AMCP partnership forum: Managing total cost of care through medical and pharmacy data integration

Abstract

Value-driven health care models that aim to improve patient outcomes while managing total costs of care require better access to integrated health care data. Health care organizations that integrate data from multiple platforms (e.g., pharmacy, medical, electronic medical records, and lab data) can better streamline and guide effective, efficient, and coordinated utilization and care management programs. To address strategies for integrating health care data, the Academy of Managed Care Pharmacy convened a forum in Baltimore, MD, on September 25-26, 2018. The goal of the forum was to develop a roadmap for managed care entities interested in (a) managing medications across the spectrum of health care—regardless of whether the medications are covered by a medical or pharmacy benefit; (b) driving performance improvements in clinical quality with integrated datasets; (c) streamlining care transitions and case management; and (d) facilitating the development of datasets formatted for use in value-based care contracts. Forum deliberations highlighted the need for data integration in value-based health care systems, explored making data actionable through rapid and predictive analytics of integrated datasets, identified the challenges of doing so, and developed a practical roadmap for managing the total cost of care through data integration. Health care leaders representing health plans, integrated delivery systems, pharmacy benefit managers, employers, the federal government, technology companies, data integrators, standards development leaders, and biopharmaceutical companies participated in the forum, which was supported in collaboration with Abbvie, Alkermes, Amgen, Bayer, Boehringer Ingelheim, Genentech, Merck, National Pharmaceutical Council, PhRMA, Takeda, and Xcenda. These proceedings represent common themes and comments from individual participants; they are not necessarily endorsed by all attendees, nor should they be construed as reflecting group consensus.