By: Jerry Clor
Managed Care Training has not yet emerged as a separate discipline within our industry although the trend is defiantly on the rise. The advent of specific staff trainers responsible for that content category is slowly taking their place beside the product and sales skills trainers within a number of Pharma organizations.
Managed care poses a unique training environment. On one hand maintaining message quality concerning product promotion is important, but understanding the complexities of the ever-changing reimbursement and delivery arena of managed care certainly demands a new skill set. Expanding a competency in this area is quite dynamic. The basic challenge is that reimbursement and other factors that impact the “sell” within managed markets seem to be a moving target. Regular changes occur on at least an annual basis. This makes a definitive curriculum difficult to set. While it is possible to set a historical frame of reference for the managed care environment the real work of any training department is to stay ahead of the advance we see in such disciplines as risk and risk management, ever evolving reimbursement scenarios and new health policy legislation.
There is also a paradigm shift for us in this industry because in the past we have dealt successfully with sub-markets such as hospitals. Hospitals seem to be a constant as pharmaceutical manufacturers have most certainly gotten their arms around that market both in the training as well as promotional disciplines.
Even with a few reimbursement changes, how hospitals purchase pharmaceuticals has remained relatively constant, with only a few alterations over time. The hospital represents a fair comparison as it has both of the components that cause us difficulty in the managed care arena; reimbursement and delivery. I would submit to you that we as an industry train well in this environment as the delivery has become more sophisticated, but essentially unchanged. Reimbursement has seen more significant change but those changes DO NOT effect how a hospital determines pharmaceutical use.
Managed Care Organizations on the other hand represent quite a different scenario. Health care delivery within a model can change within a short period of time and we have seen certainly types of delivery models completely disappear and then be replaced with something quite different. We are watching that right now as the HMO enrollment in the US migrates to the PPO model. That indeed DOES have an effect on pharmaceuticals as “choice” alters pharmacy benefits considerably. How do we train around this dynamic? Even a bigger question is begged, how do we train to EMPOWER an account manager in this changing market?
Like many in the training ranks today, I came out of a sales environment. I spent time in the field both as a national account manager and as a region account manager. The obvious reason that our industry draws on its sales professionals as trainers is that we have been there. We know the nuances and the real life challenges and frustrations that are our market. We know also that there is a fine line between delivering “content” and delivering work altering tools. As an account manager I had to seek out training.
Today, the benefit that a designated trainer should bring to an organization is that very ability to reach to the functional part of the job that an account manager performs in. It is a different discipline than the traditional sales roll, a more complicated one and one that asks for additional competencies. The need to train to those competencies may seem obvious, but because they tend to represent “soft” skills it may be difficult to find support in the organization for such development.
Let’s consider that the “empowerment” issue as a two way street. The responsibility does not reside entirely in the front of the classroom; it is a shared responsibility. The objective setting portion of the program gives us an excellent opportunity to set the stage for this sharing. In the case of a managed care / managed markets program, due to the diverse issues and disciplines, objectives become very important. Letting the learner know that they have a part in accomplishing the goals becomes a key element in behavioral change.
Steering the class toward accepting the responsibility for FINDING the points needed for change enlists automatically an anticipated participation in the program.
I have found myself over time developing a component of my efforts with senior level account managers that develops a rational for using the presented information. Much like trial attorney would build a case, the learning circumstance in Managed Care walks a fine line between raw information and the reason one would implement any change based on it. In most instances the account management team within your company represents a senior core of experienced employees. They have risen through the ranks and have achieved a level of success using the skill set developed over time. Appealing to their business acumen and taking advantage of their knowledge base can set the stage for aggressive participation.
While the presentation basics that we all use in reaching our adult audiences certainly remain in place, a real sensitivity is needed to address the fluid circumstance of the managed care environment. Reimbursement that changes annually, the dynamics of physician and plan risk, enrollment migrations are all areas that an account manager needs to recognize in his or her market to be effective. They all occur to greater or lesser degrees and including the learner in the discernment of their own market nuances becomes a critical component in developing the relevance of the tools that we hope to impart in our training efforts.
FIGHTING THE “STATUS QUO”
Time and tenure can encourage a complacency of sorts within ranks of such senior individuals. They have come to a place that they indeed know their position well and they have reached a level of success based on their existing behaviors. This in itself could pose a training dilemma, but intuitively an account manager recognizes the dynamics of change within the market. This can be used to a training advantage. Imparting a recognition of the account managers roll in this changing environment and noting the actual market environment are all aspects of enlisting the learner to seek out the information they need to act and enhance their skill set in managing their accounts.
I have found that we as trainers need to keep in mind that with senior level attendees, as with any other adult learning environment we need to recognize that no two adults learn the same way. In each and every training effort we need to reach out in some way to each auditory, visual or kinetic learner. Again draw the analogy of a trial attorney, having a component that appeals to the left-brain as well as right brain learners improves your potential to accomplish your combined goals.
HOW DO YOU KNOW YOU’VE “ARRIVED”
So we agree we have a dynamic and potentially difficult subject matter. We also agree we have tenured, successful adult learners. We also know that this is as much a training event as it is also an attempt to influence change and provide valid, usable tools.
How do you know you’ve arrived? Did you reach the collective goal? How can you assess the net result?
One technique that works well in the managed care discipline is an active case study exercise. Want to see the result of your efforts? Put forth a real world case study. Give real time statistics if possible or use current account data from your Managed Markets Department. Set the exercise to demonstrate the new information and let your account teams go to work.
This case study exercise can be a simple one or one with considerable complexity depending on time and circumstance. But the active expression of the new information in the work environment can make the “light go on” for even the most experienced in the group.
I would summarize by saying that managed care training asks that we use every one of our skills in a cooperative learning environment. That we recognize the unique environment and enlist the learner as an active participant, and finally that we let the new information functionally be used in a real-world training exercise. It’s what “empowerment” is all about.
Jerry Clor is currently Senior Manager, Managed Markets Training for Sanofi~Synthelabo, Department of Continuous Learning. He is the newest member of the Training Team at Sanofi and has served in training capacities at two previous US Pharma manufactures. He recently was the Operations and Training Director of Delphi Health Systems; a CT based Disease State Management Company.
This article is has been accepted for publication in the Fall 2004 edition of FOCUS MAGAZINE the official magazine of the Society of Pharmaceutical and Biotech Trainers. |
