Highlights...
November 19, 2009
Senate Healthcare Reform Proposal Includes Concepts of Value-Based Insurance Design
Last night, U.S. Senate Majority Leader Harry Reid (D-NV) released the Patient Protection and Affordable Care Act. This legislation represents a combination of bills passed previously by the Senate Finance and Health, Education, Labor & Pensions Committees, and will become the vehicle for debate on health care reform in the Senate. Section 2713 (c) of the legislation [page 18] allows the Secretary of Health and Human Services to develop guidelines to permit health plans to use the concepts of value-based insurance design in providing coverage.
November 9, 2009
House of Representatives Healthcare Reform Legislation Highlights Value-Based Insurance Design
On Saturday November 7, the House of Representatives passed H.R. 3962, the Affordable Health Care for America Act, by a vote of 220-215. The legislation would allow health benefits plans to modify cost-sharing and payment rates to encourage the use of services that promote health and value. Please see Section 324 (c) of the bill, located on page 219.
October 2009
Leaders of the University of Michigan Center for Value-Based Insurance Design and the Center for Health Value Innovation provided testimony to the State of Michigan House of Representatives’ Committee on Public Employee Health Care Reform. This committee was created by House Speaker Andy Dillon (D-Redford Township) in August 2009 to analyze his proposal to overhaul public employee health care in Michigan, H.B. 5345.
More Information
A. Mark Fendrick, MD Testimony
Ms. Cyndy Nayer Testimony
September 2009
Numerous academic articles and press reports note the role of Value-Based Insurance Design in health care reform. In particular, founding VBID Center Director Michael Chernew joined Former CMS administrator Mark McClellan and a bipartisan group of health policy experts to release "Bending the Curve: Effective Steps to Address Long- Term Health Care Spending Growth". As one of the key reforms to promote value, the report calls to "Establish tiered copays consistent with the principles of value-based insurance design".
August 2009
The August 2009 edition of Managed Care prominently features value-based insurance design. The magazine cover cites Denis Cortese, MD, CEO of the Mayo Clinic, noting that value-based insurance design is “a great idea”…catching on with some health plans and employers – even the U.S. Senate. The article quotes Center for Value-Based Insurance Design co-director A. Mark Fendrick and founding director Michael Chernew, and highlights the University of Michigan’s MHealthy: Focus on Diabetes project, among others. Read More
August 19, 2009
Founding VBID Center Director Michael Chernew, PhD, Discusses Health Care Reform in Time.com.
As reported in TIME's article, A Public Option vs. Co-Ops: What's the Difference?, Dr. Chernew describes various reactions to the proposed government-sponsored health insurance mechanism, and how it might address coverage and cost issues. Read More
July 28, 2009
The Center for Value-Based Insurance Design and the National Pharmaceutical Council are pleased to announce publication of a report entitled, "Value-Based Insurance Design Landscape Digest." This report defines the concept of value-based insurance design (VBID), outlines key objectives, design features and potential barriers to implementation, and describes evaluation tools for measuring the outcomes of VBID programs. In addition, it provides examples of existing VBID programs and reviews the clinical and economic implications of VBID.
Read Report
Press Release
Video
V-BID Faculty Receive National Award
On June 15, the National Institute for Health Care Management Foundation presented V-BID faculty with the 2009 Health Care Research Award for “Impact of Decreasing Copayments on Medication Adherence Within a Disease Management Environment,” published in Health Affairs in January 2008. Selected unanimously by the judges as the best health services research of the year, the article revealed the potential of reducing copayments on high value pharmaceuticals to alter patient behavior and improve medication adherence.
NIHCM Foundation
Press Release
May 14, 2009
Federal Legislation to Advance Concepts of Value-Based Insurance Design in Medicare
Senators Debbie Stabenow (D-MI) and Kay Bailey Hutchison (R-TX) introduced S. 1040, the “Seniors’ Medication Copayment Reduction Act of 2009,” advancing the principles of value-based insurance design in the Medicare population. This legislation will establish a five-year demonstration program using value-based insurance design to assess the impact of a reduction in copayments or coinsurance charged Medicare beneficiaries for certain high value medications on adherence to those medications.
Senator Stabenow Press Release
More Information
Read the Bill
April 7, 2009
"A Controlled Trial of Value- Based Insurance Design -- The MHealthy: Focus on Diabetes Trial" describing the design and implementation of the first prospective controlled trial of targeted co- payment reductions for high value therapies for individuals with diabetes has been published in the current issue of Implementation Science. Read More
March 26, 2009
The National Pharmaceutical Council co-sponsored a town hall on Value Based Benefit Design with the New York Business Group on Health (NYBGH).
Watch the webcast on Value Based Benefit Design: Promoting Value, Quality and Access
March 20, 2009
Commonwealth Fund Quality Matters Podcast: Increasing the Value of Health Care
Listen to an Interview with Dr. A. Mark Fendrick, Co-Director of the Center for Value-Based Insurance Design of the University of Michigan
March 3, 2009
Immediate Options Exist to Integrate Value-Based Insurance Design into
Medicare Part D
On March 3, the Center for Value-Based Insurance Design and Avalere Health released a paper showing that the Medicare program could immediately modernize its benefit structure to incorporate value-based insurance design. Read Paper
Read Press Release
February 6, 2009
Senator Debbie Stabenow and Representative John Dingell
Host Congressional Staff Briefing
“Value-Based Insurance Design: Restoring Health to the Health Care Reform Debate”
Read Story
View Dr. Fendrick's PowerPoint presentation from the briefing (2.26MB PDF)
January 5, 2009
Staying Healthy in a Tough Economy -
While many individuals are dealing with cutbacks, it is important that health care remain a top priority, says Center Co-director A. Mark Fendrick, MD. Read Press Release
Watch a video of Dr. Fendrick explaining ways that patients can continue to adhere to their health care regimen, despite economic hardships.
The University of Michigan Center for Value-Based Insurance Design was established in 2005 to develop, evaluate, and promote value-based insurance initiatives that achieve improvements in health outcomes and contain health care costs. The Center is the first academic venue in which faculty with both clinical and economic expertise conduct empirical research to determine the health and economic impact of innovative benefit designs.
Value-based insurance design offers a potential solution to the health care financing crisis. Value – the clinical benefit achieved for the money spent – is absent from the current dialogue on how to solve the health care dilemma. Instead, the dialogue focuses on two trends in benefit design – cost containment and quality improvement – which create a conflict of incentives for patients. For example, employers increasingly enroll beneficiaries in expensive disease management programs designed to improve patient self-management, often by intervening to enhance compliance with specific medications. However, at the same time, rising copayments and greater cost-sharing create financial barriers that discourage the use of recommended services. When patients are required to pay more for their health care, it is well known that they buy less – of both essential and excessive therapies alike. Value-based benefit packages would adjust out-of-pocket costs on an assessment of the clinical benefit to the specific patient population. Thus, the more clinically beneficial the therapy for the patient, the lower that patient's cost share would be. By aligning financial incentives, this strategy would encourage the use of high-value care while discouraging the use of low-value or unproven services.
Watch a video of Dr. Fendrick explaining the concept of "value-based insurance design" and its implications to patients, employers and insurers.