And both payers and manufacturers can be resistant to taking financial risks on patient-reported responses. They may want a provider’s documentation, such as claims or physician notes. This model solves for both of those concerns.
I think it all comes down to one question: how do we do this well? The outcomes-based contracting enablement platform allows us to meaningfully measure outcomes over the time frame that is relevant to each of these therapies.
Optum is committed to our mission, and we have all the core capabilities required to do this well. That includes deep experience using real-world data for health economics and outcomes research expertise, robust data assets and the scale of Optum.
This puts us in a unique position to support value-based contracts.
You’ve emphasized the importance of starting early. How would a life sciences manufacturer engage with you to get started on developing a value-based program.
Our team is willing to engage with a life sciences partner wherever they are in their journey toward developing a meaningful outcomes-based program.
Often, the first step is engaging in a research study that leverages our de-identified real-world data assets. These include our claims data, structured electronic health record (EHR) data and unstructured EHR notes. We leverage these to characterize what is measurable and what could be used to support a potential value-based contract.
It is important to understand and build trust in the data that’s available today, and to understand what might need to change in the future. This helps build the foundation of insight necessary to engage payers and other stakeholders on the value of your therapy.
Another way we partner in value-based program concept development is through educational and consulting workshops. This helps manufacturers understand the processes and perspectives that health plans and other stakeholders bring to VBC conversations.
All this is part of building a well-thought-out VBC implementation strategy to support contracting, including which specific outcomes will be measured and a protocol for how they will be measured.
It’s important for manufacturers to have this in place at approval to help with early access for their therapy. It also ensures the VBC helps generate compelling real-world evidence that can help prove the cost and quality of the therapy over time.