for manufacturers to
- [Dr. Jill Sackman Presents at <em>eyeforpharma</em> Real World Evidence Conference ](https://nai-consulting.com/news/dr-jill-sackman-presents-at-eyeforpharma-real-world-evidence-conference/) - NAI Senior Consultant Dr. Jill Sackman, led a panel session titled Making the Case for Market Access at the Eyeforpharma Real World Evidence 2013 Conference, October 16-17 in Bethesda, Maryland. Dr. Sam Ho (EVP/ CMO, UnitedHealthcare), Steve Bonner, (Chairman, CTCA), and Dr. Luke Wright (Jackson Clinic) joined Jill to discuss the evidence, capabilities, and relationships
- [Podcast: Dr. Jill Sackman Interviewed on the Impact of Biosimlars on the Innovator Market](https://nai-consulting.com/news/podcast-dr-jill-sackman-speaks-interviewed-on-the-impact-of-biosimlars-on-the-innovator-market/) - Dr. Jill Sackman, Senior Consultant at NAI, discusses the market forces impacting biopharmaceutical manufacturing with Rita Peters at Pharmaceutical Technology in the latest podcast on PharmTech TV. To listen to the podcast, click here.
- [NAI Published in <em>Physician Executive Journal</em> on Quality and Cost Improvement](https://nai-consulting.com/news/nai-published-in-physician-executive-journal-on-quality-and-cost-improvement/) - Over the years, hospital administrators have employed numerous strategies to reduce costs and improve quality of care. In spite of efforts to merge into larger systems, consolidate vendors, and establish lean operations programs, costs continue rising and gaps in quality remain. Physician decision making is one of the largest drivers of the ultimate costs of
- [NAI Interviewed by <em>St. Louis Post-Dispatch</em> on CMS’ Hospital Value-Based Purchasing Program](https://nai-consulting.com/news/nai-interviewed-by-st-louis-post-dispatch-on-cms-hospital-value-based-purchasing-program/) - NAI President Dr. Rita Numerof discusses the latest data released by CMS on the over 3,000 hospitals participating in the Hospital Value-Based Purchasing Program. This year, the program reduced Medicare payments to all hospitals by 1.25 percent, reserving the funds for hospitals that demonstrate high performance. “When you think about how a lot of these
- [NAI Published in <em>eyeforpharma</em> on FDA Breakthrough Program ](https://nai-consulting.com/news/nai-published-in-eyeforpharma-on-fda-breakthrough-program/) - In her most recent Industry Insights Column for eyeforpharma, NAI President, Rita Numerof, Ph.D., assesses the success of the FDA’s Breakthrough Therapy Designation, and explains what this fledgling submission process means for pharmaceutical market access. See the full article, published November 14, 2013: The Breakthrough Designation Program: Four Factors for Long Term Success.
- [NAI Published in <em>eyeforpharma</em> on Risk Sharing Agreements](https://nai-consulting.com/news/nai-published-in-eyeforpharma-on-risk-sharing-agreements/) - In this latest installment of her Industry Insights column published December 9, 2013, NAI President Rita Numerof, Ph.D., discusses the growing use of risk sharing agreements (RSAs) by private and public payers in contracts with pharmaceutical manufacturers. Titled Key Considerations for Entering Into Risk Sharing, Rita’s column discusses strategies to develop effective RSAs with insurer
- [NAI Published in <em>BioPharm International</em> on the Emerging Israel Market  ](https://nai-consulting.com/news/nai-published-in-biopharm-international-on-the-emerging-israel-market/) - Jill E. Sackman, D.V.M., Ph.D., NAI Senior Consultant, and Mike Kuchenreuther, Ph.D, NAI Research Analyst, explore biotechnology and growth in Israel in the latest installment of her emerging markets series, Navigating Emerging Markets – Israel, published December 1, 2013, featured in BioPharm International. Jill and Mike provide insight on how Israel’s diverse population, high quality
- [NAI Authors Whitepaper on Oncology Market Access for <em>eyeforpharma</em>](https://nai-consulting.com/news/nai-authors-whitepaper-on-oncology-market-access-for-eyeforpharma/) - NAI was commissioned by eyeforpharma to write the whitepaper, Oncology Market Access: Trends, Challenges, and Strategies for U.S. Pharma. One of eyeforpharma’s most downloaded whitepapers, the paper was produced in coordination with the upcoming conference, Oncology USA Summit 2014, in Boston March 25-26. Relying on a synthesis of recent actions by healthcare stakeholders and illuminated by
- [Numerof Published in <em>Becker’s Hospital Review</em> on Avoiding Common Pitfalls in Cost Management Efforts](https://nai-consulting.com/news/numerof-published-in-beckers-hospital-review-on-avoiding-common-pitfalls-in-cost-management-efforts/) - Managing Partner Michael Abrams, M.A., and Senior Consultant Glenn Mitchell, M.D., M.P.H., highlight the importance of executing a new operations model for cost management in, Avoid Common Pitfalls in Cost Management Efforts: Think Outside the Box, published in Becker’s Hospital Review on February 6, 2014. “Ideally, such a model would be based on your own
