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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?

• Articles for peer-reviewed journals

• Payer, provider, office staff detail aids

• Sales training e-learning modules and workshops

• Reimbursement and coding guides

• Value propositions for payers

• Payer surveys

• 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• 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• 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• 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?

• 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-on-medicare-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

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: jennifer@jgmaybin.com