We hope you enjoy this month's newsletter. If you would like additional information on these stories, please feel free to contact us at 734-615-9635.

January newsletter highlights:

V-BID included in landmark Medicare reform bill: Better Care, Lower Cost Act
Republicans include V-BID in Affordable Care Act alternative
Atlantic: Chernew on V-BID's role in transforming health care
Journal Clinical Oncology: Out-of-pocket costs deter adherence in cancer care
Kaiser Family Foundation: Effects of medical debt among the insured
AJMC: Reduced medical utilization and adherence in HSA-eligible CDHPs
California Healthcare Foundation: Workers face reduced coverage, higher costs
Health Affairs study raises questions about wellness programs' results
V-BID Brief--Consumer Operated & Oriented Plans: A potential role for V-BID implementation

V-BID included in Better Care, Lower Cost Act of 2014

The bipartisan, bicameral Better Care, Lower Cost Act of 2014 was introduced to enhance quality and contain costs for Medicare enrollees suffering from multiple chronic conditions. The legislation expands the use of multi-disciplinary health teams to keep patients as healthy as possible in their communities and creates "Better Care Programs" equipped with the central V-BID premise to lower cost-sharing on evidence-based chronic disease services and provider visits.

Republicans include V-BID in Affordable Care Act alternative

Three Republican Senators introduced an alternate health care reform plan that includes V-BID as an approach to add efficiency to State Medicaid plans. The proposal would repeal the
individual/employer mandates and minimum coverage requirements, reduce Medicaid expansion to select populations, and uphold new Medicare provisions, the ban on lifetime benefit limits, and non-discrimination for pre-existing conditions.

Atlantic: Chernew on V-BID's role in transforming health care

Dr. Michael Chernew, V-BID Center co-founder,and Leonard D. Schaeffer, Professor of Health Care Policy at Harvard Medical School, explains how V-BID can transform health care by providing incentives such as reducing copays for high-value services and increasing copays for low-value services. Communicating the concept to patients and aligning consumer engagement with payment reform initiatives is critical for success.

Journal of Clinical Oncology: Out-of-pocket costs
deter adherence in cancer care

A December 2013 study published by the Journal of Clinical Oncology reports that cancer patients with higher copayments were 70% more likely to stop taking their cancer treatment, and 42% were more likely to skip doses. This study adds to the growing literature on cost-related non-adherence and strengthens the argument for reducing cost-sharing for high-value services and providers.

Kaiser Family Foundation: Medical debt among the insured

A Kaiser Family Foundation study found that nearly 1 in 3 people with health insurance face medical debts related to increased cost-sharing, high out-of-network charges, and higher monthly premiums. Medical debt impacts personal assets, savings, and credit ratings while causing significant emotional distress. While tax-credit subsidies, cost-sharing limits, and essential health benefit standards put in place as a result of the Affordable Care Act may reduce costs and improve access to care, the impact of medical debt remains significant.

AJMC: Reduced medical utilization & adherence
in HSA-eligible CDHPs

Little research is available on how full-replacement consumer directed health plans (CDHPs) coupled with health savings accounts (HSAs) impact medication adherence, especially in chronic disease populations. Results from a 3-year analysis performed by the Employee Benefits Research Institute (EBRI) published in the American Journal of Managed Care indicate that a CDHP-HSA full-replacement plan was associated with reduced adherence of evidence-based services in 4 out of 5 chronic conditions.

California Healthcare Foundation: Workers face reduced coverage & higher costs

According to a new California Employer Health Benefits Survey, California workers, who have higher than national average health care premiums, will face reduced employer-sponsored coverage, additional increases in monthly costs, as well as reductions in benefits in 2014.

Health Affairs: Questions for employer wellness programs

A RAND study of wellness programs reported that programs aimed at helping people with chronic illnesses stay healthy through education and medication reminders resulted in significant cost savings, while lifestyle management offerings focusing on weight loss or stress management resulted in no net savings.

V-BID Brief: Consumer Operated and Oriented Plans-
A Potential Role for V-BID Implementation

This month's issue brief offers an overview of Consumer Operated and Oriented Plans (CO-OPs) and how Maine's CO-OP has implemented V-BID principles to align member benefits with high-value services, integrated care, improved quality, and reduced member costs.

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 vbidcenter@umich.edu or call 734-615-9635.

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