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Value-Based Contracting Services

Life science innovation and health care reimbursement models

The health care system is going through a volume-to-value transformation with the goal of controlling cost and improving patient outcomes with value-based contracting services and health care reimbursement models. At the same time, we are seeing tremendous innovation in new therapies that are being developed. The health care system is challenged with how to provide sufficient access to these new therapies while controlling overall health care spending.

Multiple stakeholders and the data hurdle

Value-based contracts (VBCs) and value-based care are promising ways to accelerate the shift from volume to value in health care. These arrangements between life sciences manufacturers (pharmaceuticals and medical technology) and payers and providers will play a critical role in enabling appropriate access to new innovations and tools for value-based care. They can improve patients’ health, by sharing risk across stakeholders and helping to control costs. Drug pricing will likely be a top priority for Congress in 2019, increasing the need for companies to demonstrate value.

While the number of publicly announced value-based contracts between life sciences companies and payers has increased over the past few years, there continues to be barriers preventing wider spread adoption. According to Deloitte’s 2018 real-world evidence (RWE) benchmarking survey, participants ranked challenges with collecting, linking, and analyzing data as the biggest hurdle, along with gaining stakeholder alignment and assigning value-based care to benefit.

How Deloitte can help with value-based contracts enablement

The right team. Demonstrated experience.

Deloitte has the breadth and depth of capabilities to help the health care and life sciences sector overcome these barriers. Our Value-based Care practice, repeatedly acknowledged by KLAS as the leader in our field, acts as a trusted intermediary for multi-stakeholder contracts. We take a healthy mix of cross-functional perspectives, from actuaries to data scientists, from industry consultants to technologists, to help facilitate the necessary shifts from volume to value-based care. Our approach outlined below entails value-based contracting strategy as well as operationalizing the arrangements in an end-to-end lifecycle.

Value Based Contracting Services

Leveraging a strategic position in the health care ecosystem

Deloitte serves the majority of top 10 global life sciences companies, many of the largest national and regional health plans, hospitals systems and provider networks, as well as government bodies and rapidly evolving pharmacy benefit managers and pharmacy players. Our position in the health care ecosystem provides us with a unique perspective and ability to bring stakeholders together.

In November 2018, Deloitte held a Value Exchange Summit in which nearly 30 participants representing health plans, health systems, pharmaceutical manufacturers, and patient organizations came together to address the core question, "How do we accelerate VBCs to positively impact patient outcomes and reduce health care’s overall cost?"

Participants brainstormed what is needed to make VBCs a reality from each stakeholder’s perspective, pragmatic approaches to overcoming hurdles to VBCs, and where to start in making VBCs mainstream. Three therapeutic areas were analyzed: cardiovascular, inflammation, and oncology. While each area had its own set of characteristics and metrics to contend with, the overreaching challenges concerning transparency, data, and standardization were consistent among all of them.

Blue galaxy

Get in touch

If you want more details about how Deloitte can help strategize, design, execute, and adjudicate VBCs while managing health care reimbursement models, we should talk.

Joe Coppola
Commercial Ops Practice Leader for Life Sciences
Deloitte Consulting LLP

Andy Davis
Senior Manager
Deloitte Consulting LLP

Jeff Morgan
Managing Director
Deloitte Consulting LLP

Marcy Imada
Principal
Deloitte and Touche LLP

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