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