This update features policy developments, media reports, and events supporting continued momentum for multiple V-BID Center initiatives from the end of 2018 through mid-February 2019.
The Drug Price Iceberg: More Than Meets the Eye When it comes to the political iceberg of drug prices, there is more than meets the eye. Policies that reduce prices but do not lower consumers’ out-of-pocket costs will not address the main challenge facing most Americans. Access to affordable prescription drugs is a topic of increasing public concern. In a recent survey, 82% of respondents identified medical costs as their biggest financial challenge. Although prescription spending growth has moderated and drug spending remains a relatively small part of total medical expenditures, a 2018 Kaiser Family Foundation poll showed that a significant majority of Americans think that Congress and the president are not doing enough about the problem. The fact that a majority of American adults use prescription medications is likely driving the issue of drug affordability as a policy priority. Nearly 3 in 5 American adults take [...]
Originally Produced: June 2013 Updated: January 2019 Implementing Value-Based Insurance Design in Medicare Advantage Introduction Due to misaligned incentives, Medicare beneficiaries currently receive too little high-value care and too much low-value care. Value-Based Insurance Design (V-BID) is an innovative approach that can address this problem when implemented correctly. The basic premise of V-BID is to align consumer incentives with value by reducing barriers to high-value health services and providers (‘carrots’) and discouraging the use of low-value health services and providers (‘sticks’). When ‘carrots’ and ‘sticks’ are used in a clinically nuanced manner, V-BID improves health care quality and controls spending growth. The concept of clinical nuance recognizes that 1) medical services differ in the amount of health produced, and 2) the clinical benefit derived from a specific service depends on the consumer using it, as well as when, where, and by whom the service is provided. [...]
Introducing V-BID 2.0: CMS Announces Updates to Medicare Advantage V-BID Demo January 18, 2019 - The Centers for Medicare and Medicaid Services (CMS) announced transformative updates to the Medicare Advantage Value-Based Insurance Design (MA V-BID) model. These changes aim to increase choice, lower cost, and improve the quality of care for Medicare beneficiaries. The model launched on January 1, 2017, and has since been expanded to include 25 states, 9 chronic conditions, Chronic Condition Special Needs Plans, and allows participants to propose their own systems or methods for identifying eligible enrollees. Riding on the heels of the Bipartisan Budget Act of 2018, which included a directive to expand the model to all 50 states by 2020, today's release makes sweeping changes to the CY2020 model, including: Allows plans to provide reduced cost-sharing and additional benefits to enrollees in a more targeted fashion Bolsters rewards and incentives programs that plans can offer beneficiaries to [...]
This update features policy developments, media reports, and events supporting continued momentum for multiple V-BID Center initiatives.
The American Medical Association Council on Medical Service and Council on Science and Public Health recently released a joint report that strongly endorsed value-based insurance design as a potential solution to align clinical and financial incentives for high-value care. The report listed eleven key policy recommendations, including the following: Support clinically nuanced V-BID plans Support the requirement of private health plans to provide coverage for evidence-based preventive services without cost-sharing for patients Support Medicare Advantage V-BID plans Support legislative and regulatory flexibility to implement V-BID, including expanding the safe harbor of HSA-eligible high-deductible health plans to include coverage for preventive care and chronic diseases Encourage national medical specialty societies to identify high-value services and collaborate with payers to experiment with plan designs that align incentives with utilization of high-value services The AMA House of Delegates adopted all report recommendations. To read the full report and AMA News [...]
A Patient-Centered Approach to Medicare Drug Reform Dr. A Mark Fendrick, V-BID Center Director The Trump administration has recently proposed a number of sweeping changes to the Medicare program to curb taxpayer spending on prescription drugs. These include price setting, revamping how doctors and hospitals acquire drugs, and changing how physicians are reimbursed for medicines. The changes apply to “Part B,” the component of Medicare that covers medicines administered in a health-care facility, like gene therapies and advanced treatments for cancer, arthritis, and multiple sclerosis. Today, physicians purchase these medications directly. Each of the suggested reforms are blunt instruments that focus exclusively on drug prices without fully accounting for clinical value. These changes may reduce short-term expenditures, but will likely restrict access to the lifesaving medications that many seniors rely on. These policies also miss the critical clinical point that in certain patient [...]
