Value-Based Insurance Design

More Health at Any Price

For many health insurance plans, regardless of the clinical indication, out-of-pocket amounts for patients are the same for many health care services. Research, however, indicates that static out-of-pocket fees lead to underuse of high-value services and overuse of interventions with little or no clinical benefit.

This article explores value-based insurance design (V-BID), which acknowledges the importance of cost-sharing, but aligns patient contributions with the intervention’s potential for clinical benefit. This allows patients to make treatment decisions based on the service and its value. This article explains what V-BID is and its progression from idea to practice.

Recent research has demonstrated that patients use services with high clinical benefit less often when it costs them more. Recent V-BID demonstration projects show that V-BID is “feasible, acceptable to employees, and produces clinical and economic returns,” (Mahoney 2008). Growing evidence and education of V-BID’s potential merits in both addressing quality improvement, and cost containment and advocacy work ensured its inclusion in the Patient Protection and Affordable Care Act (PPACA).

Special Issue of Health Services Research Links Health Care Research and Health Policy

  1. 1 Expanding the Safety-Net of Specialty Care for the Uninsured
  2. 2 Translation of Evidence-Based Clinical Standards into a New Prehospital Resuscitation Policy in Los Angeles
  3. 3 Physician Social Networks and Variation in Prostate Cancer Treatment in Three Cities
  4. 4 Value-Based Insurance Design
  5. 5 Is Patient Safety Improving?
  6. 6 The Association of Health Insurance and Disease Impairment with Reported Asthma Prevalence in U.S. Children
  7. 7 A Policy Impact Analysis of the Mandatory NCAA Sickle Cell Trait Screening Program
  8. 8 Nonfinancial Barriers and Access to Care for US Adults
  9. 9 Physician Practices and Readiness for Medical Home Reforms
  10. 10 Does a Video-Interpreting Network Improve Delivery of Care in the Emergency Department?
  11. 11 Comparative Cost Analysis of Housing and Case Management Program for Chronically Ill Homeless Adults Compared to Usual Care
  12. 12 State-Level Variations in Racial Disparities in Life Expectancy
  13. 13 "Does this Doctor Speak My Language?"

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