Value-Based Insurance Design: Helping Employers Improve the Value of Health Care
Posted on: Monday, 24 August 2009, 14:52 CDT
The report, "Value-Based Insurance Design Landscape Digest," authored by
Dr.
"Under a VBID program, the alignment of financial incentives - for patients and providers - encourages the use of high-value care, while discouraging the use of low-value or unproven services. Ultimately, this can produce more health at any level of health care expenditure," said Dr. Fendrick.
In the report, Fendrick explains how VBID encompasses several key principles: value equals the clinical benefit achieved for the money spent; health care services differ in the health benefits they produce; and the value of health care services depends upon the individual who receives them. The more clinically beneficial a therapy is for a patient, the lower the patient's cost share. Thus, VBID encourages the use of medically necessary therapies and services and reduces barriers to access for these services.
The report also highlights how companies like Caterpillar, Inc., Hannaford Brothers Company, and UnitedHealthcare, among others, have improved employee health via one of the four basic approaches to VBID:
- Design by service, in which copayments or coinsurance are waived or reduced for select drugs or services, such as statins or cholesterol tests, no matter which patients are using them. - Design by condition, in which copayments or coinsurance are waived or reduced for medications or services, based on the specific clinical conditions with which patients have been diagnosed. - Design by condition severity, in which copayments or coinsurance are waived or reduced for high-risk members who would be eligible for enrollment in a disease management program. - Design by disease management participation, in which high-risk members who actively participate in a disease management program are provided reduced or waived copayments or coinsurance. "VBID, along with comparative effectiveness research, could assist public
and private payers in realizing the best value for their health care dollar
while improving the quality of health care services and employee health,"
said NPC President
The study and a video interview with Dr. Fendrick are available on NPC's website at http://www.npcnow.org.
About the National Pharmaceutical Council
NPC's overarching mission is to sponsor and conduct scientific analyses of the appropriate use of biopharmaceuticals and the clinical and economic value of innovation. The organization's strategic focus is on evidence-based medicine (EBM) for health care decision-making, to ensure that patients have access to high-quality care. NPC was established in 1953 and is supported by the nation's major research-based biopharmaceutical companies. For more information, visit http://www.npcnow.org.
Contact:
SOURCE National Pharmaceutical Council
Source: PR Newswire
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