The international insurance market has started to analyze data beyond revenue and utilization. Carriers are focused on indicators that help them understand the impact of the coverage and the programs they offer. As this shift occurs, there is an emphasis on linking medical and Rx care. This article shares challenges in harmonizing care across borders, collecting disparate data, and enhancing communication.
New Frontier Group has engaged with US and worldwide Rx industry experts to create a series of 5 Always There Global Rx Care articles, highlighting the importance of driving innovation into the modern global economy to achieve Whole Person Health through Whole System Health.
About the Authors
All five articles in this series were co-authored by three influential representatives and experts in the global healthcare industry:
Gitte Bach, President and CEO of New Frontier Group. After gaining extensive experience in international insurance and assistance through her initial years at IHI Denmark, Gitte founded New Frontier Group in 2002. Since its inception 20 years ago, New Frontier Group has been a market disruptor and innovator in the global cost management industry, being a pioneer that provides unparalleled cost management, claims administration, pharmacy solutions, telehealth, and assistance services to their clients worldwide. Gitte is passionate about customer service and innovation and holds a B.A. in Economics from Copenhagen Business School and a B.A. in Languages from Aarhus School of Business.
John Frick, Registered Pharmacist and CEO at Innovative Pharmaceutical Services. John is an industry leader for over 35 years in all aspects of pharmaceutical care. He is an accomplished healthcare professional offering comprehensive knowledge of specialty niche markets relative to the pharmacy and home health care professions, long term care, hospice and beyond. John is focused on projects differentiating themselves from the mediocrities of the industry and is the Chairman of the Board for the New Frontier Group Advisory Board where he assists in developing global Rx strategies focused on superior concierge, expert solutions for the global market.
Johan Porto, Cofounder of PharmCare Services. Prior to co-founding PharmCare Services (PCS), the first International Pharmacy Benefit Manager (iPBM) specialized in the international health insurers industry, managed various specialty pharmacy-related businesses for the private sector which developed the experience that has been a key element for the PCS global strategic planning and cost-containment initiatives that drives many aspects of the customer engagement and business development strategies provided to its clients. PCS is the first International Pharmacy Benefit Manager with an extensive national and international network of retail and specialty pharmacies, authorized distributors and manufacturing partners bringing the highest standards in HealthCare and modern customized cost optimization planning to the IPMIs and travel industry
Changing Global Healthcare
Previous articles in our Always There, Global Rx Care series share information on the intricacies of specialized global Rx and how the landscape is changing. In addition, we detailed how to integrate and coordinate medication across borders.
In this article, we take a deeper dive into what is needed for the international market to move from a per claim system to a whole person system.
Global healthcare organizations realize they need to move from a transactional healthcare model to a value-based model. Countries across the world are adopting various forms of value-based care, and now it is time for cross-border care to do the same. A whole patient view is crucial to addressing and treating the global population in a holistic way, but the challenges lie in how to get there.
The US healthcare model is focused on shifting care from volume to value, and there are things the global healthcare industry can learn. We have identified four factors that international insurance programs can adopt to begin the shift to whole person care:
- Stakeholder Goal Alignment: All entities who manage global patient data (brokers, payers, providers, pharmacies, administrators, case managers) need to align on a common goal of coordinated care across the value chain. The end goal should be a shared vision and purpose for all the entities involved with a complete understanding of the challenges unique to each party.
- A Successful and Proven Design: A value-based care system has a program design. There is an infrastructure which allows collaboration among stakeholders in the patient ecosystem. Global healthcare stakeholders should all have input into the design of a value-based program.
- Access to Decision Support Data: For global healthcare programs to succeed in value-based care they need access to shared data. Medical and Rx programs that work with brokers, providers, case managers, and carriers can play a large role in improving the quality and integration of data.
- Program Design Delivery: Well-organized protocols for initiating, planning, controlling, and monitoring value-based care are needed. Strategic decisions will need to be made, and key performance indicators will need to be identified. Performance will need to be evaluated and shared so a value-based system can evolve.
Stakeholder coordination can contribute to a value-based program which makes an impact on rising medical and Rx costs. Downstream costs are reduced when there are fewer unnecessary doctor visits, including emergency services. The goal is not reducing patient care, but treating the whole patient to prevent further health issues. Check out the details on how we avoided medication misadventures in the last article in our series. In that case, there was additional care coordination to manage a whole patient, but the result was avoiding high costs and even death. Innovative thinking and global collaboration is what will continue to promote positive patient outcomes. Overall, it is a crucial model for treating the whole person and not just each claim.
About New Frontier Group’s Global Pharmacy Program
Choosing New Frontier Group for your pharmacy solutions provides a global pharmacy concierge program with benefits such as:
- Exclusive medication management with hands on patient care
- Pharmacy solutions combined with medical and telehealth services
- Direct engagement with providers to obtain essential medications at time of service
- No burden of logistics or financial barriers for patients and no out of pocket costs
- Needed medications are shipped to home country and after care is coordinated
- White glove, cross border service is focused on medication adherence
New Frontier Group’s pharmacy solutions is an exclusive medication management program that merges hands-on patient care services with concierge medical services that crosses borders.
Our global pharmacy solution includes a review of existing data and the development of a strategy to increase patient medication adherence by removing communication gaps, defragmenting the system, simplifying logistics and relieving the burden of financial barriers. Patients do not have to seek out pharmacy services in a foreign place because we handle all of the details for them from point of care to travel home. Our superior concierge solution reduces hospital readmission and ensures there is no out of pocket expense for members.
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