- [NAI Published in <em>eyeforpharma</em> on Pharma Sales Reps](https://nai-consulting.com/news/nai-published-in-eyeforpharma-on-pharma-sales-reps/) - In a two-part installment of her Industry Insights column, NAI President Rita Numerof, Ph.D., examines the changing role of the pharmaceutical sales rep and how it must evolve. The Future of Pharma Sales: Part I, published on January 9, 2014, discusses impact of the changing healthcare landscape on the competencies required of sales reps, and
- [NAI Published in <em>PM360</em> on the Impact of Healthcare Reform on Manufacturing’s Commercial Model](https://nai-consulting.com/news/nai-published-in-pm360-on-the-impact-of-healthcare-reform-on-manufacturings-commercial-model/) - Providers are under growing financial pressure as a result of healthcare reform legislation. This pressure increasingly is being translated to manufacturers that sell into the industry, changing long-standing dynamics with profound implications for commercial models. In the article titled Practical Healthcare Reform and the Impact of Change, published February 14, 2014 in PM360, NAI Consultants
- [NAI Published in <em>Pharmaceutical Compliance Monitor</em> on the Next Step in Compliance Programs](https://nai-consulting.com/news/nai-published-in-pharmaceutical-compliance-monitor-on-the-next-step-in-compliance-programs/) - NAI Consultant, Stephen E. Rothenberg, J.D., discusses the important issues in establishing effective compliance programs in his recent article, Is More Compliance Better Compliance, published in Pharmaceutical Compliance Monitor on February 25, 2014. “Strengthening an organization’s culture of compliance starts at the top by demonstrating a commitment to compliance and ethics, and defining the compliance
- [NAI Published in <em>BioPharm International</em> on The ACA’s Impact on Innovation in Biopharma](https://nai-consulting.com/news/nai-published-in-biopharm-international-on-the-acas-impact-on-innovation-in-biopharma/) - As the Affordable Care Act approaches its four-year anniversary, its effects are still rippling through the economy and the healthcare marketplace. The legislation and concurrent recession has dramatically changed the dynamics of the pharmaceutical industry, rendering many business model assumptions obsolete. Understanding the implications of those changes for core processes like new product development and
- [Numerof Published in <em>HFM Magazine</em> on How to Address Cost Outliers](https://nai-consulting.com/news/numerof-published-in-hfm-magazine-on-how-to-address-cost-outliers/) - Over the years most delivery organizations have had some kind of cost management activity in place but have not managed to bend the cost curve. Senior Consultant Jill Sackman, D.V.M., Ph.D. and Business Analyst Levi Citrin, J.D., discuss the process for making sense of and controlling cost and quality variation in Cracking Down on Cost
- [NAI Published in <em>eyeforpharma</em> on Prospects for Price Controls in the Pharmaceutical Industry](https://nai-consulting.com/news/nai-published-in-eyeforpharma-on-prospects-for-price-controls-in-the-pharmaceutical-industry/) - As the spotlight is turned to the cost of branded drugs in the U.S., pharmaceutical companies are under growing pressure from payers and providers to contain costs. In their article, Are De Facto Price Controls Imminent, published on March 19, 2014 in eyeforpharma, NAI President Rita Numerof, Ph.D. and Consultant Christopher de Wolff examine the
- [Numerof Presents at <em>eyeforpharma</em> Oncology USA Conference ](https://nai-consulting.com/news/numerof-presents-at-eyeforpharma-oncology-usa-conference/) - Numerof Senior Consultant Dr. Jill Sackman, led a panel session titled Innovative New Payment Mechanisms – Value in Cancer Care at the eyeforpharma Oncology USA Summit 2014 conference in Cambridge, Massachusetts, March 25-26. Executives from Aetna, CIGNA, and Dana-Farber Cancer Institute joined Jill to discuss new mechanisms of payment, and new data requirements for demonstrating
- [NAI Published in <em>eyeforpharma</em> on Distribution of Sales and Marketing ](https://nai-consulting.com/news/nai-published-in-eyeforpharma-on-distribution-of-sales-and-marketing/) - In her April Industry Insights Column for eyeforpharma, (April 6, 2014), NAI President, Rita Numerof, Ph.D., discusses rapidly evolving changes in the healthcare marketplace, and the responses they demand to the commercial model historically used by pharmaceutical companies. Distribution of Sales and Marketing Spend Must Change focuses on the need to give market access a
