On October 26, 2016, leaders from across the health care spectrum came together to discuss strategies for tackling some of the industry’s most relevant challenges at the University of Michigan Center for Value-Based Insurance Design‘s 2016 V-BID Summit: Precision Medicine Needs Precision Benefit Design.
Dr. Marschall S. Runge, University of Michigan Health System Executive Vice President for Medical Affairs, delivered the welcoming remarks to kick off Wednesday’s panel discussions. The day-long summit consisted of 4 interactive sessions: Aligning Precision Medicine with Precision Payment and Benefit Design, Insured But Not Covered – Reducing Underinsurance, Determining Value, and Addressing Low-Value Care. All panels were moderated by Clifford Goodman of the Lewin Group.
Aligning Precision Medicine with Precision Payment and Benefit Design
- David Cowling, California Public Employees’ Retirement System (CalPERS)
- Claire Levitt, Deputy Commissioner, NYC Mayor’s Office of Labor Relations
- John Rother, National Coalition on Health Care
Moderator: Clifford Goodman, Lewin Group
In the first session, panelists kicked off the day by talking about their approaches to incorporating V-BID. David Cowling (CalPERS) spoke about how to incorporate V-BID more broadly into plan design and the panel quickly jumped right into the need to align provider and consumer initiatives to ultimately achieve the Triple Aim. Claire Levitt (NYC Mayor’s Office) discussed shifting care to the appropriate setting by establishing the appropriate co-payments, so we can move towards providing high-value health care. John Rother (National Coalition on Health Care) highlighted the importance of changing provider behaviors in conjunction with consumer behaviors to aid in reducing low-value care. The panel agreed that in order to be most successful, provider and consumer incentives need to be aligned and must be done in tandem with addressing high-price and low-value care. Much of this work can be guided through the application of clinical nuance. The conversation concluded with an enthusiastic discussion about how precision medicine may be re-framing the definition of health equity, as we work to ensure that access to services will allow for optimal care for everyone’s respective needs. This new approach illustrates how, as Claire Levitt said, “equity is not one size fits all.”
For additional information, please read the American Journal for Managed Care (AJMC) blog post: The Changing Definition of Equity in Healthcare
Insured But Not Covered - Reducing Underinsurance
- Gary Bacher, Smarter Healthcare Coalition
- Michael Chernew, Harvard University
- Robert W. Dubois, National Pharmaceutical Council
Moderator: Clifford Goodman, Lewin Group
The second panel began with health experts discussed the evolution of the issue of underinsurance and how V-BID principles can address the burden this has on key health care stakeholders – most importantly patients. Gary Bacher (Smarter Healthcare Coalition) reflected on the impact of high deductible health plans and the new financial challenges facing consumers; whereas before there was the potential to suffer a catastrophic financial event from medical bills, the new landscape has prevented some individuals from seeking care because of high, unmet deductibles. One potential solution is the high-value health plan. Michael Chernew (Harvard University) spoke to an underlying cause of this issue: the high price of care. “We don’t have a reasonable mechanism for segments of the population to afford care as currently presented. Benefit design is the easiest lever to pull,” he said. Robert Dubois (National Pharmaceutical Council) echoed the conversation around equity that began in the first panel, mentioning the need to balance equity with beneficence and autonomy. The panel concluded by discussing how to manage two growing issues: 1) growing inequality impacting health care benefits; and 2) managing the cost of care based on conditions.
For additional information, please read the American Journal for Managed Care (AJMC) blog post: Addressing Underinsurance With a More Clinically Nuanced Approach[/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]