http://www.statewaterheaters.com/lit/im/res-gas/184326-001.pdf
Note pages 17 and 18 of this PDF installation manual from State.
I can see where it would seem practical to have the slope go towards the outside of the house to allow drainage of condensation. But, especially in colder regions, condensation will freeze into a little icy waterfall on the outlet and block the flow of air. Also, most power vented HWTs and high efficiency furnaces allow for a vertical install of the vent. Both vertical and horizontal installs are designed to accommodate the free flow of rising hot air/carbon monoxide with assistance from the blower. Returning condensation will be heated, evaporated and discharged.
As always, though, consult the manufacturers installation manual for any changes in design that require an atypical installation.