AMCP Partnership Forum to Develop Consensus Roadmap for Managing Total Cost of Care by Integrating Medical and Pharmacy Data

Alexandria, Va., October 1, 2018 — Health information technology (IT) should be the foundation of all business and clinical operations and not a secondary byproduct. That was one conclusion reached by health care stakeholders at an Academy of Managed Care Pharmacy (AMCP) event last week on finding ways to better integrate medical and pharmacy data. 

Health IT systems with integrated data can support more than cost containment efforts. Such systems can support actionable insights, clinical decision-making and more efficient business practices, according to more than 30 health care experts from across the county who gathered for the AMCP Partnership Forum, “Managing Total Cost of Care Through Medical and Pharmacy Data Integration.” 

The event, held Sept. 25 and 26 in Baltimore, Maryland, examined ways to best utilize and integrate medical and pharmacy data to improve health outcomes and lower costs. 

AMCP CEO Susan A. Cantrell, RPh CAE, noted that data integration is especially needed in light of the trend away from fee-for-service models and towards value-based models.

“Data integration is crucial to actualizing today’s health care models, which increasingly reward value over volume,” Cantrell said. “These models look at overall patient improvements — whether they come from a medical or pharmaceutical intervention. To demonstrate these improvements requires data from both sides of the benefit.” 

Working toward this end, the Partnership Forum attendees examined various efforts to:
 

• Manage medications across the spectrum of health care, regardless of whether the medications are covered by a medical or pharmacy benefit.
• Use health IT and other innovations to streamline access to information and data.
• Drive performance improvements in clinical quality with integrated datasets.
• Facilitate the development of datasets formatted for utilization in value-based care contracts.

Participants agreed on the need for greater cost transparency, as well as more education on principles and techniques to integrate data. In addition, they cited the need for leadership buy-in and alignment of incentives among all business and care delivery partners. To this end, participants drafted a roadmap for managed care organizations to pursue managing total cost of care through data integration. Specifically, the roadmap will focus on how to achieve integration through four functional areas; (1) Leadership and Governance, (2) Business and Finance; (3) Health Information Technology and (4) Coordinated Care and Benefits.

AMCP will release a roadmap early next year based on these findings and others. The roadmap also will identify ways to improve alignment of an organization’s medical and pharmacy leadership, as well as its data analytics, quality initiatives and budgeting processes. In addition, it will showcase examples where data integration improved medication use, achieved financial and quality measures, and lowered total cost of care.

The Partnership Forum was made possible with support from AbbVie, Alkermes, Amgen, Bayer, Boehringer Ingelheim, Genentech, Merck, National Pharmaceutical Council, Pharmaceutical Research and Manufacturers of America, Takeda, and Xcenda: AmerisourceBergen.