Pharma, providers, and payers want to tie payment to patient outcomes. But the infrastructure to run these contracts doesn't exist. Metritx builds it.
58% of US payers already have at least one outcomes-based contract. Global medicine spend will hit $2.3T by 2028. But when pharma companies have tried outcomes-based pricing, payers couldn't operationally execute it. The contracts everyone wants still can't run.
of US payers have an outcomes-based contract
annual US drug spend suitable for OBC
gene therapy price tags driving payer pressure
of eligible drug spend actually runs under OBC today
Each party tracks outcomes in its own system. A US insurer exec told ProPublica that tracking patient outcomes is "not cost-effective" because "the work is expensive and burdensome." Without a shared ledger, contracts stall or never get signed.
Italy's early OBC experiments were described as "very, very poor" because admin costs and data barriers consumed any savings. Most contracts still run on emailed spreadsheets and PDF amendments. Every step is slow and error-prone.
Payers and pharma both want outcomes-based deals, but tracking patient results across fragmented systems is expensive and burdensome. The infrastructure to run these contracts at scale simply doesn't exist yet. With gene therapies at $2M+ and CAR-T at $400K+, solving this is urgent.
ACCORD replaces the spreadsheets, PDF amendments, and manual reconciliation with a single system every party can trust. Contracts in, verified outcomes and payments out.
AI-powered extraction transforms PDF contracts into structured, machine-readable logic that drives automated workflows.
Capture clinical measurements, validate data quality in real time, and evaluate patient outcomes against contract-defined success criteria.
Automated ACH transfers based on verified outcomes. Multi-party approvals, transparent fee calculations, and full settlement tracking.
Four capabilities that turn a paper agreement into an automated, auditable financial workflow.
Upload PDF contracts and our AI extracts the terms, success criteria, payment tiers, and eligibility rules into a structured digital format. Human review ensures accuracy before contracts go live.
Clinical data flows through real-time validation. Every measurement is checked for completeness and quality, flagged for review when needed, and only verified data drives payment decisions.
When outcomes are verified, payments are calculated automatically based on contract terms. Multi-party approval workflows and direct ACH transfers handle the money movement end to end.
Every action is logged. Every data change is versioned. Every payment calculation is reproducible. An immutable audit trail gives all parties full transparency and regulatory confidence.
Upload a contract PDF on Monday, settle verified outcome payments by Friday. Here's how.
Upload your contract PDF. AI extracts terms, success criteria, payment tiers, and eligibility rules into structured data. Review and approve the digital version.
Enroll eligible patients and capture clinical measurements over time. Real-time validation flags data quality issues before they become problems.
Evaluate patient outcomes against contract-defined success criteria. Every party sees the same verified data -- no disputes, no black boxes.
Payment amounts are calculated from verified outcomes. Multi-party approval triggers direct ACH transfers. Full audit trail from outcome to settlement.
Single-patient therapies priced above $400K, where one failed contract destroys the economics for everyone involved.
High-cost, high-uncertainty treatments where outcome-based pricing aligns incentives and manages financial risk for all parties.
Small patient populations with measurable clinical endpoints, where per-patient outcome tracking is both feasible and valuable.
Pre-approval drugs where outcome-based agreements enable patient access while managing uncertainty for manufacturers and payers.
If you're a pharma company pricing a therapy on outcomes, a health system managing OBC agreements, or a payer tired of unverifiable contracts, we should talk.