Achieving Value in Care Delivery: Policy, Politics, and Progress to Support Value-Based Design On Wednesday, October 24th, 2018, Dr. A. Mark Fendrick, MD, Director of the Center for Value-Based Insurance Design (V-BID), spoke at the SHCC V-BID Summit in Washington, DC. Dr. Fendrick spoke about how value-based insurance design can be used to reduce low-value care. You can view his presentation and the summit agenda below. Want to learn more about low-value care? Check out the following resources:
Webinar: V-BID in Diabetes On Thursday, October 4th, 2018, the V-BID Center hosted a webinar in cooperation with the Center for Workforce Health and Performance (CWHP). This interactive program addressed the growing problem of cost-related non-adherence for patients with diabetes and explored the potential role of value-based insurance design in enhancing access to evidence-based care and improving patient centered outcomes. The webinar was moderated by Kim Jinnett, PhD, President of CWHP. Panelists included A. Mark Fendrick, MD, Director of the V-BID Center; J. Frank Wharam, MD, Director of the Division of Health Policy and Insurance Research in Harvard's Department of Population Medicine; and Josh Fangmeier, Research Director for the Employee Insurance Division at Minnesota Management and Budget. View the recording below: https://youtube.com/watch?v=sJmWp1sT1Dc V-BID in Diabetes Webinar Slides V-BID in Diabetes Inforgraphic V-BID in Diabetes Webinar Q&A
This update features policy developments, media reports, and events supporting continued momentum for multiple V-BID Center initiatives.
The University of Michigan Center for Value-Based Insurance Design (V-BID Center) is an advocate for development, implementation, and evaluation of clinically nuanced health benefit plans and payment models. Since its inception in 2005, the V-BID Center has been actively engaged in understanding the impact of consumer engagement initiatives on health outcomes. Through collaboration with employers, consumer advocates, health plans, policy leaders, and academics, the Center hopes to improve clinical outcomes and enhance economic efficiency of the U.S. health care system. Director's Message Dear Friends, As I reflect back on the past two years, the Center for Value-Based Insurance Design (V-BID) has experienced many challenges and triumphs. With that, I am excited to see the progress we have made in shifting the U.S. health care system from one of volume to one of value, and am confident that our progress will be sustained. The year [...]
2020 V-BID Summit Sponsorship Opportunities The 2020 V-BID Summit will be held as a two-day event at the University of Michigan on March 24/25.The Summit invites stakeholders to engage in a highly interactive all-day discussion to address the opportunities and challenges that arise from the conceptual design to the implementation of clinically nuanced payment reform and benefit design strategies across some of today’s most relevant and challenging health care topics. Find agenda here.All donations/sponsorships will be gratefully accepted, including amounts lower and higher than those listed below. Special consideration will be given to non-profit organizations. For more information, please contact Susan Lynne Oesterle at 734-615-9635 or sloester@umich.edu. silver $20,000 Two invitations to the 15th Anniversary Summit Recognition in event program Logo featured on event website Logo featured on event signage gold $30,000 Four invitations to the 15th Anniversary Summit Half-page recognition in event program Logo featured on [...]
Basing patients' medication costs on the health benefits they'll get from a drug, rather than its price, means they're more likely to take it Excerpt from IHPI press release:"Taking a medicine every day in the hopes that it will prevent some long-range potential health catastrophe -- like a heart attack or kidney failure -- isn’t easy.Many people skip doses, or don’t refill their prescriptions on time, or at all. And plenty of studies have shown that the more patients have to pay for those prescriptions, the less likely they are to take them as directed.But new evidence shows the power of a method aimed at changing this behavior: insurance plans that charge patients less for the medicines that could help them most. Some plans even make some of the medicines free to the patients with certain conditions.In an article published in the July issue of Health [...]
Press Release: V-BID Highlighted at Two Congressional Hearings The Health Subcommittee of the Congressional Committee on Ways & Means and the Joint Economic Committee held hearings on lowering health care costs and expanding access to health care. Value-Based Insurance Design principles were highlighted at both hearings as a potential cost-saving, health-improving measure. June 6, 2018: Ways and Means Hearing on Consumer-Directed Health Plans "How do we lower costs and expand access to health care?" The Health Subcommittee of the Congressional Committee on Ways & Means held a hearing on lowering costs and expanding access to health care through Consumer-Directed Health Plans. Value-Based Insurance Design principles were highlighted as a promising reform to high-deductible health plans, particularly in chronic disease management and HSA rule flexibility. Matt Eyles, President and CEO of America’s Health Insurance Plans (AHIP), highlighted that HSAs should have more [...]
This update features policy developments, media reports, and events supporting continued momentum for multiple V-BID Center initiatives.
