PHTI Launches Performance-Based Contracting Playbook to Drive Measurable Digital Health Outcomes  

NEW YORK —

The Peterson Health Technology Institute (PHTI) today released the Playbook on Performance-Based Contracting—a comprehensive report and interactive toolkits designed to help employers and health plans tie payment for digital health solutions to measurable outcomes.

The Playbook was developed in collaboration with more than 50 stakeholders, including health plans, vendors, brokers, consultants, data warehouses, and other industry experts. It provides a practical guide for purchasers and vendors seeking to implement PBCs more efficiently at scale. The Playbook synthesizes market insights, highlights leading practices, and includes condition-specific toolkits for implementing contracts that tie vendor payment to clinical outcomes, engagement, and cost savings.

“Performance-based contracting is no longer aspirational—it’s table stakes,” said Caroline Pearson, executive director of PHTI. “Health plans and employers are demanding more from their digital health vendors, including access to data, proven health outcomes, and better value for their investments. At the same time, leading vendors are increasingly confident in their solutions and ready to put their payments at risk.”

“With more experience and available data, purchasers and vendors are ready to embrace performance-based contracts, which can be time consuming to negotiate and adjudicate,” said Meg Barron, managing director at PHTI. “The Performance-Based Contracting Playbook serves as a starting point for negotiations to speed alignment around standard definitions and contract terms, such as outcome measures and engagement metrics.”

The Playbook builds on PHTI’s 2025 State of Digital Health Purchasing survey, which shows a market shift toward a focus on clinical effectiveness and return on investment. However, despite the increased interest in PBCs, the ability to execute these contracts effectively has lagged behind demand. The survey shows the majority of those currently using PBCs are not yet satisfied with them. PHTI’s new resources aim to close that gap, providing standardized frameworks, validated metrics, and practical implementation strategies that make adoption of PBCs easier and ensure better outcomes.

PHTI has also developed four condition-specific toolkits with actionable contract terms for digital solutions that address health conditions affecting nearly half of all Americans: diabetes, musculoskeletal care, hypertension, and depression and anxiety. The toolkits were developed in collaboration with leading purchasers and vendors to ensure they reflect real-world feasibility and address needs from both sides of the negotiating table.

The Playbook on Performance-Based Contracting addresses seven key decision points that purchasers and vendors must navigate when designing effective contracts. These elements work together to structure payments that reward outcomes, define which members benefit most, establish credible measurement standards, enable accurate performance evaluation, and balance long-term impact with practical constraints while protecting member trust.

“For years, we’ve been paying based on satisfaction surveys and enrollment numbers when what really matters is whether the health of our employees and their families is actually improving,” said Emily Munroe, benefits director, Live Nation. “Are diabetes levels coming down? Is hypertension under better control? PHTI’s Playbook finally gives us the framework to tie payments to validated clinical measures instead of vendor-reported metrics. That’s the accountability we need.”

The resources also highlight best practices from market-leading purchasers, including structured pilot programs, annual vendor scorecards, network overlap analysis for access solutions, and investments in data infrastructure to validate vendor-reported performance. 

“Performance-based contracting has long been an industry goal, but most employers lack the actuarial capacity that large health plans have to negotiate and enforce these contracts,” said Nate Counts, VP, Total Rewards at Amtrak. “We’ve been in need of more standardized benchmarks and clear definitions—like what constitutes meaningful engagement versus just app downloads—that level the playing field and let us focus on selecting the right solutions rather than reinventing contract language with every vendor.”

The Playbook on Performance-Based Contracting and condition-specific toolkits are available here. Join PHTI on Thursday, January 22 at 12:30 PM ET for the launch of the Playbook, featuring a panel with leading employers who contributed to the development of these resources. Register here.