Chronic Kidney Disease is when the kidneys gradually get damaged over time and the kidneys are unable to complete functions such as removing wastes from your body, maintain blood pressure, and keeping your bones healthy.
Value-Based Contracts Resources
Advancement in medications, vaccines, and gene therapies requires innovation in payment and reimbursement methods. New value-based and alternative payment contracts are increasingly implemented across a variety of health care plans, and pharmacy benefit managers and a range of care delivery providers are also engaging in these contracts. However, the types of conditions treated (e.g., rare vs. common diseases), the compliance and regulatory requirements, contractual terms, and risk/payment models used are complex.
These AMCP, AMCP Learn, and Journal of Managed Care + Specialty Pharmacy resources can help advance the role of value-based contracts to improve access and affordability of medications.
AMCP Resources and Continuing Education
- Innovative Contracting: Value-Based Strategies and Global Trends
April 30, 2024 - Innovations in Value-Based Partnerships for Patient Care Services
April 10, 2024 - Talking the Talk. In the World of Value-Based Care, Words Matter: A Lexicon for Value-Based Purchasing
December 2023
Value-based contracts often require significant time to reach final negotiation and implementation. Disconnect, misalignment, and lack of a common framework for value-based purchasing agreements has exacerbated these challenges. This lexicon provides a unified language for discussing and designing value-based contracts across payers, provider systems, and manufacturers.- Download the Lexicon | One-Pager | Slide Deck (Members Only)
- AMCP Partnership Forum: High-Investment Medications
April 2022
High-investment medications raise sustainability and affordability concerns for employers, payers, and patients. This Partnership Forum addressed payment and benefit challenges for high-investment medications and explored alternative payment reform, financial tools, and policy initiatives to improve the predictability, affordability, and accessibility of these treatments. - State Model Legislation: Value in Pharmacy Care Act
January 2022
AMCP developed the model state legislation to improve and modernize pharmacy benefit policy. Establishing standards for and expanding adoption of value- and outcomes-based contracts are key to improving care. - AMCP Partnership Forum: Integrated Delivery Network’s Role in Value-Based Agreements for Pharmacy and Medical Benefits
November 2018
Implementing value-based reimbursement models for both pharmaceuticals and medical care poses significant challenges and opportunities and depends on integrated delivery networks (IDNs) to execute the processes and programs. This Partnership Forum convened industry thought leaders to discuss the issues. - AMCP Partnership Forum: Designing Benefits and Payment Models for Innovative High-Investment Medications Partnership Forum
July 2018
New health care innovations are bringing the promise of life changing treatment for specific diseases. Financial models for innovative, high-investment medications are needed to maintain patient access. This AMCP Partnership Forum brought together thought leaders in July 2018 to discuss the issues and solutions needed on this key issue. - AMCP Foundation: Value-Based Health Care for Patients, Providers & Payers — Summary from AMCP Foundation Research Symposium
November 2017
AMCP Foundation webinar that discussed highlights from the 7th Annual Research Symposium. - Advancing Value-Based Contracting: Proceedings from the AMCP Partnership Forum Program
July 2017
Value-based contracts (VBCs) have emerged as a mechanism that payers may use to better align their contracting strategies with broader changes in the health care system. This AMCP Partnership Forum brought together thought leaders in June 2017 to discuss definitions, performance benchmarks, best practices, and other action plans needed to advance VBCs.
Journal of Managed Care + Specialty Pharmacy (JMCP)
- Performance-Based Risk-Sharing Arrangements for Devices and Diagnostics in the United States: A Systematic Review
Jan 2022
Performance-based risk-sharing arrangements have continued to emerge and evolve over the last 2 decades. To date, most of the attention and available literature have focused on pharmaceuticals. This JMCP review describes publicly available risk-sharing agreements for diagnostics and devices. - Using the Delphi Method to Identify Meaningful and Feasible Outcomes for Pharmaceutical Value-Based Contracting
November 2020
This Viewpoints article published in JMCP outlines an approach to more effectively align the interests of all key stakeholders and maximize the effect and transparency of value-based pharmaceutical contracts. The authors describe their experience using a validated Delphi surveying technique in five disease contexts to gather information and build stakeholder consensus on key elements before contract development. - Examining Misaligned Incentives for Payers and Manufacturers in Value-Based Pharmaceutical Contracts
January 2020
This JMCP study compares pay-for-success and pay-for-failure models to identify the short- and long-term incentives that manufacturers and payers should consider when developing value-based contracts. More research is needed on the effect of different types of value-based contract schemes on cost and clinical outcomes. - Regulatory, Policy, and Operational Considerations for Outcomes-Based Risk-Sharing Agreements in the U.S. Market: Opportunities for Reform
November 2019
Major reasons for the slow uptake of outcomes-based risk-sharing agreements in the U.S. are regulatory issues, operational requirements, and deficits in information sharing, according to a literature review published in JMCP. - Determination of Multiple Sclerosis Indicators for Value-Based Contracting Using the Delphi Method
July 2019
This JMCP article describes using a Delphi method approach with patients, payers, providers, and pharmaceutical company and pharmacy benefits manager representatives to identify meaningful multiple sclerosis indicators and inform a value-based contract for these medications.
Related
Prescription Digital Therapeutics (PDTs) offer vast opportunities but require careful consideration for coverage and reimbursement. At the direction of the AMCP Board of Directors we have developed definitions and principles to simplify your decision-making and provide digital health innovators with essential insights for evaluating safety and efficacy.
The United States Pharmacopeia Convention (USP) and the United States Food and Drug Administration (FDA) have updated an educational resource on biosimilars to help healthcare practitioners improve patient confidence in the quality and effectiveness of these treatment options. The following are recommended social media, website, and email content you can use to share this resource with your network.
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