Value-Based Contracts with Big Payer: A Guide for Health Innovators
In my second go-to-market guide, I outline how to find product-market fit with traditional payers.
Finding the elusive product-market fit in any business? It matters. It's not obvious what it should look like in healthcare, particularly when you're trying to sell something to major third-party payers. Blue Cross, United, CIGNA, Aetna, and to a degree Humana, follow different rules than you might imagine. Getting to Value-Based contracts in behavioral health has been elusive, much less valuable care. Andreessen Horowitz has a guide. It is well beyond the assertion that “this will obviously save money!”
What follows is an article based on what insiders have told me. This, reportedly, is what they're looking for, across a number of major payers. I would love to see more value-based care with actual value existing in the world!1
I don't actually think building for the sole purpose of pleasing Big Health is a great idea, but plenty of investors think this is a good plan. It gets companies to scale, after all. I prefer to work with bespoke aligned payers with aligned incentives in …