Fee Structure & Value-Based Terms
How the program is priced, what portion is at risk, and how fees tie to measured outcomes.
Fee composition by component
ObservedAt-risk outcome terms
3/4 metPersistence > 78% and weight loss ≥5% > 60%
Fee & value comparison across scenarios
Modeled| Metric | Conservative | Base | Optimistic |
|---|---|---|---|
| Enrollment rate | 1.5% | 2% | 3% |
| Productivity reduction | 18% | 25% | 32% |
| Fee per member | $5,400 | $5,400 | $5,400 |
| At-risk percentage | 30% | 25% | 20% |
| Eligible population | 30,000 | 30,000 | 30,000 |
| Enrolled members | 1,500 | 2,000 | 3,000 |
| Total annual fee | $8.10M | $10.80M | $16.20M |
| Fee at risk | $2.43M | $2.70M | $3.24M |
| Cost avoidance | $3.33M | $5.25M | $8.77M |
| Productivity value | $5.22M | $6.16M | $8.34M |
| Net economic impact | $3.02M | $4.02M | $6.03M |
How value-based pricing works
1. Guaranteed base
75% of the per-member fee ($8,100,000) is guaranteed regardless of outcomes. Covers medication, platform, and care team costs.
2. At-risk portion
25% ($2,700,000) is at risk, tied to persistence, weight loss, data capture, and satisfaction targets. Released only when targets are met.
3. Performance bonus
Up to $60K in bonus fees when persistence exceeds 78% and weight loss ≥5% exceeds 60% of cohort.
Employee Privacy Protected by Design
Employer reporting is designed to present aggregate workforce and health-program insights without exposing individual clinical records. Small-group reporting restrictions help reduce the risk of employee identification.
Aggregated information is not described as HIPAA-de-identified unless applicable de-identification requirements have been satisfied and verified.