- [Christopher de Wolff Presents at <em>eyeforpharma</em> Annual Philadelphia Summit](https://nai-consulting.com/news/christopher-de-wolff-presents-at-eyeforpharma-annual-philadelphia-summit/) - NAI Consultant, Christopher de Wolff, led a keynote session entitled Evolving Stakeholder Perspectives: What Pharma Needs to Know at the eyeforpharma Annual Philadelphia Summit 2014 conference on April 15. Executives from Cancer Treatment Centers of America, Inspira Health Network, and Cigna joined Christopher to present payer and provider perspectives on what they expect from pharma
- [Numerof Published in <em>Becker’s Hospital Review</em> on Big Data Analytics in Health Care Delivery ](https://nai-consulting.com/news/numerof-published-in-beckers-hospital-review-on-big-data-analytics-in-health-care-delivery/) - Focused more than ever on controlling costs and improving quality of care, all healthcare sectors are scrambling to understand how their business models must change moving forward. One thing is certain, increased reliance on big data analytics is critical for their success. Research Analyst Michael Kuchenreuther, Ph.D., and Managing Partner Michael Abrams, MA, provide insights
- [Numerof Published in <em>Modern Healthcare</em> on Defining the Job Description for Population Health ](https://nai-consulting.com/news/numerof-published-in-modern-healthcare-on-defining-the-job-description-for-population-health/) - Many healthcare organizations are naming physician leaders to take charge of their population health strategies. Defining the role of “Dr. Population Health” has come to the forefront for most physician leaders as they seek to understand what their new role actually means. President Rita E. Numerof, Ph.D., and Jefferson School of Population Health Dean David
- [NAI Published in <em>BioPharm International</em> on The Emerging Market of India](https://nai-consulting.com/news/nai-published-in-biopharm-international-on-the-emerging-market-of-india/) - NAI Senior Consultant, Jill E. Sackman, D.V.M., Ph.D. and Research Analyst Michael Kuchenreuther, Ph.D., discuss the significant growth opportunities that characterize the emerging market of India in their latest Navigating Emerging Markets column in BioPharm International. Jill and Michael provide insight and guidance regarding trends in regulatory harmonization, reimbursement, and regional considerations of India that
- [Christopher de Wolff Interviewed on Pharma’s Reputation Management Problem](https://nai-consulting.com/news/christopher-de-wolff-interviewed-on-pharmas-reputation-management-problem/) - NAI Consultant Christopher de Wolff was interviewed on the steps the pharma industry should proactively take to improve its reputation in the article, Devalued and Distrusted: How Can Pharma Rebuild its Image?, published in eyeforpharma. According to Christopher, restoring their tarnished image “…needs to be a strategic goal set at the level of the CEO,
- [Dr. Jill Sackman Interviewed by FOX 2 News](https://nai-consulting.com/news/dr-jill-sackman-interviewed-by-fox-2-news/) - NAI Senior Consultant Dr. Jill Sackman discusses the changing healthcare landscape with Fox 2 News in St. Louis after Mercy’s recent announcement of 200-300 system-wide layoffs. In her interview, Sackman says that patients, hospitals and medical staff should expect monumental changes in health care in the future. Click here to watch the Fox 2 News
- [Dr. Rita Numerof Interviewed on US Healthcare’s Low Rankings by FOX 2/KPLR](https://nai-consulting.com/news/dr-rita-numerof-interviewed-on-us-healthcares-low-rankings-by-fox-2kplr/) - Prompted by the last place ranking of the US in the Commonwealth Fund’s annual assessment of national healthcare systems, NAI President Dr. Rita Numerof was interviewed on the issues behind the poor results. In her interview, Dr. Numerof focused on the central theme of her recent book, Healthcare at a Turning Point: A Roadmap for
- [Numerof Presents at BIO International](https://nai-consulting.com/news/christopher-de-wolff-presents-at-bio-international/) - Numerof Consultant Christopher de Wolff led a session entitled Reimbursement Considerations for Early-Stage Companies at the 2014 BIO International Convention on June 24. Executives from Aerial BioPharma, RiverVest Venture Partners, and Bayer joined Christopher in sharing perspectives on the need for data-based evidence to support product value, and considerations for early-stage pharma companies conducting their
- [Michael Abrams Interviewed by <em>BenefitsPro</em> on Reference Pricing](https://nai-consulting.com/news/michael-abrams-interviewed-by-benefitspro-on-reference-pricing/) - Managing Partner Michael Abrams commented on the increased attention the healthcare industry is giving to reference pricing and the opportunities it presents for payers in the article, Would reference pricing hold down hold down health costs? Abrams said that, as premiums increase, “… the more incentive there will be for insurers to do things that
