Non-members: Click here to review a complimentary excerpt from "Managing Healthcare Reform: Government Affairs, Public Policy and Aligning Structures & Groups to Manage the Government Ecosystem"
The influence of the Centers for Medicare and Medicaid Services (CMS) on healthcare policy and reimbursement is increasing as the US population ages and healthcare reform unfolds. Federal, state and local government healthcare spending is projected to be 50 percent of national health expenditures by 2021. Consequently, the importance of understanding, translating, and engaging CMS and other influential government agencies/groups will only grow.
Best Practices, LLC conducted this research to help biopharmaceutical executives in Government Affairs, Public Policy, Managed Markets and other groups formulate a strategic approach for optimizing engagement with CMS and the ecosystem of agencies and groups that shape U.S. healthcare guidelines and reimbursement policy. The study identifies current trends and future directions in structure, alignment, and information exchange across key functional groups in the biopharmaceutical and medical device sectors that interact with the agencies and committees that influence the government healthcare sector.
The study includes three segments: a Large Pharma Segment, a Mid-Cap Pharma Segment, and an Emerging Pharma segment.
- Align Structures, Resources & Groups To Manage The Healthcare “Ecosystem”
- Intelligence Dissemination: "The Routing"
SAMPLE KEY METRICS
- Coverage of Federal Healthcare Groups
- Coverage of CMS Influencing Groups
- Strategic Engagement Strategy for Federal Government
- U.S. Public Policy Relationship to Government Affairs
- U.S. Government Affairs Reporting Relationship
- U.S. Public Policy Reporting Relationship
- U.S. Public Policy Group Location
- U.S. Public Policy Staffing Mix
- U.S. Public Policy and Headquarters Interactions
- Keeping Pace with Healthcare Change and Structural Effectiveness
- Frequency of Federal and State Healthcare
- Structural Effectiveness as it relates to healthcare regulations
- Effectiveness of Information Exchange Channels
- Frequency of Federal and State Healthcare Information Sharing
- Tracking of state-level issues and communication to headquarters
SAMPLE KEY FINDING
- U.S. Public Policy Organizational Structure: While a majority of organizations (58%) have Policy and Government Affairs within the same group, the structure of policy is clearly influenced by an organization’s size. The Large Pharma segment favors having Policy and Government Affairs organized as separate groups that report to the same group.
- Engagement Strategies for Key Federal Healthcare Groups: A vast majority of study participants have either an informal or formal engagement strategy for seven federal healthcare organizations: FDA, CMS, VA, NIH, HHS, AHRQ and CDC. While many companies have formal engagement strategies for most of the groups, a majority of study participants (and almost all of the Large Pharma Segment) have formal engagement strategies for only two agencies: the FDA and CMS.
Best Practices, LLC engaged 23 experienced executives, mainly in Government Affairs, Public Policy and Managed Markets, from 23 different pharmaceutical companies. In addition, deep-dive interviews were conducted with six participating companies to gather additional insights.