Managed Care 101: A Must for Sales and Account Managers in Pharma

Managed Care 101


Managed care is a process that gives patients an option to receive care at a reduced cost through their healthcare plans that have specialized contracts with healthcare providers. Managed care’s primary focus is on wellness and prevention, though it also supports better utilization of healthcare services, better healthcare quality, and lower costs.

In other words, managed care can benefit both patients and providers through a coordinated approach; patients get access to lower-cost benefits while providers gain access to an efficient process for acquiring new patients and managing receivables.

Managed care plans come in a variety of options, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Point Of Service (POS) Plans, And Medicaid Managed Care. Population survey data shows that over 70 million Americans have been enrolled in HMOs, and nearly 90 million have been involved with PPOs. It is fair to say that managed markets are a focal point of modern healthcare – and pharmaceutical personnel need to understand how the interplay of various participants in managed care affect their sales and operations.

The Role of Pharmaceutical Sales and Account Managers in Managed Care

Pharmaceutical sales reps bear a heavy burden. As product specialists and provider liaisons, sales reps have more to do than simply memorize spec sheets. Succeeding in managed care requires an understanding of the general market environment, the economics of managed markets, and how to match their products and solutions to the potential buyers based on the critical business issues faced by the key decision makers.

Sales reps need a deeper understanding of influencing factors such as regulations in product pricing, prescribing restrictions, authorizations, copay management, and more. Account Managers on the other hand need to be able to have tremendous insights into the concerns and challenges of the Key Decision Makers, and based on that build and deliver a unique value proposition that speaks undeniable value and long-term engagement.

This is why, in addition to the standard account management training, most pharmaceutical companies require their sales and account reps to go through managed care training seminars to gain a deep understanding of the system.

Managed Care Training Offers a Competitive Edge

In order to be able to deliver the above-mentioned value, pharma sales and account managers must be well versed in the intricacies of the managed market.

This involves-

  • Understanding managed healthcare & the different components
  • Identifying the providers & how they impact managed healthcare
  • Defining quality & identifying quality initiatives in addition to the leading quality organizations
  • Understanding the U.S. healthcare market framework

Pharma managers and sales reps are most effective when they are coached by those familiar with the specialized needs of managed markets. As a leading healthcare consulting firm, The Brooks Group has accumulated a wealth of knowledge and experience in this field.

The Brooks Group offers a dedicated course called “Managed Care 101” – a training course specifically designed for account managers, field sales reps, and senior level sales professionals looking for insight into the various strategies and techniques used to support managed care markets. Registration is available through open-enrollment sessions at The Brooks Group or by a custom course with your team/organization.

If you’re interested in learning more about our managed care training curriculum or about our healthcare executive training programs, contact us today for more information.

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