- [Dr. Rita Numerof Published by Jefferson School of Population Health in <em>Prescriptions for Excellence in Health Care</em>](https://nai-consulting.com/news/dr-rita-numerof-published-by-jefferson-school-of-population-health-for-prescriptions-for-excellence-in-health-care/) - As pressure grows for more effective, lower cost care, providers and manufacturers are facing demands for increased accountability, and improvements in patient safety, quality, and consistency. Rita Numerof, Ph.D., discusses this increased focus on value in Creating a Framework for Accountable Care: Ensuring Product Value, as seen in the Spring 2014 edition of Prescriptions for
- [Numerof Published in <em>Population Health News</em> on The Challenges Facing Dr. Population Health](https://nai-consulting.com/news/numerof-published-in-population-health-news-on-the-challenges-facing-dr-population-health/) - Better management of health at a population level is increasingly important as our nation works to improve the quality of healthcare at lower cost. Alternative payment models, such as bundled payment and at-risk contracts, also put a premium on population health. Physician leaders taking charge of their organizations’ population health strategy may wonder what this
- [Numerof Published in <em>H&HN</em> and <em>FierceHealthcare</em> on Population Health Management ](https://nai-consulting.com/news/numerof-published-in-hhn-and-fiercehealthcare-on-population-health-management/) - To cope with new reimbursement demands, including increased financial and clinical accountability, healthcare systems and physician groups are finding they need to move toward population health management. It’s not a new concept but, increasingly, PHM has become a hot topic because of these challenges. Senior Consultant, Jill E. Sackman, D.V.M., Ph.D., and Managing Partner, Michael
- [Numerof Published in <em>The Physician Executive Journal</em> on The Silver Tsunami ](https://nai-consulting.com/news/numerof-published-in-the-physician-executive-journal-on-the-silver-tsunami/) - NUMEROF PUBLISHED IN THE PHYSICIAN EXECUTIVE JOURNAL ON THE SILVER TSUNAMI The U.S. is facing an unprecedented expansion in the elderly population as the Baby Boom ages. Meanwhile, healthcare spending continues to increase, due in part to the effects of this “silver tsunami.” Dr. Glenn Mitchell discusses the resulting need for more and more intense,
- [Numerof Published in <em>eyeforpharma</em> on Biosimilars ](https://nai-consulting.com/news/numerof-published-in-eyeforpharma-on-biosimilars/) - Will Biosimilars Meet the Market Similar Test? That’s the question Rita Numerof, Ph.D. asks in her eyeforpharma Industry Insights column on August 1, 2014. Today, branded biologics go to market with a variety of additional wrap-around services. For example, patient education programs teach patients to use and store injectables, and compliance programs help physicians maximize outcomes.
- [Numerof Published in <em>BioPharm International</em> on Marrying Big Data with Personalized Medicine](https://nai-consulting.com/news/numerof-published-in-biopharm-international-on-marrying-big-data-with-personalized-medicine/) - Senior Consultant Jill E. Sackman, D.V.M., Ph.D., and Research Analyst Michael Kuchenreuther, Ph.D., discuss the importance of coupling big data with personalized medicine as a tool for pharma manufacturers to transform the way biopharmaceutical drugs are discovered, developed and marketed. Jill and Michael provide insight on data analytic strategies that pharmaceutical companies are considering to
- [Numerof Published in <em>eyeforpharma</em> on Healthcare Exchanges Shaping Consumers](https://nai-consulting.com/news/numerof-published-in-eyeforpharma-on-healthcare-exchanges-shaping-consumers/) - In her August Industry Insights Column for eyeforpharma, President, Rita Numerof, Ph.D., discusses the potential exchanges have to expand the market for some therapeutic areas and how they will likely impact consumer purchasing behavior for healthcare products and services. Her article, Exchanges: Shaping the Consumers of the Future, helps manufacturers understand how consumers are responding
- [Kim White Interviewed by <em>Becker’s ASC Review</em> on ASC Benchmarks](https://nai-consulting.com/news/kim-white-interviewed-by-beckers-asc-review-on-asc-benchmarks/) - Senior Consultant Kim White described how ambulatory surgery centers (ASC) can improve internal benchmarks to become more profitable in the article, Which benchmarks can turn my ASC around? A diagnostic test. White said a vital part of benchmarking is, “…dealing with internal data collection, because creating clear and maintainable data collection practices is important.” To
- [Numerof 'Second Opinion' Published In Medical Progress Today](https://nai-consulting.com/news/numerof-second-opinion-5/) - NUMEROF "SECOND OPINION" PUBLISHED IN MEDICAL PROGRESS TODAY Rita Numerof, President of NAI, was invited to contribute to Second Opinion, a regular feature of Medical Progress Today in which experts publish brief commentary on current policy issues. The focus in the January 28 forum was conflict of interest regulation, specifically by academic medical centers constraining

