Adjusting cost sharing to recognize clinical and financial differences among treatments and patients can improve care and save money, according to an article on “value-based insurance design” published on the Health Affairs web site. The authors, who are affiliated with the University of Michigan Center for Value-Based Insurance Design, advocate developing a “clinically sensitive” benefit design that encourages the use of cost-effective medical interventions by reducing or eliminating copayments, while raising cost-sharing requirements for inappropriate treatments that might otherwise be overused.
Employers are currently experimenting with two general approaches to VBID: targeting certain services deemed clinically valuable for copayment reduction, and lowering cost sharing for specific, high-value services for patients with specific clinical indications. The authors emphasize that “the driving idea behind VBID” is not saving money, but rather “that the use of high-value services should be encouraged.”
