“Clinically nuanced” Medicaid cost-sharing

Excerpt from the Journal of Medical Economics:

V-BID plans are designed with the tenets of “clinical nuance” in mind. These tenets recognize that (1) medical services differ in the amount of health produced, and (2) the clinical benefit derived from a specific service depends on the person using it, as well as when, where, and by whom the service is provided. In the commercial market, V-BID plans have been shown to increase medication adherence, reduce socioeconomic disparities, and lower adverse events associated with disease progression.  Still, many insurance plans, including most Medicaid plans, impose cost-sharing across the spectrum of care in a blunt, “one-size-fits-all” fashion. This approach lacks incentives that encourage enrollees to use healthcare in a more efficient way. Incorporating the idea of behavioural hazard into insurance benefit structures could improve enrollee health and the efficiency of how this population uses the healthcare system.

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