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November newsletter highlights include:
Smarter consuming cost-sharing using clinical nuanceHarvard

The Harvard Business Review Insight Center features a collaborative blog post on smarter "clinically nuanced" consumer cost-sharing by Drs. Mark Fendrick and John Ayanian, Directors of the University of Michigan Center for Value-Based Insurance Design (V-BID) and Institute for Healthcare Policy and Innovation (IHPI).

The blog post explores how "one-size-fits-all" increases in consumer cost-sharing can lead to decreases in the use of both essential and nonessential services. To mitigate the negative health effects of cost-related lower utilization of evidence-based services, Fendrick and Ayanian advocate that payers utilize evidence-based recommendations and patient risk factors to structure cost-sharing. By basing consumer cost-sharing on the clinical value - not the price - of services, payers can actively engage consumers to seek high-value care and foster more regular conversations with providers regarding low-value services.

Healthcare Payer News: V-BID goes mainstreamHealthcarepayer

Healthcare Payer News recently featured an overview of key V-BID concepts as well as examples of how clinical nuance can be applied across the spectrum of high-deductible health plans, state employee health plans and Medicaid and Medicare plans.    
Commonwealth: U.S. adults skip the most care and pay highest out-of-pocketcommonwealth 

new international survey and infographic from The Commonwealth Fund surveyed 11 industrialized nations and reports that adults in the United States pay the most out-of-pocket for care and are far more likely to go without health care because of the cost and the hassle of time-consuming health insurance paperwork.  
New York Times: Discussing the cost of careNYT  

In a recent NYT Op-Ed piece, a Duke physician argues that providers should incorporate the cost of care into clinical conversations with their patients, as the burden of paying for medical care can cause more distress in patients' lives than many medical side effects. Further, he notes that patients should not be afraid to ask how much a pill or procedure will cost as they consider treatment options.  
JAMA: Engaging with patients to improve adherenceJAMA  

The World Health Organization cites that nearly fifty percent of medications for chronic disease are not taken as prescribed. A November JAMA article offers options to increase adherence by improving patients' understanding of their treatments, increasing access to affordable medications, providing counseling and accountability, and ensuring that there are tools and strategies to assist patient self-monitoring. 

A downloadable white paper from Castlight Health highlights commonly over-utilized medical goods and the significant scale of this spending in relation to the U.S. economy. The paper also offers practical management strategies for patients and providers that detail financial and health benefits of utilization management programs. 
CPR: Improving infant health and reducing costsCPR 

A new case study released by Catalyst for Payment Reform with support from the Milbank Memorial Fund chronicles how South Carolina HHS, the largest commercial health plan, and many other stakeholders agreed to stop paying for early elective deliveries to improve infant health and reduce birth costs. An action brief that provides an overview of the payment reform opportunities is available. 

V-BID November brief: Preventive care coverage in the ACABRIEF  

By basing consumer cost-sharing on a health service's clinical benefit instead of price, Section 2713 of the ACA creates incentives for Americans to receive clinically nuanced, effective care.  Read this month's issue brief on V-BID's impact on preventive care coverage in the Patient Protection and Affordable Care Act. 
Infusing clinical nuance into health care transformationSummit   

The 2013 V-BID Summit, Volume to Value: Infusing Clinical Nuance into Health Care Transformation, engaged policymakers, state health commissioners, plan directors, and health system leaders in a highly interactive format to address supply- and demand-side innovations in numerous payer settings including state health insurance exchanges, accountable care organizations, commercial insurance plans, and Medicaid and Medicare plans.  Videos and slides from the day's summit are available.  

The University of Michigan Center for Value-Based Insurance Design (V-BID) leads in research, development and advocacy for innovative health benefit designs.

For more information about V-BID, please visit our website and sign up to receive our newsletter.


To contact the V-BID Center, email us at or call 734-615-9635.
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