Transcript Jennifer Maybin - HealthEconomics.Com

Jennifer Maybin, MA, ELS
• Medical writer/editor for 25+ years
• Managed markets writing/editing for ~10 years
• Educational background is non-science
• Learned this writing “on-the-job” by working for clients
who specialize in this area
Managed Markets Communication Companies
Are Growing
Other Companies Hire Managed Markets
Writers Too
What is Managed Markets Writing?
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Articles for peer-reviewed journals
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Payer, provider, office staff detail aids
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Sales training e-learning modules and workshops
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Reimbursement and coding guides
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Value propositions for payers
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Payer surveys
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Primers on Medicare/Medicaid
What Are Hiring Companies Looking For?
What Are Hiring Companies Looking For?
Requires a BA
in English or
Life Sciences
What Do Other Managed Markets Writers Say
You Need to Know?
• Experience in pharma communications (promotional)
• Deep grounding in the impact of managed care on
payers, prescribers, and patients
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Medicare
Medicaid
Commercial payers
Health exchanges
ACA
Government agencies and their programs
What Do Other Managed Markets Writers Say
You Need to Know?
• Deep understanding of CMS initiatives
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Value-based purchasing
Health outcomes
Performance metrics and the payment structures they inform
Quality metrics and the payment structures they inform
ACA changes by year and date
Medicare, Medicare, Medicare
Electronic health records and meaningful use
Hospital incentive and penalty programs
What Do Other Managed Markets Writers Say
You Need to Know?
• Pharma sales teams
• Account directors, KAMs, account managers
• Sales reps
• MSLs
• Reimbursement specialists
• Patient assistance program specialists
What Do Other Managed Markets Writers Say
You Need to Know?
• Changes in physician practices
• Staffing: reimbursement specialist, practice manager, financial
planner, infusion nurse, patient navigator, drug utilization
committee
• Models: IDNs, ACOs, PCMHs
• Relatively new to EHRs
• Moving from paternalistic care to patient centered
• Changing from payment based on quantity to payment based on
quality and cost-effectiveness
What Do Other Managed Markets Writers Say
You Need to Know?
• Differing perspectives and pain points of providers,
payers, and patients:
• Hospital P&T committees
• PBMs
• Specialty pharmacy
• Wholesalers
• Pharmaceutical distribution channels
• Hospitals, ACOs, GPOs, PCMHs, IDNs, physician practices
• Patients
What Do Other Managed Markets Writers Say
You Need to Know?
• Managed care terminology
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http://www.amcp.org/ManagedCareTerms/
http://www.amcp.org/CERglossaryofterms/
http://www.mcres.com/mcrdef.htm
https://www.cms.gov/apps/glossary/default.asp?Letter=A&Language=English
• Federal and state rulings regarding pharmaceutical sales
• State boards of pharmacy
• Medicaid.gov
• Federal Register, HRSA
• NCSL
• ICD-9/10 coding:
• http://www.icd10data.com
• http://apps.who.int/classifications/icd10/browse/2015/en
Where Do You Get This Knowledge?
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Kaiser Family Foundation
Government: CMS, AHRQ, NCQA, PCORI
Commonwealth Fund
Patient-Centered Primary Care Collaborative
HSCA, AMCP, FDA, PCMA, PhRMA
EMD Serono Digests, PBM trend reports
Avalere Health, PWC, Deloitte, LeapFrog Group
Pharma product websites
Specialty physician organizations
Disease websites
Patient support group websites
Articles and Books
McCain J. Distribution models for biologics and other specialty pharmaceutical
products. Biotechnol Healthc. 2012;9(2):8-13.
Kirschenbaum BE. Specialty pharmacies and other restricted drug distribution
systems: financial and safety considerations for patients and health-system
pharmacists. Am J Health Syst Pharm. 2009;66(24 suppl 7):S13-S20.
CPT, RBRVS, RUC: a primer on the alphabet soup of coding and reimbursement. J
Oncol Pract. 2007;3(1):20-22.
Vogenberg FR. Understanding Pharmacy Reimbursement. Bethesda, MD: American
Society of Health-System Pharmacists; 2006.
Cubanski J et al. A Primer on Medicare. http://kff.org/medicare/report/a-primer-onmedicare-key-facts-about-the-medicare-program-and-the-people-it-covers/
KFF. How Private Health Coverage Works: A Primer.
https://kaiserfamilyfoundation.files.wordpress.com/2013/01/7766.pdf
Data on Reimbursement
Physician Fee Schedule (CMS)
Medicare.gov (Medicare & You)
Medicaid.gov
Q1Medicare.com
Pharmaceutical product websites (patient and
provider pages)
• Medicare.gov
• Commercial payer websites
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Other Things You Need to Know
• Know the MLR review process
• Client’s preferences/limits on what you can say
• Audience
• Watch in using a variety of sources in one piece
because numbers and stats may differ
• Be ready for constant changes in data that can
dramatically change after first draft
How Does HEOR Fit Into Managed Markets
Writing?
• “HEOR is important, but is an advanced topic. So
much baseline managed markets understanding has
to occur that HEOR has to wait its turn!”
• “Companies today have to be EXTREMELY mindful
about keeping HEOR messaging within label – for
example, they can’t promote the value of a 10%
reduction in HbA1c for a diabetes product unless they
have data from well-controlled studies that
demonstrates their product can do this consistently
for a specified patient population.”
Should You Take the Leap?
• Do you like promotional writing?
• Do you like to read endlessly about reimbursement,
health reform laws, and pharmacy distribution
channels?
• Are you a strategic thinker?
• Do you mind revising something ad nauseam? (Would
version 25 make you wince? How about 35?)
• Do you want to work in a field where there is plenty of
work?
Thank you!
Comments or questions?
Email me at: [email protected]