Phone: 734-615-9635|Email: vbidcenter@umich.edu
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So far V-BID Interns has created 328 blog entries.

Shifting the Healthcare Cost Discussion from “How Much” to “How Well”

Despite large, innovative improvements in medicine, cost growth in healthcare is the main focus for healthcare reform. The V-BID Center proposes that we shift the healthcare cost discussion from "how much" to "how well" through clinical nuance. This new approach takes into consideration that services differ in the clinical benefit produced and that clinical benefit depends on the patient, provider, and healthcare setting. Through clinically-nuanced cost sharing, we can encourage patients to use high value services and discourage them from using low value services. Watch the video to learn more. View our 'Clinical Nuance' Infographic by clicking the button below.

V-BID Interns2019-10-30T18:17:02+05:00April 5th, 2014|Videos|
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V-BID in Action: Michigan Medicaid Expansion

V-BID in action: Michigan Medicaid Expansion February 25, 2014 In September 2013, Michigan became the 25th state to expand Medicaid under the Affordable Care Act. The new Healthy Michigan Plan will provide coverage to an additional 470,000 residents over the next several years.  Among the provisions of Public Act 107 of 2013, the Healthy Michigan Plan relies on V-BID to improve access, control costs, and enhance personal responsibility. Read more in our newest V-BID Brief: Michigan Medicaid Expansion. Incorporating V-BID into the Healthy Michigan Plan follows the recent CMS rule giving Medicaid programs greater flexibility to vary enrollee cost-sharing for drugs as well as certain outpatient, emergency department, and inpatient visits. When V-BID principles are used to set enrollee cost-sharing levels, Medicaid programs can improve quality of care, remove waste, foster consumer engagement, and mitigate the legitimate concern that non-nuanced cost-sharing may lead individuals to forgo clinically important [...]

V-BID Interns2020-01-03T17:54:14+05:00February 25th, 2014|Press Releases|
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Consumer Operated and Oriented Plans: A Potential Role for V-BID Implementation

Consumer Operated and Oriented Plans:  A Potential Role for V-BID Implementation [1] Originally Produced: January 2014. Updated: July 2016 Introduction Value-Based Insurance Design (V-BID) aligns consumer incentives with value by reducing barriers to high-value clinical services and providers (“carrots”) and by discouraging the use of low-value services and providers (“sticks”).  V-BID is driven by the concept of clinical nuance which recognizes that:  1) medical services differ in the benefit provided; and 2) the clinical benefit derived from a specific service depends on the patient using it, who provides it, and where the service is delivered.  V-BID is included in the Affordable Care Act (ACA) and a 2013 CMS rule which permits State Medicaid programs to alter co-payments for provider visits and prescription drugs.  Currently, hundreds of public and private organizations utilize V-BID principles to enhance health outcomes and constrain cost growth.  This brief offers an overview of Consumer Operated [...]

V-BID Interns2020-02-05T22:55:03+05:00January 1st, 2014|Briefs|
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Harvard Business Review: Smarter Consumer Cost Sharing Using Clinical Nuance

Harvard Business Review Insight Center: Smarter Consumer Cost Sharing Using Clinical Nuance November 18, 2013 The Harvard Business Review Insight Center features a collaborative blog post on smarter "clinically nuanced" consumer cost-sharing by Drs. Mark Fendrick and John Ayanian, Directors of the University of Michigan Center for Value-Based Insurance Design (V-BID) and Institute for Healthcare Policy and Innovation (IHPI), respectively. The blog post recommends that the focus of the health care cost debate turn from how much to how well we spend our health care dollars.  To encourage this shift from volume to value, Fendrick and Ayanian contend that insurance benefits and payment models must be redesigned with the basic V-BID tenets of clinical nuance in mind.  These tenets recognize that 1) medical services and providers differ in the amount of health produced, and 2) the clinical benefit derived from a specific service depends on the consumer using [...]

