Approximately 56% of health plans and pharmacy benefit managers have outcomes-based contract (OBC) with provider organizations in place as of September 2021, based on an Avalere survey of 51 U.S. -based health plans and pharmacy benefit managers (PBMs), representing approximately 59 Million covered lives. An OBC is a reimbursement arrangement that ties provider organization payment, contract extensions, or contract renewals to the achievement of specific, measurable performance standards and requirements.
The most common therapeutic areas in which payers are utilizing OBC in 2021 include cardiology (79%), endocrinology (68%), and respiratory illness (54%) solutions. Payers focusing on OBCs in . . .