Objectives: There is an increasing shift towards outcomes based contracts (OBCs). However, these agreements are typically simple and not scaled. To keep up with increasing complexities of treatments, current types of OBC agreements are no longer sufficient. This abstract considers the development of a standardized approach to multi-tenant user agreements, establishing a framework for these novel contracts. A modeling of various scenarios is presented at a TA and population level within diabetes, cardiovascular disease, renal failure and hemophilia to see how these agreements improve on the modalities currently employed. Methods: A dynamic model was developed, following the creation of a library of current economic (n=104), clinical (n=392) and humanistic (n=98) endpoints, therapeutic areas (n=4) and established value frameworks (n=7). As comparitors, we incorporated 47 publically available OBC and a proprietary dataset linking public contracts to therapeutic spend within a given payer or system. With this foundation we built scenarios to explore how adding additional stakeholders, incorporating more than one therapy and increasing term complexity can drive additional value realization of OBCs. Results: When applied across each of the therapeutic areas noted above, we forecasted a 12% acceleration of access and a 20% reduction in overall spend on average across therapies. Additionally, a 3% revenue upside was observed for manufacturers , while simultaneously reducing overall spend for payers in the same therapeutic class. Conclusions: This model supports the need for OBCs to evolve to reflect the stakeholder interconnectivity and therapy complexity, while identifying mechanisms to standardize value-creating metrics to incentivize outperformance for all parties involved. This will allow parties to deliver better outcome for patients, and translate multi-tenant contracts into outsized value for healthcare systems. By increasing the complexity, the types of terms, and multiple therapies in a single agreement, OBCs can balance out the spend and risk in appropriate measure.