Pharmaceutical manufacturers and payers have developed a number of agreements under which reimbursement is contingent on specific outcomes over the last few years
Background on risk-sharing and insight into risk-sharing agreements from a payer’s and manufacturer’s perspective.
Outcome-Based Contracting Acceptance Grows in market with the concept of taking on financial risk on complex contracts as a result of market pressure combined with more familiarity. Outcome-based contracts between pharma companies and health insurers are becoming increasingly popular. In 2016, Novartis, Amgen, and Sanofi publicized risk-sharing, value-based, outcomes-based, or pay-for-performance deals, all of which vary […]
Insurers-Hospitals Face Cost Structure Change Insurance fundamentals (risk) that supersede the ACA are driving changes seen in coverage, and at a more rapid pace each year, resulting from ACA impacts. One of those changes has been a significant increase in the use of alternate sites of care (ASOCs) due to medical policy changes driven by […]