3 Trends Changing Health Care in 2018

As we look ahead to 2018, innovative treatments, new technologies and greater connectivity bring opportunity to our shifting healthcare landscape.

Throughout these themes, putting patients first results in better care coordination, healthier outcomes and continued savings to both payers and patients.

Here are three trends for 2018 and examples of how we’re already addressing today:

1. Value Based Care

In 2017, new treatments like groundbreaking gene therapies raised the need for new payment models among payers, pharma companies, and pharmacy benefit managers like Express Scripts. As new therapies come to market, they will require payment and patient care systems which are as novel as the medications themselves.

Value-based care protects patients and payers from skyrocketing drug prices while delivering better health outcomes.

At a time when value-based care is being debated in terms of what form it takes or how it gets delivered, Express Scripts is leading the way:

• SafeGuardRx: With a patient-first approach, Express Scripts SafeGuardRx^® solutions are the industry’s first, and most effective value-based programs, helping payers deliver the highest standard of care for their members with complex health challenges. In 2018, we will leverage our scale, data insights and technology innovations to enrich our SafeGuardRx programs, providing the best value to our clients in this always evolving market.
• Medical Benefit Management: Express Scripts’ acquisition of eviCore improves our ability to address $1 trillion annually wasted on unnecessary healthcare spending. Through evidence-based medical benefit management, we can now do even more to ensure there is value for every healthcare dollar spent.

2. Personalized Clinical Care Powered by Technology

By 2020, 83% of employers will offer a consumer-directed health plan (CDHPs). These plans are characterized by cost sharing between employer and member, where high deductibles and out of pocket limits are the tradeoff for lower premiums and tax benefits.

As consumers find themselves responsible for a larger portion of their healthcare bill, Express Scripts is committed to protecting patients by improving health outcomes while driving down costs. We do this by uncovering insights that individuals and their physicians can actually act on:

• Remote Monitoring: Patients with conditions like asthma, COPD and diabetes require proactive management of their disease. Leveraging data from sensors on inhalers or glucose meters, specialist pharmacists can identify trends or gaps in care and perform counseling using patient-specific data, minimizing negative downstream health events.
• Healthcare Connectivity: In addition to efficacy and clinical considerations, physicians must take cost and coverage decisions into account. By providing real-time benefit checks, electronic prescribing capabilities and electronic prior authorization, Express Scripts gives physicians a faster, easier and more efficient method to ensure each patient is prescribed the most cost-effective and clinically appropriate medications, specific to their coverage.

3. Data Across the Care Continuum

The healthcare industry produces an exorbitant amount of data. Yet, in many cases, information and insights derived from this data are poor. To effectively manage costs and care, and to take on national emergencies like the opioid epidemic, smarter pharmacy practice is needed.

Express Scripts leverages big data to generate actionable insights that make better health more affordable and accessible.

• Advanced Analytics and Artificial Intelligence: Predictive analytics and machine learning provides the cutting edge capability to determine the health risk of individuals. By layering medical, lab and nontraditional data onto our already robust pharmacy data, we can identify very personalized healthcare gaps. More importantly, we can recommend how to change behaviors that improves health and lowers downstream costs.
• Addressing the Opioid Crisis: The Advanced Opioid Management^SM solution uniquely takes a comprehensive and proactive approach – addressing all parties that influence opioid decisions: the doctor’s office, the pharmacy and patient, ensuring they fully understand the safety concerns and risks associated with opioid medication use. Coupling data analytics with our specialized care model, we will do more to help stop abuse before it starts.