Outcomes-based payment models

Your business challenge

As health care becomes smarter, the need to maintain trust, data security and patient confidentiality becomes more critical than ever before. Health care stakeholders recognize the benefits of value-based contracting; however, multiple challenges have prevented them being a practical reality. These challenges include:

• The higher levels of trust and coordination required across ecosystem stakeholders to develop and implement value-based contracts versus traditional contracting types
• Strict privacy regulations surrounding the use of personal information
• The fragmentation of health data across multiple systems — instead of a streamlined, holistic process of data sharing, stakeholders are working in silos, making for a more time-consuming process
• The high administrative burden on health care stakeholders to manage value-based contracts through activities such as tracking patient outcomes/metrics, calculation of contract performance and associated rebate, which makes them overly time-consuming and prevents such contracts from scaling

Solution benefits

The EY Health Outcomes Platform is an industry-specific, technology-enabled service that will shape the future of value-based contracting by:

• Enabling value-based contracting at scale
• Maintaining data ownership, data security and patient confidentiality by never moving data from its source
• Automating the contract management so contracting is seamless, frictionless and fluid and requires minimal manual intervention

Use case

While pharmaceuticals, payers and providers seek better health outcomes, their value and respective stakes are not always aligned. Innovative contracts can play an important role in the alignment of value.