## Events

- [Navigating the Evolving Delivery Environment: Tactics and Strategies for Commercial Success](https://nai-consulting.com/events/navigating-the-evolving-delivery-environment-tactics-and-strategies-for-commercial-success/) - Join Numerof and a small group of other commercial leaders for a two-day, highly interactive seminar. Return to your organization ready to improve performance, with new insights and proven tools.
- [How to Compete for the Emerging Healthcare Consumer](https://nai-consulting.com/events/how-to-compete-for-the-emerging-healthcare-consumer/) - Join Numerof and a small group of other forward-thinking senior healthcare executives for a two-day, highly interactive seminar. Return to your organization ready to lead change, with new insights and proven tools.

## Careers

- [Senior Analyst - Life Sciences Practice](https://nai-consulting.com/careers/strategy-consulting-analyst-life-sciences-practice/) - Driven to discover? Love the details, and figuring out what they mean for businesses across the healthcare sector?

## Case Studies

- [Driving Growth and Differentiation through Network Strategy](https://nai-consulting.com/case-studies/driving-growth-and-differentiation-through-network-strategy/) - A top healthcare insurance company called on Numerof for an independent view on efforts to improve market share and margins. Our rigorous review of network strategy and recommendations supported continued growth through innovative approaches, better alignment, and more productive partnerships with providers.
- [Enabling Value-Based Pricing with Robust Infrastructure](https://nai-consulting.com/case-studies/enabling-value-based-pricing-with-robust-infrastructure/) - This renowned global manufacturer engaged Numerof to develop a disciplined approach to integrating value and market access considerations into key product development and commercialization decisions. By reshaping roles, processes, and organizational structure, our work transformed reimbursement and health economics functions to support a diversified, value-driven product portfolio.
- [Reducing Cost and LOS, Enhancing Service Lines, and Improving Care](https://nai-consulting.com/case-studies/reducing-cost-and-los-enhancing-service-lines-and-improving-care/) - Numerof helped this well-known academic healthcare system respond to competitive pressure. Our comprehensive analysis and implementation support led to reduced LOS, better alignment, enhanced service lines and care, and $76M in annual cost savings.
- [Managing Variation and Preparing for New Payment Models](https://nai-consulting.com/case-studies/managing-variation-and-preparing-for-new-payment-models/) - This nationally recognized healthcare system looked to Numerof for help preparing for bundled payments. In addition to providing a plan the organization could rally around, we helped them better manage variation in cost and quality, develop evidence-based care paths, and achieve meaningful improvements in the current fee-for-service environment.
- [Managing International Mergers and Acquisitions](https://nai-consulting.com/case-studies/managing-international-mergers-and-acquisitions/) - A global asset management firm encountered problems integrating overseas acquisitions. Numerof diagnosed the key issues and developed a model for evaluating targets and capturing value that was implemented on a global basis.
- [Making a Rigorous Case for Economic and Clinical Value](https://nai-consulting.com/case-studies/making-a-rigorous-case-for-economic-and-clinical-value/) - Facing potential commoditization and certain reimbursement pressure, this nationally prominent network of hospitals engaged Numerof to strengthen its value case. Our work helped secure contracts with payers and employers, embedded a new organizational focus on data to demonstrate outcomes, and continues to support growth efforts.
- [Improving Performance in a Competitive Market](https://nai-consulting.com/case-studies/improving-performance-in-a-competitive-market/) - In the face of performance shortfalls, a financial services company trusted Numerof to identity the causes, restructure core processes, and redefine roles to support growth efforts.
