Value-based contracts between pharmaceutical manufacturers and payers are a fast-growing, new development that is here to stay. These pharma contracts put in place a reward system - higher payment rates - in exchange for demonstrably improved patient outcomes. This type of agreement is intended to reward healthcare value over volume.
Some outcomes can be measured easily, such as hepatitis C cure rates. Other outcomes are significantly more difficult to measure, such as those that include a care team and are lifestyle- dependent.
So what is needed to ensure the success of these pharma contracts? Curant Health President and CEO, Patrick Dunham, discussed four key components for successful outcomes-based contracts at this year’s Asembia 2016 conference:
1. Inclusion of all stakeholders, including patients and caregivers, clinicians, payers, manufacturers and specialty pharmacists.
2. Agreed-upon outcomes metrics, such as the CMS Core Quality Measures with guiding principles that are meaningful to patients, consumers and physicians while reducing variability in measure selection, collection burden and cost.
3. The right tech tools to fill the gaps created as patients migrate between insurers and jobs, such as patient-facing HIT, patient in-home monitoring, better data analytics and meaningful improvement in communication between EHRs.
4. Leveraging the strongest links in the care coordination team, specifically the clinical pharmacists and dedicated patient care coordinators (especially regarding barriers to access and adherence).
Having these components in place ensures stakeholders will implement value-based pharma contracts with a strong foundation.
To read Curant Health’s Marc O’Connor’s full article on this topic, visit Managed Healthcare Executive.
To learn more about Curant Health, contact Kristin Lindsey, Marketing Director, at klindsey@curanthealth.com.