News

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 [...]

November 2012, Ann Arbor, MI In their plan for health and fiscal policy, the National Coalition on Health Care (NCHC) refers to value-based insurance design (V-BID) as a "game-changer", putting the concept of value in insurance design at the forefront of ideas that could address fiscal challenges and transform health system incentives. Released earlier this month, the NCHC plan was written after a year of intensive discussions with health experts and others involved in health care delivery.  The plan recommends a policy framework for curbing costs without sacrificing quality and explicitly cites V-BID for its ability to "give consumers incentives to seek out the highest value care." The report references V-BID Center Director Dr. Mark Fendrick's testimony before the Senate Committee on Health, Education, Labor, and Pensions, and suggests that Congress "implement MedPAC's recommendation to empower the Secretary of Health and Human Services (HHS) to vary cost-sharing based on [...]

Evidence accumulates for Value-Based Insurance Design:  Adherence improvements enhanced by plan characteristics February 20, 2012 The basic premise of Value-Based Insurance Design (V-BID) is to align consumer incentives with value by reducing barriers to high-value health services and providers ("carrots").  When "carrots" 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. Recent evaluations add to the published evidence that clinically nuanced copayment reductions lead to improvements in medication adherence.  A 2014 Journal of Managed Care Pharmacy study reported that copay reductions for Medicare beneficiaries prescribed statins resulted in a 5.9% increase in adherence over 6 months compared to those paying standard copayments.  A second [...]