- [Establishing New Tools and Processes for Portfolio Management](https://nai-consulting.com/case-studies/establishing-new-tools-and-processes-for-portfolio-management/) - A rapidly expanding medical device company outgrew its portfolio management processes. Numerof defined new approaches that helped our client articulate clear priorities, reconcile regional and global needs, and retain market leadership.
- [Diagnosing Cultural and Infrastructure Issues Threatening Viability](https://nai-consulting.com/case-studies/diagnosing-cultural-and-infrastructure-issues-threatening-viability/) - While delivering outstanding care, this nationally renowned integrated delivery network faced increasing financial challenges and had struggled to find root causes. Numerof diagnosed the issues and helped to change the culture, improve clinical-administrative alignment, and address critical gaps in capabilities, processes, and accountabilities.
- [Developing New Growth Platforms](https://nai-consulting.com/case-studies/developing-new-growth-platforms/) - A global pharmaceutical and consumer health company needed to refill its business development pipeline. Numerof identified key trends, defined new growth platforms, and presented a strategically relevant set of candidates.
- [Developing and Pressure Testing New Business Model Concepts](https://nai-consulting.com/case-studies/developing-and-pressure-testing-new-business-model-concepts/) - A leading global device manufacturer needed to understand the changing market and identify new business models. Numerof pressure tested strategies and identified new ones to help them maintain their advantage.
- [Designing a More Competitive Infrastructure ](https://nai-consulting.com/case-studies/designing-a-more-competitive-infrastructure/) - A global manufacturing organization facing tough competition turned to Numerof to assess their internal organization and processes. Redefined roles, responsibilities, and competencies provided the necessary infrastructure for success.
- [Demonstrating Value and Preparing for Market Launch](https://nai-consulting.com/case-studies/demonstrating-value-and-preparing-for-market-launch/) - Numerof enabled a global pharmaceutical company to exceed their market access goals by helping them demonstrate product value in the face of growing market restrictions.
- [Defending Market Share with an Integrated Commercial Model](https://nai-consulting.com/case-studies/defending-market-share-with-an-integrated-commercial-model/) - This leading international bank faced new competition and commoditization. Numerof helped define and implement a new relationship management model that enabled the company to bring more value to its target markets and capture a greater share of key clients’ business.
- [An Integrated Model for Managing Strategic Accounts](https://nai-consulting.com/case-studies/an-integrated-model-for-managing-strategic-accounts/) - Numerof helped this manufacturer and distributor of healthcare products keep pace with a changing market and an evolving customer base by defining a new approach to strategic account management, redesigning roles and processes, and supporting implementation.
- [A Roadmap to Population Health Management](https://nai-consulting.com/case-studies/a-roadmap-to-population-health-management/) - Numerof helped this recently merged health system define and move forward on a path to managing population health. In addition to modeling a new pricing structure and its implications, we provided actionable insight into issues causing $30M in annual losses within a single clinical area.
- [A New Approach to Adjacencies](https://nai-consulting.com/case-studies/a-new-approach-to-adjacencies/) - This global consumer healthcare products company wanted to expand its presence in a fast-growing market. Numerof laid out a strategy for acquisitive growth and developed a framework that became the organization’s primary reference for making investment decisions and integrating new business units.

