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Value-Based Insurance Design: Helping Employers Improve the Value of Health Care
Date:8/24/2009

hlights how companies like Caterpillar, Inc., Hannaford Brothers Company, and UnitedHealthcare, among others, have improved employee health via one of the four basic approaches to VBID:

    - Design by service, in which copayments or coinsurance are waived or
      reduced for select drugs or services, such as statins or cholesterol
      tests, no matter which patients are using them.

    - Design by condition, in which copayments or coinsurance are waived or
      reduced for medications or services, based on the specific clinical
      conditions with which patients have been diagnosed.

    - Design by condition severity, in which copayments or coinsurance are
      waived or reduced for high-risk members who would be eligible for
      enrollment in a disease management program.

    - Design by disease management participation, in which high-risk members
      who actively participate in a disease management program are provided
      reduced or waived copayments or coinsurance.

"VBID, along with comparative effectiveness research, could assist public and private payers in realizing the best value for their health care dollar while improving the quality of health care services and employee health," said NPC President Dan Leonard. "These programs already are leading to a healthier workforce, with reductions in absenteeism, medical disability, and productivity losses associated with health conditions. Implementing them on a wider scale could help policy makers reach their goal of improving quality in the system while 'bending the curve' of overall health care spending in the right direction."

The study and a video interview with Dr. Fendrick are available on NPC's website at http://www.npcnow.org.

About the National Pharmaceutical Council

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