CENTER UPDATE | Late March 2021

This update features recent policy developments, literature items, media reports, and events
supporting continued momentum for multiple V-BID Center initiatives throughout March.

Recording Available: Virtual V-BID Summit 2021 - 20 Years of Impact & Innovation

On Wednesday, March 10th, over 600 participants attended the 2021 V-BID Summit. The webinar featured a roster of leaders from across the health care spectrum to celebrate the 20th anniversary of the first V-BID publication and discuss the future of value-based insurance design. Click here to view a webinar recording!
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Millions More Smokers, Ex-Smokers Recommended For Free Annual Lung Cancer Screenings

On March 9th, the US Preventive Services Task Force updated recommendations for lung cancer screening, encouraging people with a long smoking history to get screened at age 50 and broadening the definition of people considered at high risk of lung cancer. The expanded testing must be covered without patient cost-sharing, and it has the potential to save lives and especially benefit Black people and women.

Financial Pollution in the U.S. Health Care System

Low-value care costs billions of dollars per year and harms population health. Authors of a recent JAMA Insight recommend the term financial pollution be used to describe wasteful care and its insidious effects on the population. Policymakers should examine effective approaches for addressing environmental pollution while designing methods to reduce health care financial pollution.

Out-of-Pocket Spending for Retail Prescribed Drugs by Age and Type of Prescription Drug Coverage, 2009 to 2018

Data from the Medical Expenditure Panel Survey suggests that overall patient affordability of retail prescription drugs may have stabilized or improved in recent years. Aggregate out-of-pocket spending on prescription drugs fell 17.5% from 2009 to 2016, and declines in out-of-pocket costs were observed in all age and insurance status subgroups.

Why Nearly Everyone Hates Cost-Sharing

While cost-sharing levels are widely criticized as too high and harming medically vulnerable populations, overall out-of-pocket spending as a share of total national health expenditures has consistently declined over the past 60 years. Other factors are driving increases in total health care costs and the use of wasteful care. Cost-sharing should be targeted more carefully to limit the use of low-value care.

Monthly Cost-Sharing Doubles Throughout the Year for Some Medicare Insulin Users

The price of insulin has skyrocketed over the last decade, leading to considerable increases in out-of-pocket costs for Medicare Part D beneficiaries. Despite recent efforts to close the Part D coverage gap, Medicare beneficiaries still face highly variable monthly out-of-pocket costs. New research examines how use of insulin changes as cost-sharing fluctuates throughout the year.

Uptake of Statin Guidelines to Prevent and Treat Cardiovascular Disease

In a recent study, patients’ adherence to statin therapy guidelines only increased slightly after treatment guidelines were changed in 2013, and only half of all high-risk patients were on any statin. In addition to ensuring guidelines will target patients who will benefit the most from treatment, the role of out-of-pocket costs in statin nonadherence for high-risk patients should be examined.

Responding to Health-Improving but Cost-Ineffective Care

In contrast to no-value care, low-value care may improve the health of those receiving it, but it also reduces the benefits of health care spending to below what is achievable through other investments. A new theory-based approach suggests that reducing the quantity of heath-improving but cost-ineffective care should be the final step in the process of reducing health spending.

Avoiding a Crisis with High-Deductible Insurance Plans: A Teachable Moment

High-deductible health plans may be attractive for patients who infrequently use care or cannot afford higher premiums. However, if care is needed, the high deductible may deter patients from seeking appropriate care. A case study presented in JAMA Internal Medicine shows how high-deductibles can be detrimental to timely diagnosis and treatment of disease.

Expanding Health Coverage Is Good - But We Also Need to Fix Stingy Plans

While the Biden administration has taken steps to reduce the number of uninsured Americans, more attention is needed to the problem of underinsurance. One in five Americans are underinsured, and many are enrolled in high-deductible health plans that expose members to high levels of cost-sharing. To address this issue, the government could offer incentives for employers to adopt more flexible HDHP benefit designs.

Timeline: 20 Years of Impact - V-BID Policy Achievements

To celebrate the 20th anniversary of the first V-BID publication, we have highlighted key V-BID policy developments over the last two decades. Click here to scroll through the timeline and learn how V-BID policies have improved quality, enhanced patient experience, and promoted cost-containment over the past two decades.

Please Help Support the V-BID Center

As a non-profit entity, the V-BID Center relies on fundraising to support our research, education, and policy efforts. Please help us continue our work by donating here. We truly appreciate your consideration.

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