## Team

- [Ron Kierpa](https://nai-consulting.com/team/ron-kierpa/)
- [Laurent Carter, MBA](https://nai-consulting.com/team/laurent-carter-mba/)
- [Susan Alpert, PhD, MD](https://nai-consulting.com/team/susan-alpert-phd-md/)
- [Matt Chatmon](https://nai-consulting.com/team/matt-chatmon/)
- [Mark Twyman](https://nai-consulting.com/team/mark-twyman/)
- [Alexa Schultz](https://nai-consulting.com/team/alexa-s/)
- [Justin Lipner, PhD](https://nai-consulting.com/team/justin-lipner-phd/)
- [Emily Czajkowski, PhD](https://nai-consulting.com/team/emily-czajkowski-phd/)
- [Courtney Marsh](https://nai-consulting.com/team/courtney-marsh/)
- [Christopher Arndt](https://nai-consulting.com/team/christopher-arndt/)
- [Carmin Williams](https://nai-consulting.com/team/carmin-williams/)
- [Michael Ryan, PharmD](https://nai-consulting.com/team/michael-ryan-pharmd/)
- [Jamie Grainger, DPT](https://nai-consulting.com/team/jamie-grainger-dpt/)
- [Maggie Wininger](https://nai-consulting.com/team/maggie-wininger/)
- [Prajakta Dogmane](https://nai-consulting.com/team/prajakta-dogmane/)
- [Sri Krishnarathnam, MS](https://nai-consulting.com/team/sri-krishnarathnam-ms/)
- [Sarah Porter](https://nai-consulting.com/team/sarah-porter-2/)
- [Kyle Benzinger](https://nai-consulting.com/team/kyle-benzinger/)
- [Evan Bruce](https://nai-consulting.com/team/evan-bruce/)
- [Michael Kuchenreuther, PhD](https://nai-consulting.com/team/michael-kuchenreuther-phd/)
- [Oliver Prince, PhD](https://nai-consulting.com/team/oliver-prince-phd/)
- [Kelsey Tinkum, PhD](https://nai-consulting.com/team/kelsey-tinkum-phd/)
- [Gordon Phillips, MPS](https://nai-consulting.com/team/gordon-phillips-2/)
- [Jill Sackman, DVM, PhD](https://nai-consulting.com/team/jill-sackman-dvm-phd/)
- [Sydney Ver Mehren](https://nai-consulting.com/team/sydney-ver-mehren/)
- [Matt Althage, MBA](https://nai-consulting.com/team/matt-althage-mba/)
- [Megan Michalski](https://nai-consulting.com/team/megan-michalski-2/)
- [Eric Abrams, MBA](https://nai-consulting.com/team/eric-abrams-mba/)
- [Dana Hage, MPH](https://nai-consulting.com/team/dana-hage/)
- [Matt Levy, JD](https://nai-consulting.com/team/matt-levy/)
- [Simone Cummings, MHA, PhD](https://nai-consulting.com/team/simone-cummings/)
- [Vince Ovlia, MBA](https://nai-consulting.com/team/vince/)
- [Jennifer Rainwater](https://nai-consulting.com/team/jennifer-rainwater/)
- [Jamie Pancer](https://nai-consulting.com/team/jamie-pancer/)
- [Stephen Littlejohn, MA, MBA](https://nai-consulting.com/team/stephen-littlejohn-ma-mba/)
- [Daniel King, PhD, MBA](https://nai-consulting.com/team/dan/)
- [Christopher de Wolff, MSFS](https://nai-consulting.com/team/christopher-de-wolff-msfs/)
- [Michael Abrams, MA](https://nai-consulting.com/team/michael-abrams-ma/)
- [Rita Numerof, PhD](https://nai-consulting.com/team/rita-numerof-phd/)
- [David Horwitz, MD, PhD, MBA, FACP](https://nai-consulting.com/team/david-horwitz-md-phd-mba-facp/)
- [Patrick Drake](https://nai-consulting.com/team/patrick-drake/)
- [Jack Nightingale](https://nai-consulting.com/team/jack-nightingale/)
- [Stephen Rothenberg](https://nai-consulting.com/team/stephen-rothenberg/)
- [Mark Morgan](https://nai-consulting.com/team/mark-morgan/)
- [Levi Citrin](https://nai-consulting.com/team/levi-citrin/)
- [Glenn Mitchell](https://nai-consulting.com/team/glenn-mitchell/)

## Categories

- [Other Industries](https://nai-consulting.com/category/other-industries/)
- [Healthcare Delivery](https://nai-consulting.com/category/healthcare-delivery/)
- [Pharmaceuticals](https://nai-consulting.com/category/pharmaceuticals/)
- [Medical Device and Diagnostics](https://nai-consulting.com/category/medical-device-and-diagnostics/)
- [Payers](https://nai-consulting.com/category/payers/)
- [Featured](https://nai-consulting.com/category/featured/)
- [Healthcare Delivery and Payers](https://nai-consulting.com/category/healthcare-delivery-and-payers/)
- [Pharmaceuticals and Medical Devices](https://nai-consulting.com/category/pharmaceuticals-and-medical-devices/)

## Team Categories

- [Principals](https://nai-consulting.com/teamcategory/principals/) - At Numerof, you’ll notice something different. Our principals are intimately involved in every project. Read more about their expertise and experience.
- [Core Consulting Staff](https://nai-consulting.com/teamcategory/core-consulting-staff/) - Our core consulting staff members bring together strategic and operational experience, rigorous analytics, creative thinking, and practical strategies to address our clients’ most critical challenges.
- [Operations](https://nai-consulting.com/teamcategory/operations/) - Numerof’s operations team members deliver to the highest standards of excellence and ensure that even our most complex projects run smoothly.
- [Marketing](https://nai-consulting.com/teamcategory/marketing/) - Our marketing team connects the media with our staff and shares Numerof’s insights with leaders in the industries we serve.

