Optum and Merck simulate contractual reimbursement models

The companies will use a shared laboratory to explore both value-based and pay-for-performance models.
The companies will use a shared laboratory to explore both value-based and pay-for-performance models. | Contributed image

Optum, UnitedHealth Group’s health services business, and Merck are collaborating on developing and simulating the performance of contractual reimbursement models that align payment for prescription drugs with patient health outcomes.

“Ensuring that health care dollars are spent on interventions that improve patient care and health outcomes is a shared goal for all stakeholders,” Curt Medeiros, president of Optum Life Sciences, said in a statement. “This collaboration offers an opportunity to leverage our collective strengths to increase knowledge about the design and implementation of outcomes-based contracts in the U.S. health system.”

The companies signed a multi-year collaboration agreement and will use a shared laboratory to explore both value-based and pay-for-performance models. The focus will be on whether these ideas have potential for broad adoption among health insurance companies.

“Our collaboration will create a unique data-driven platform to enable modeling and analysis of innovative contracts that are needed to move to a value-based health care model,” Merck senior vice president Susan Shiff said. “The collaboration between Merck and Optum will help advance both organizations’ common goals of improving patient health outcomes, expanding access to innovative therapies, and ensuring the best use of health care spending.”