Employers increase scrutiny of digital health contracts

As healthcare costs continue to rise, employers are tightening the reins on digital health contracts to ensure real value and outcomes. Historically, many digital health solutions were bought with “per-member, per-month” contracts that paid vendors regardless of engagement or results. Today, the focus is shifting from broad availability to proven performance and ROI.

Primary drivers of increased scrutiny

  • Containing rising costs: Cost is now the top factor for two-thirds of employers when evaluating digital health providers.
  • Adoption of performance-based models: More than half of employers want contracts tied to key metrics like patient outcomes and ROI.
  • Transparency: Demand for clear pricing models and data-use transparency; transparency in pricing is expanding beyond PBMs to digital health.
  • Fiduciary duty: Regulations (e.g., Consolidated Appropriations Act 2021) heighten accountability for healthcare spending.
  • Economic changes: A shifting labor market allows emphasis on solutions with a stronger bottom line.

What employers want from digital health vendors

Beyond cost reduction, there is a demand for solutions that demonstrably improve employee health and satisfaction.

Clinical and operational priorities

  • Improved patient outcomes: Clear evidence of health improvements, especially for chronic conditions.
  • Higher employee engagement: Easy-to-use solutions with strong uptake.
  • Enhanced care navigation: Concierge-like guidance to high-quality, cost-effective providers.
  • Integrated solutions: Moving toward platforms that offer whole-person care, including physical and mental health, with fewer point solutions.

Contractual and legal requirements

  • Robust data security: Strong protections for PHI and clear data-security protocols.
  • Clear IP and data rights: Explicit ownership and usage terms; de-identified data for product improvement where applicable.
  • Liability and indemnification: Greater protection against data breaches or vendor failures.
  • Interoperability: Seamless integration with existing benefits ecosystems and HR platforms.

Future outlook for digital health vendors

  • Compete on performance, not features: Prove clinical and financial outcomes.
  • Embrace risk-based contracts: Willingness to share risk makes vendors more attractive.
  • Leverage data for insights: Provide aggregated, actionable population health insights.
  • Focus on integration: Preference for comprehensive, integrated platforms over point solutions

If you’re a vendor or an employer, the name of the game is value, transparency, and measurable outcomes. Let’s align on contracts that reward real health improvements and sustainable savings.

#DigitalHealth #HealthcareCosts #EmployerBenefits #HealthTech #ValueBasedCare #ROI #PerformanceBasedContracts #DataSecurity #Interoperability #PHI #Wellness #EmployeeWellbeing #IntegratedCare

Leave a Comment

Your email address will not be published. Required fields are marked *