30% of health plans are pursuing outcomes-based contract negotiations, Avalere study finds

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Thirty percent of health plans reported they are currently negotiating one or more outcomes-based contracts, according to a recent Avalere study.

Avalere researchers surveyed 50 decision makers at 45 health plans via an online platform between April 11 and May 1. Health plan respondents represented 183 million covered individuals in the U.S., including Medicare Advantage and Medicaid beneficiaries.

Twenty-four percent of health plans reported they are in at least one outcomes-based contract, while 29 percent of health plans are not planning to pursue outcomes-based contracts. In addition, 70 percent of health plans view outcomes-based contracts favorably.

Avalere experts said the shift toward value-based care has broadened the reach of outcomes-based arrangements. Most outcomes-based contracts instituted by responding health plans addressed endocrine, infectious disease, cardiovascular and respiratory conditions, but respondents expressed interest in expanding to other areas like immune and inflammatory diseases.

"While some plans have experienced administrative and operational challenges in implementing outcomes-based contracts, most are figuring out ways to benefit from these types of contracts in multiple therapeutic areas," Kathy Hughes, vice president at Avalere, said in a statement.  

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