The Top 5 Highest Ranked Goals of Payers

Oncology and specialty medications have proven to be a key challenge faced by payers in managing pharmaceuticals for the past 2 years, according to the EMD Serono Specialty Digest.

Payers were given a list of cancer management goals and asked to rate the importance of each. They were then asked to rate their organization’s effectiveness in reaching that particular goal.

Researchers found that although these improvement targets are ranked very high, the actual improvements are still in the very early stages and most effectiveness levels were less than 25%.

Goals were rated on a scale from 1 (not at all important or effective) to 5 (extremely important or effective).

The top 5 highest ranked goals of payers (rated a 4 or 5) are:

1. Reduce Drug Costs

Approximately 91% of payers rated this goal highly. However, the payers rated their effectiveness at achieving this goal extremely low, at 21%.

2. Reduce ER Visits and Hospital Stays

Approximately 89% of payers rated this goal as important and they rated their effectiveness as 23%.

3. Use Evidence-Based Guidelines

Though ranked slightly less important than the others at 88%, the payers were the most effective at meeting this goal with 41% reporting effectiveness.

4. Transition to hospice where appropriate

This goal was ranked as a 4 or 5 for 77% of payers, but only 21% reported their organization was effective at achieving this goal.

5. Reduce Treatment Variability

Payers ranked this goal much lower than the others at 66%. However, they reported 21% effectiveness, which was the same ranking as other higher ranked goals.