Engaging Integrated Delivery Networks (IDNs) effectively requires a reconsideration of the traditional commercial model. The traditional commercial model based on reach & frequency and patient metrics is inadequate. Embracing a more account-centric model is necessary to adapt to the growing influence of IDNs.
Some examples of approaches emerging throughout the industry are:
- Hybrid Sales Forces – that are being piloted and rolled out — given that internal functions such as Sales Operations, Sales Analytics, and Marketing are under pressure to transcend traditional functional silos
- Managed Care Account Management – that are leveraging their skills and experience throughout commercial organizations
- Changes in internal business processes and analytical frameworks — to better emphasize the need as developing and deploying the right skills with which to engage IDNs is proving to be complex.
- Localized customer-centric models — As customers evolve, it is critical to tailor engagement models to local needs using novel metrics beyond reach and frequency
- Outcomes-based approaches to marketing strategy and execution that can help align with customer priorities. This focuses on: customer valued outcomes, optimizing product utilization, one view of the patient, physician, provider and payer, and how to measure outcomes and manage brand performance real-time.
In my opinion, there are at least six critical elements to consider for an IDN engagement strategy assessment:
1) Customer Segmentation — Segmenting IDN accounts
To understand the range of maturity of IDNs, a behavioral segmentation is useful across key dimensions. It is also useful to understand IDN accounts on their operating priorities and structures:
- Accounts that have different priorities – what are they?
- Are all needs equally valuable to address?
- Which accounts align with your therapy area capabilities?
- How do brand strategies align with IDN needs?
- How best to systematize ways of working to address priorities?
2) Assess and understand IDNs operating priorities to uncover clinical and operational needs
It is crucial to understand specific IDN objectives, reflecting their geographies, patient populations, organizational structures, payment models, and other operating drivers.
- Patient engagement: Target the right intervention to the right patient – the challenge is to deliver more “wow” experiences to grow and retain patient base and design support mechanisms to engage patients in their care.
- Physician engagement: Identify and establish best treatment practices — the challenge is to identify treatment protocols based on meaningful evidence, make decisions using evidence and value criteria and to align physicians on care standards to improve quality of care.
- Operational effectiveness: Identify and establish best treatment practices — the challenge is to use benchmark information to identify opportunities and drive out care variation to lower costs.
The key is to determine how to align engagement approach and offerings with these objectives.
3) Identify key decision-makers and influencers, including those outside the traditional ecosystem
Leading institutions are establishing centers of excellence around patient experience and innovation. Engaging with IDNs will require engaging with many stakeholders within the system. Therefore it is imperative that the engagement interface will have to be at multi-stakeholder level rather than just at the physician level. Evolution toward value orientation and centralized control demands some fundamental shifts in engaging with IDNs by pharma.
4) Introduce capabilities that IDNs value to help them address their operating priorities
Segmentation of IDNs is a starting point. However it is important to create a value proposition for each micro-segments of the IDNs which is a key to effective engagement strategy. The value proposition should address the following aspects:
- Operating priority of the IDN
- Require a stronger, more strategic segmentation of IDN customers
- Consider scalability and deployment of the messages
- Mandate strong collaboration between Brand, Managed Care, Medical, and HEOR to use this framework to create alternatives
5) Align the commercial model to deliver and measure the capabilities and outcomes IDN customers want
This mandates a pharma commercial model redesign including new roles, processes, and ways of working both at the sales operations and field deployment from:
- Roster Maintenance – Multiple roles and positions per sales force member
- Sales Crediting – Novel metrics and data sources at sub-national level
- Performance Reporting – Sub-national tailoring to local customer needs and performance metrics
- Alignment & Call Plan Maintenance – Locally tailored business rules and approval process
6) Real-world evidence (RWE) is a tool for strategic engagement across IDN stakeholders
RWE can be used as a currency for discussions with IDNs on the following issues of interest to IDN stakeholders as well as apply in engagement strategy: Quality measures; Decision Support; Physician P4P metrics; P4P Schemes; Population Wellness; Decision support; Evidence support; Franchise evidence; Quality measures; Patient subpopulations; Patient journey tools
Conclusion:
The emerging healthcare ecosystem is already moving towards building new commercial capabilities. However a transition plan is needed given the complexities involved in implementing these capabilities:
- Knowing which capabilities differentiate and accelerate market acceptance is key
- Customer-facing capabilities are often prioritized, but enabling capabilities ensure long term value
- Capabilities are cross-functional and must be built by multi-disciplinary teams
- Capabilities must become embedded throughout the organization
- More importantly, the “changeover” must not diminish traditional customer capabilities