Beyond algorithms: why people still make or break innovative contracts

An Expert View from Omar Ali (pictured below), head of payers, Verpora.

As AI-driven modelling and performance-based frameworks continue to evolve, it’s easy to get caught up in what the technology can do. There’s a sense of momentum—a feeling that with the right data and design, we can engineer our way to better agreements. And in many ways, we can. The technical tools we now have at our fingertips are smarter, faster, and more sophisticated than ever before.

But that excitement has tilted the balance. Somewhere along the way, the human factor has slipped out of focus. And for all the advances we’ve made, the success of any value-based agreement still depends on something far less futuristic: how people behave, how they communicate, and how they collaborate to deliver what’s been agreed.

What often gets overlooked in the excitement around innovation is that even the most technically sound agreement still relies on human judgement, coordination, and commitment to deliver. It’s not just about what’s in the contract—it’s about who’s behind it, and whether they’re ready and able to make it happen.

I’ve seen contracts succeed not because of elegant design, but because teams were  aligned, engaged, and trusted one another to follow through. And I’ve seen them fail despite strong foundations—because the people involved weren’t brought in early enough, weren’t confident in the approach, or didn’t see their role in making it work.

That’s not to say failure is always a problem. Some VBAs are meant to be pressure tested—and failing fast is often the right outcome when the design doesn’t hold. But many don’t fail fast. They drift. They lose energy. And too often, it’s not the model that’s wrong—it’s the human connection that was never really built.

In this article, I want to explore what it takes to shift that balance. Not by rejecting the technical—but by restoring focus on pivotal aspect of innovation in access; the human side of innovative contracting.

1. Prioritize cross-functional alignment early and often

Misalignment doesn't usually announce itself. It tends to show up quietly—when teams are making different assumptions, when communication drops off, or when actions don’t quite join up. It’s easy to miss until you’re too far in to fix it cleanly.

That’s why alignment has to start early—and stay active. It means checking that everyone’s working from the same assumptions and understands their role in delivering the agreement. It’s not about creating new processes. It’s about building regular touchpoints where people can ask questions, raise concerns, and flag what’s not clear.

And you need to pace it sensibly. Some teams move fast. Others need more time to absorb and respond. The point is to meet them where they are, involve them early, and keep them engaged. When people know what’s coming and feel part of it, things move forward.

2. Build capability beyond compliance

I’ve seen teams handed a contract and expected to just run with it. And technically, they can—but that doesn’t mean they’re confident, or that they feel equipped to make it work. The VBA will become a living breathing entity and requires a certain amount of nurturing to let it mature and deliver. That requires capability within teams.

Real capability is more than understanding the wording. It’s about being comfortable navigating the grey areas and feeling able to speak up when something doesn’t add up. That only happens when people feel supported—not just trained, but trusted. Pragmatically, they require sound training, a level of immersional experience in the world of VBA & IC; and then application in a safe environment to hone some of the skills integrating access and negotiation, tuned in to the level of payer they may be dealing with.

That’s where psychological safety comes in. It gives people room to try, to challenge, even to get it wrong—and to learn quickly without blame. You also need visible champions. The people who get it, who care, and who are willing to help others find their feet. Give them the tools and encouragement to lead by example, and they’ll keep momentum going long after the contract launches.

3. Build trust from day one—internally and externally

Trust is the quiet enabler of everything else. It’s what lets people stick with an agreement when things aren’t going to plan. And you can’t retrofit it later—it has to be there from the start.

That means looping people in early, not after the decisions are made. It means designing outcomes that people recognize as meaningful—not just the ones that are easiest to measure. And it means showing up when there are bumps in the road, not going quiet.

Trust doesn’t come from being nice. It comes from being consistent and credible. From doing what you said you’d do. From making sure that everyone—from clinicians to commercial leads—feels informed, respected, and heard. That’s what turns contracts into commitments.

Looking ahead: a human-centered approach to contracting

The future of contracting won’t be won by choosing between data and people—it will be shaped by those who balance both. Scalable VBAs will come from organizations that embed behavioral thinking alongside analytics, and that invest in communication with the same rigor as legal frameworks. If you’re ready to move from pilot to impact, here’s the question I’d be asking: have we built a contract that people not only understand, but are ready to deliver? And, is the juice worth the squeeze?

If the answer to both is yes—scalability is a nice problem to have.