V-BID Interns2020-01-06T16:56:48+05:00November 18th, 2013|News|
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V-BID in Action: Michigan Medicaid Expansion

Originally Produced:  August 2013   Updated:  February 2014V-BID in Action:  Michigan Medicaid ExpansionIntroductionValue-Based Insurance Design (V-BID) is an innovative approach that can improve clinical outcomes and contain costs.  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 benefit provided;  and 2) the clinical benefit derived from a specific service depends on the patient using it, as well as when and where the service is provided.  By Incorporating greater clinical nuance into benefit design, payers, purchasers, taxpayers, and consumers can attain more health for every dollar spent.Federal Government Allows V-BID in [...]

V-BID Interns2020-07-28T01:10:03+05:00August 29th, 2013|Briefs|
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V-BID in the New York Times: When Co-Pay Impedes Health

August 13, 2013 In a recent New York Times article, Harvard economist Sendhil Mullainathan articulates strong support for clinically nuanced value-based insurance design (V-BID) programs.  Mullainathan highlights the well-documented problem of cost-related medication non-adherence and recommends that high-value drugs such as those that treat heart disease and diabetes be provided at no cost to the populations that need them. The concept of 'clinical nuance' was developed at the University of Michigan Center for Value-Based Insurance Design.  The basic tenets of clinical nuance are: 1) medical services and providers differ in the benefit provided; and 2) the clinical benefit of the service depends on the person using it, as well as where and by whom the service is provided.  Unlike "one-size-fits-all" plan designs that set a single co-payment for all clinician visits, diagnostic tests and drugs, V-BID programs base cost-sharing on the clinical value of the service--not the cost.  Published evidence [...]

V-BID Interns2020-01-06T17:43:03+05:00August 13th, 2013|Press Releases|
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Implementing V-BID in State Medicaid Programs

New Regulations Permit Use of Value-Based Insurance Design in State Medicaid Programs Originally Produced: July 2013   Updated: June 2016. Introduction Value-Based Insurance Design (V-BID) is an innovative approach that can improve clinical outcomes and contain costs.  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 benefit provided; and 2) the clinical benefit derived from a specific service depends on the patient using it, as well as when and where the service is provided. Incorporating greater clinical nuance into benefit design, payers, purchasers, taxpayers, and consumers can attain more health [...]

V-BID Interns2022-09-23T20:13:42+05:00July 1st, 2013|Briefs|
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States looking at V-BID for exchanges and Medicaid

June 25, 2013 Value-Based Insurance Design (V-BID), a concept developed and researched by the V-BID Center at the University of Michigan, has garnered recent attention from high profile state health policy makers.  In a U.S. House of Representatives Energy and Commerce Committee hearing, Anthony Keck, Director of the South Carolina Department of Health and Human Services, testified that he was a "strong believer in V-BID" and hoped to use clinically nuanced designs in the state's Medicaid program.  View the video here.  Medicaid policy expert Seema Verma supported the use of V-BID in Medicaid during her testimony at the same hearing. Separately, during a national summit on state health insurance exchanges, Dr. Joshua Sharfstein, Secretary of the Maryland Department of Health and Mental Hygiene, noted that his state was examining V-BID's role in the Maryland Health Benefits Exchange and that the V-BID concept could "improve health outcomes and lower costs."  View the video here. Both Sharfstein and Keck [...]

V-BID Interns2020-01-06T17:47:08+05:00June 25th, 2013|Press Releases|
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Implementing Value-Based Insurance Design in Medicare Advantage

Originally Produced:  June 2013   Updated:  February 2016 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. [...]

V-BID Interns2020-01-06T17:50:14+05:00June 1st, 2013|Briefs|
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Key stakeholders support V-BID

April 17, 2013 A recent report published by the Partnership for Sustainable Health Care and funded by the Robert Wood Johnson Foundation singled out the adoption of Value-Based Insurance Design (V-BID) as one of five recommendations to sustain affordability and quality in America's health care system.  This inclusion again highlights the V-BID concept as one of a small number of ideas with strong, bipartisan support to control costs, enhance clinical outcomes and create a better experience for patients. The report is the result of discussions of a diverse group of organizations that came together over the past year to develop reforms to improve efficiency, efficacy and value in the U.S. health system.  Influential groups including America's Health Insurance Plans, Families USA, the Pacific Business Group on Health, the National Coalition on Health Care, Ascension Health and the American College of Surgeons contributed to the report. "Value-Based Insurance [...]

