
Issue 001 · October 2026
Your buyers just rewrote the contract. Most digital health companies haven’t noticed.
PHTI’s 2026 purchasing survey dropped this week. The headline: 57% of employers, health plans, and health systems now use performance-based contracts for digital health. 85% of those put at least a quarter of fees at risk.
And the metric vendors miss most often? Cost savings. The thing on the first slide of almost every pitch deck.
- Your pricing model is now a risk model. If you can’t say which outcomes you’ll stake fees on, a buyer will pick them for you.
- Your engagement numbers need to hold up to someone else’s claims data. “Enrolled” doesn’t count anymore. Active use and clinical milestones do.
- Your sales team is negotiating actuarial terms. Most were hired to run demos.
Budgets are flat for most purchasers, and they’re cutting the number of vendors they keep. The companies that survive the next renewal cycle will be the ones that built contracting, measurement, and reporting into the commercial engine, not bolted on after the pilot.
We’ve sat on the buyer side of these deals. If you’re rethinking how you price and contract, tell us what’s stuck.
Source: Peterson Health Technology Institute — 2026 State of Digital Health Purchasing