## Challenges

- [New Payment and Delivery Models](https://nai-consulting.com/challenge/new-payment-and-delivery-models/)
- [Clinical Excellence, Quality, and Safety](https://nai-consulting.com/challenge/clinical-excellence-quality-and-safety/)
- [Competition and Growth](https://nai-consulting.com/challenge/competition-and-growth/)
- [Financial Viability and Cost Improvement](https://nai-consulting.com/challenge/financial-viability-and-cost-improvement/)
- [Organizational Alignment](https://nai-consulting.com/challenge/organizational-alignment/)
- [Demands for Greater Transparency](https://nai-consulting.com/challenge/demands-for-greater-transparency/)
- [Defining and Demonstrating Value](https://nai-consulting.com/challenge/defining-and-demonstrating-value/)
- [Selling to Complex, Evolving Customers](https://nai-consulting.com/challenge/selling-to-complex-evolving-customers/)
- [Developing a Robust Portfolio](https://nai-consulting.com/challenge/developing-a-robust-portfolio/)
- [Achieving Market Access](https://nai-consulting.com/challenge/achieving-market-access/)
- [Delivering Global Growth](https://nai-consulting.com/challenge/delivering-global-growth/)
- [Consolidation and Competition](https://nai-consulting.com/challenge/consolidation-and-competition/)
- [Anticipating and Creating the Future](https://nai-consulting.com/challenge/anticipating-and-creating-the-future/)
- [Competing on Differentiated Value](https://nai-consulting.com/challenge/competing-on-differentiated-value/)

## Solutions

- [Strategic Planning and New Business Models](https://nai-consulting.com/solution/strategic-planning-and-new-business-models/)
- [Bundled Pricing](https://nai-consulting.com/solution/bundled-pricing/)
- [Population Health Management](https://nai-consulting.com/solution/population-health-management/)
- [Managing Variation in Cost and Quality](https://nai-consulting.com/solution/managing-variation-in-cost-and-quality/)
- [Cost Improvement](https://nai-consulting.com/solution/cost-improvement/)
- [Patient-Centered Evidence-Based Care](https://nai-consulting.com/solution/patient-centered-evidence-based-care/)
- [Competitive Differentiation](https://nai-consulting.com/solution/competitive-differentiation/)
- [Alliance Strategy and Implementation](https://nai-consulting.com/solution/alliance-strategy-and-implementation/)
- [M&A Strategy and Integration](https://nai-consulting.com/solution/ma-strategy-and-integration/)
- [Organizational Infrastructure](https://nai-consulting.com/solution/organizational-infrastructure/)
- [Network Strategy and Strategic Planning](https://nai-consulting.com/solution/network-strategy-and-strategic-planning/)
- [Population Health and Risk-based Models](https://nai-consulting.com/solution/population-health-and-risk-based-models/)
- [Consumer Engagement](https://nai-consulting.com/solution/consumer-engagement/)
- [Modeling and Analytics](https://nai-consulting.com/solution/modeling-and-analytics/)
- [New Commercial Models](https://nai-consulting.com/solution/new-commercial-models/)
- [Making the Value Case](https://nai-consulting.com/solution/making-the-value-case/)
- [Managing Globally and Locally](https://nai-consulting.com/solution/managing-globally-and-locally/)
- [Portfolio Strategy](https://nai-consulting.com/solution/portfolio-strategy/)
- [Reshaping R&D](https://nai-consulting.com/solution/reshaping-rd/)
- [Strategic Approaches to Regulatory and Compliance](https://nai-consulting.com/solution/strategic-approaches-to-regulatory-and-compliance/)
- [Network Strategy and Provider Alignment](https://nai-consulting.com/solution/network-strategy-and-provider-alignment/)
- [Service Lines](https://nai-consulting.com/solution/service-lines/)