V-BID Interns2020-01-06T17:53:10+05:00April 17th, 2013|Press Releases|
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V-BID and Grandfathered Health Plans: Promoting High Value Services and Controlling Costs

Originally Produced: April 2013   Updated: July 2016. V-BID and Grandfathered Health Plans: Promoting High Value Services and Controlling Costs Introduction Value-Based Insurance Design (V-BID) is an innovative approach that can improve clinical outcomes and contain costs.  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 healthcare quality and controls spending growth.  The concept of clinical nuance recognizes that: 1) medical services differ in the benefit provided; and 2) the clinical benefit derived from a specific service depends on the patient using it, as well as when and where the service is provided. Maintaining Grandfathered Health Plan Status Allowing Americans to keep their existing health insurance was a critical element of [...]

V-BID Interns2020-01-06T18:00:54+05:00April 1st, 2013|Briefs|
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February 26, 2013: U.S. House Ways and Means Subcommittee on Health

U.S. House Ways and Means Subcommittee on Health V-BID Center director A. Mark Fendrick testified at a hearing on Medicare benefit design before the U.S. House Ways and Means Subcommittee on Health Dr. Fendrick's testimony focused on the importance of re-designing Medicare benefits to engage beneficiaries to utilize evidence-based clinical services and high performing providers, as well as the quality improvement and cost containment that result when clinical nuance is incorporated in benefit design. Video of the testimony is available.  

V-BID Interns2020-01-15T18:04:22+05:00February 26th, 2013|News, Press Releases|
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February 26, 2013: U.S. House Ways and Means Subcommittee on Health

U.S. House Ways and Means Subcommittee on Health V-BID Center director A. Mark Fendrick, M.D.,  testified at a hearing on Medicare benefit design before the U.S. House Ways and Means Subcommittee on Health. Dr. Fendrick's testimony focused on the importance of re-designing Medicare benefits to engage beneficiaries to utilize evidence-based clinical services and high performing providers, as well as the quality improvement and cost containment that result when clinical nuance is incorporated in benefit design. Video of the testimony is available below.     Additional testimony resources can be found below:            

V-BID Interns2020-01-20T15:59:37+05:00February 26th, 2013|Resources, Testimonies|
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A Roadmap to Using V-BID in State Exchanges

February 7, 2013 According to two recently published reports, the successful implementation of value-based insurance design (V-BID) in state exchanges is contingent on transparency and consumer education efforts.  As officials from California and other states contemplate V-BID options for their exchanges, the commentaries initiate a roadmap to effective execution. A Robert Wood Johnson Foundation funded study, published in this month's Health Affairs, praises V-BID plans for their ability to align provider/patient incentives and "reward value of care over volume of care."  The authors note the trade-offs between the flexibility required to implement clinically nuanced value-based insurance designs and the simplification permitted by a standard benefit design.  In their analysis, the authors note the evidence base for V-BID and recommend ways to support consumers who may be interested in choosing these plans. A second paper from Consumers Union lays out six evaluative criteria that should be met by California [...]

V-BID Interns2020-01-06T18:10:17+05:00February 7th, 2013|Press Releases|
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V-BID in Action: Driving Value through Clinically Nuanced Incentives

Originally Produced: February 2013   Updated: July 2016. V-BID in Action: Driving Value through Clinically Nuanced Incentives Introduction Value-Based Insurance Design (V-BID) is an innovative approach that can improve clinical outcomes and contain costs.  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" are coupled with "sticks" in a clinically nuanced manner, V-BID improves health care quality and controls spending growth.i Dangers of a Blunt Approach It has been shown that when patients are faced with increases in cost-sharing applied to all services regardless of clinical benefit, they reduce their use of both high-value and low-value services.  While this blunt approach potentially lowers expenditures in the short-term, the cost-related noncompliance with high- value services leads to inferior health outcomes and higher [...]

V-BID Interns2020-01-15T18:03:20+05:00February 1st, 2013|Briefs|
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