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Value-based insurance design: quality improvement but no cost savings.

Publication ,  Journal Article
Lee, JL; Maciejewski, M; Raju, S; Shrank, WH; Choudhry, NK
Published in: Health Aff (Millwood)
July 2013

Value-based insurance design (VBID) is an approach that attempts to improve the quality of care by selectively encouraging or discouraging the use of specific health care services, based on their potential benefit to patients' health, relative to their cost. Lowering beneficiary cost sharing or out-of-pocket spending to increase medication adherence is one common element of value-based insurance design. We conducted a systematic review of the peer-reviewed literature to evaluate the evidence of the effects of VBID policies on medication adherence and medical expenditures. We identified thirteen studies assessing the effects of VBID programs and found that the programs were consistently associated with improved adherence (average change of 3.0 percent over one year), as well as with lower out-of-pocket spending for drugs. In the studies we reviewed, providing more generous coverage did not lead to significant changes in overall medical spending for patients and insurers. Further research is needed to understand how best to structure VBID programs to both improve quality and reduce spending.

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Published In

Health Aff (Millwood)

DOI

EISSN

1544-5208

Publication Date

July 2013

Volume

32

Issue

7

Start / End Page

1251 / 1257

Location

United States

Related Subject Headings

  • Value-Based Purchasing
  • United States
  • Quality Improvement
  • Medication Adherence
  • Insurance Coverage
  • Humans
  • Health Policy & Services
  • Health Expenditures
  • Health Care Reform
  • Drug Costs
 

Citation

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Lee, J. L., Maciejewski, M., Raju, S., Shrank, W. H., & Choudhry, N. K. (2013). Value-based insurance design: quality improvement but no cost savings. Health Aff (Millwood), 32(7), 1251–1257. https://doi.org/10.1377/hlthaff.2012.0902
Lee, Joy L., Matthew Maciejewski, Shveta Raju, William H. Shrank, and Niteesh K. Choudhry. “Value-based insurance design: quality improvement but no cost savings.Health Aff (Millwood) 32, no. 7 (July 2013): 1251–57. https://doi.org/10.1377/hlthaff.2012.0902.
Lee JL, Maciejewski M, Raju S, Shrank WH, Choudhry NK. Value-based insurance design: quality improvement but no cost savings. Health Aff (Millwood). 2013 Jul;32(7):1251–7.
Lee, Joy L., et al. “Value-based insurance design: quality improvement but no cost savings.Health Aff (Millwood), vol. 32, no. 7, July 2013, pp. 1251–57. Pubmed, doi:10.1377/hlthaff.2012.0902.
Lee JL, Maciejewski M, Raju S, Shrank WH, Choudhry NK. Value-based insurance design: quality improvement but no cost savings. Health Aff (Millwood). 2013 Jul;32(7):1251–1257.

Published In

Health Aff (Millwood)

DOI

EISSN

1544-5208

Publication Date

July 2013

Volume

32

Issue

7

Start / End Page

1251 / 1257

Location

United States

Related Subject Headings

  • Value-Based Purchasing
  • United States
  • Quality Improvement
  • Medication Adherence
  • Insurance Coverage
  • Humans
  • Health Policy & Services
  • Health Expenditures
  • Health Care Reform
  • Drug Costs