Outcomes-based payment models

In Life Sciences

The EY Health Outcomes Platform (HOP) is designed to address the critical need for value-based contracting, which reimburses life sciences companies and providers for delivering prespecified, real-world results and solutions.

Related topics Life Sciences

What EY can do for you

Fueled by aging populations and new drugs to treat rare and specialty diseases, global spending on prescription medicines is expected to increase between 2% to 5% annually over the next five years. It should exceed US$1.1 trillion overall by 2024, up from US$955 billion in 2019. Governments, businesses and individuals are paying more and more to maintain the health of their populations, workers and families.

Historically, health care reimbursement has been based on volume rather than value and outcomes. Value-based contracting (VBC) is increasingly seen as a viable and sustainable way of aligning payment to value. VBC compensates life sciences companies and providers for delivering prespecified, real-world results and solutions based on three health outcome pillars: clinical efficacy, patient-reported outcomes and health care system efficiencies.

Value-based contracts have the potential to align the interests of patients, payers, providers, life sciences companies and society around a shared goal: reducing health care spending trajectories to more acceptable and accessible levels while continuing to reward important innovations.

While in reality, new digital technologies are making it easier to collect and share data, doing so securely is challenging, trust between stakeholders is hard to establish, and the tailored nature of these contracts makes them difficult to deploy at scale.

Getting started

What’s needed is an innovative platform that incentivizes all parties to drive positive results while allowing them to be more collaborative and efficient. In short, contracts among these stakeholders are needed that are standardized but flexible, automated but customized and simple but scalable.

Enter the EY Health Outcomes Platform (HOP), an industry-wide, innovative utility to support VBC. HOP fosters frictionless collaboration at scale across providers, payers and life sciences companies to meet the needs of a dynamic health care landscape. HOP helps stakeholders simplify and streamline data capture and management, increasing transparency and trust.

How it works

Life sciences companies and other health care players create digital contracts, which include the requirements for measuring success. By leveraging blockchain, data is accessed at its source while respecting data privacy, maintaining data protection and confirming regulatory compliance in the regions where it operates. These sources are connected to a transactional data layer, which manages the data, and the contracting parties can then analyze the outcomes via the user interface.

HOP facilitates a triple win: allowing payers and providers to offer better care; providing life sciences companies with the chance to prove the value of their products; and, most importantly, helping patients access the new treatments they need.

Why EY?

As a trusted advisor across the health care ecosystem and committed to building a better working world, EY member firms can work together with life sciences and health care companies to drive an analytical, fact-based assessment that is fully transparent in order to bring confidence to the relationship.

Case Study
The better the question The better the answer The better the world works
Case Study

Case study: How tax technology established future-state tax and finance operations for a pharma major

The company reimagined its future by leveraging technology and talent for its India operations.

Case Study
The better the question The better the answer The better the world works
Case Study

As a start-up, where do you want to end up?

The company wanted a futureproof and scalable system to manage accounting, payroll and tax processes.

A multinational specialty pharmaceutical group, headquartered in Europe, had recently set-up its business in India. As a start-up in the pharma sector in India, the company had limited visibility on the ever-changing and complex tax, compliance and regulatory environment surrounding the business.

With growing digitalization of tax and finance compliances across the globe and in India, the company was looking at a solution that leveraged digital solutions to help them in driving long-term efficiencies and agility in their tax and finance functions.

Further, given that the scale of operations for the client was likely to increase over the years, they needed a scalable and futureproof framework capable of risk-managed compliances.

To this extent, the client was seeking a trusted business advisor with strong industry and domain knowledge to help them in setting-up and running their accounting, payroll, and tax processes.

Tax solutions in newly established India operations
Case Study
The better the question The better the answer The better the world works
Case Study

We integrated multiple tax and finance processes into one solution

Through a technology driven delivery model, the company could re-imagine its future-state tax and finance function.

The pharma company was looking at employing an integrated solution which could help them with the following:

  • Setting-up and operating the accounting, payroll and tax processes by leveraging subject matter expertise and deep industry knowledge.
  • Establishing a robust governance framework that enables timely and risk-managed compliance, complete visibility, and continued quality improvements.
  • Delivering tax and finance compliance efficiencies through a digital solution and ensure that the organization was prepared to respond to the digitalization of administrations.

We built and provided an integrated finance-tax offering as a single service provider to the client. Under this offering, EY supported the organization across the spectrum of their accounting, payroll and tax requirements, including corporate tax, indirect tax compliances, routine tax audit and statutory audit support and tax advisory work.

Based on the identified themes, we helped the client build a strategic tax and finance function, with industry leading practices, through the following:

EY’s client engagement team working with the international pharma company
End-to-end accounting, payroll & tax compliance support
Case Study
The better the question The better the answer The better the world works
Case Study

Our solutions and market expertise are enabling growth and strategic expansion

We are helping unlock long-term efficiencies through robust governance, skill set integration, sector knowledge and experience.

With EY managing accounting, payroll and tax processes, the organization could focus on growing its operations in India and strategic initiatives. The organization realized that it could effectively navigate changes in the highly dynamic tax and regulatory environment, including matters such as emerging digital tax filing requirements.

We created a large impact for the company through the following key levers:

  • Robust governance and delivery framework

    aided by EY’s suite of digital solutions, to ensure quality reporting, timely and risk managed compliances, and adherence to strict data confidentiality norms.

  • Seamless co-ordination and integration

    across multiple skillsets and borders through a cohesive tax-finance service delivery model, including direct tax, indirect tax, accounting and bookkeeping and payroll, delivered through a cohesive tax-finance service delivery model, and strong teaming across borders.

  • In-depth sector knowledge

    demonstrated through the firm and the team’s experience, which helped the client visualize what they need to prepare for in terms of their newly set-up operations in India as well as our approach of adding value beyond the outsourcing engagement.

  • Leveraging EY’s market leading practice

    in the Life Sciences sector and tax and finance outsourcing space, leading to a cost-effective solution for the company.

EY’s solutions and services help organizations starting up in India establish their operations across multiple functions backed by deep industry expertise and skills.

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