Value Based Care Agreements

However, insurers may not be concerned about putting in place vendor-specific measurement kits, as quality improvement is not their main concern, Sears said. In fact, Nguyen stated that the suppliers of contracts to be signed is the “simple part”; Encouraging them to work with UnitedHealthcare to achieve common savings is a much bigger challenge. Whether it is a payer, supplier or life sciences company considering a results-based contract, it is important that everyone can assess their current state and that of their counterparts to determine whether a value-based contract offers value as a strategic step. There are many challenges in implementing value-based contracts: the emergence of value-based contracts (VBC) – a system in which reimbursement of a medical device or medical technology is based on the value provided – provides the ideal phase to test this new type of activity. Through the availability of Real World Evidence (RWE), life sciences companies are invited by paying organizations and suppliers to provide data to demonstrate that their product provides a documented clinical benefit without increasing health care utilization or risk from a patient cost and/or safety perspective. As the shift to a value-for-money paradigm becomes more frequent, payers, providers and life sciences companies need to think differently and behave and implement proactive strategies that foster cooperation through mutually beneficial relationships throughout the health ecosystem. Ultimately, switching to value-based reimbursement can be a blessing for your organization. Among the benefits may be as a whole: insurer Minnetonka, minn.-, reports that nearly $75 billion in annual payments to suppliers are now tied to value-based payments, but Nguyen said he often found that suppliers are not really interested in working with them. The move to value-based reimbursement requires not only a change of perspective, but other potentially important requirements depending on the type of organization, the repayment model and the financial objectives. This includes: For more information on this topic or to find out how Baker Tilly specialists can help your organization move to value-based contracts, contact our team. The question is whether a sponsor has the data to support an RWE-based value story, which a payer and/or supplier system will consult usefully. This is why it is important for life sciences companies to conduct in-depth analyses of the available RWE to determine whether existing data represents reasonable value to payers and/or suppliers.

Through this analysis, life sciences companies can assess which patient cohorts have the most effective experience and determine which outcomes, if any, are in the best interests of payers and providers, such as. B Improved accountability and safety.