During the Evernorth Outcomes event in Washington, D.C., Eric Palmer, president and CEO of Evernorth Health Services, sat down with health policy expert and President and CEO of America’s Physician Groups, Susan Dentzer to talk about the challenges and trends that will dramatically impact our health care system over the next decade.
Palmer zoomed in on the challenges of access and affordability in our system today and Evernorth’s areas of focus for the future to enhances value and improve care.
We caught up with Palmer shortly after his fireside chat to go deeper into the biggest challenges facing health care today. Watch the full video below.
Driving long-term affordability through biosimilars
Drug spending will continue to rise, driven by specialty drugs.
While the trend of new, widely used, high-priced therapies is not slowing down, the team at Evernorth is working closely across the supply chain to hold manufacturers accountable and to lower the cost of prescription drugs, especially in drug classes with potential to introduce greater competition and innovative solutions.
Evernorth supports and promotes the adoption of biosimilars, because just like generic drugs changed the affordability paradigm, biosimilars can do the same for some of the most utilized and most expensive medications in the world, Palmer said. That’s why Evernorth announced earlier this year that it would have a Humira biosimilar available for $0 out of pocket for eligible patients of Accredo, which provides an opportunity for savings for both patients and clients.
Palmer noted that he’s been talking about the eventual adoption of biosimilars and that it is finally happening. “I think we have had, unfortunately, a few too many barriers that have gotten in the way of there being effective competition in the space. Biosimilars have existed in other markets around the world, and there is an opportunity for us to work collectively to knock down barriers, to encourage competition, to encourage the smart deployment of these therapies.
Access equals outcomes
Evernorth is focused on improving access by getting people the care they need, when and where they need it, Palmer said. This guided approach helps deliver better health outcomes and meaningfully improves people’s lives. Evernorth is focused on offering care in a variety of settings, based on what meets a patient’s needs at a given time. That could mean getting care in a doctor’s office, at home, virtually, or in the workplace.
Beyond location, access includes the right treatments and support to help people succeed on their therapies. This can include coupling GLP-1 medications with appropriate lifestyle changes or providing medication support for complex specialty therapies.
“We talk at Evernorth a lot about working to get people to the right care, in the right place, at the right time, but it's not easy and it doesn’t happen automatically,” Palmer said. “Improving accessibility is a real priority for us.”
Improving access to behavioral health clinicians is another area where Evernorth is laser-focused. Approximately 40% of total health care costs are driven by people living with a behavioral health condition. “We know that half of the people in the country that have a behavioral health or mental health care challenge don’t seek treatment,” Palmer said.
And when they do seek care, they look to their medical providers for support. That is why earlier this year, Evernorth introduced the Evernorth Behavioral Care Group, an outpatient behavioral health practice, to expand access to quality, in-network therapy for millions of people.
Evernorth is positioned to help navigate the environment today and tomorrow
Palmer highlighted the capabilities of Evernorth to meet the needs of today and tomorrow by offering flexibility, customization, clinical expertise, and technology to create an integrated experience across the care continuum. And if he had a magic wand to do one thing, he’d work to make progress on improving affordability faster.