Here’s the bare-minimum definition of value-based insurance design: Those who are the most ill should pay the least for treatment.
The concept of VBID is a bit more complex, of course, but at its core, VBID would let those who would benefit the most from medications and other health care services pay the lowest in copayments and deductibles. In other words, there would be low or no financial barriers to the care these patients need.
Now let’s take the idea one step further. If some medications and medical services are so clearly beneficial that the insured would benefit to the point where savings would result, then should health insurers consider paying members to take some medications? And, should insurers also pay members to get certain high-value services?
On Thursday, A. Mark Fendrick, M.D., the director of the Center for Value-Based Insurance Design at the University of Michigan, will explain VBID in detail and address this somewhat startling possibility. In particular, he will discuss why health insurers should adopt VBID and why members of Congress in HR 5138 (pdf) are urging the federal Centers for Medicare & Medicaid to evaluate the effects of VBID for Medicare Advantage members.