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We hope you enjoy this month's newsletter.

Health Affairs:  V-BID reduces disparities in cardiovascular careHA

Joint research from CVS Caremark, Aetna, and Brigham and Women's Hospital published in the
May issue of Health Affairs finds that Value-Based Insurance Design (V-BID) plans that reduce or eliminate copays for preventive medications for post-heart attack patients can improve medication adherence and health outcomes for non-white patients.
JAMA Internal Medicine:  Medicare spends billions on low-value careJIM

A new JAMA study developed claims-based measures to identify low-value services, examine service use and associated spending in Medicare, and whether patterns of use were related across different types of low-value services.  Results indicated that the Medicare program spent $8.5 billion dollars on low- value services, including cervical cancer screening for women 65 years and older, CT scanning of the sinuses for uncomplicated acute rhinosinusitis, pre-operative stress testing, and back imaging for patients with low back pain.
JAMA Pediatrics:  High cost-sharing impacts families of children with asthmaJP

JAMA Pediatrics study reports that cost-related barriers to care among children with asthma were concentrated among low-income families with higher cost-sharing levels. While the ACA's low-income subsidies could reduce these barriers for many families, millions of dependents could remain at risk for cost-related problems.  An accompanying editorial stresses the problem of cost-related non-adherence, especially among lower-income individuals.
JMCP:  Higher out-of-pocket costs for smoking cessation reduce adherenceJMCP

A Journal of Managed Care and Specialty Pharmacy study examined the association between out-of-pocket expense and adherence to smoking cessation treatment among Medicare beneficiaries.  Among beneficiaries newly initiated on the drug varenicline, greater out-of- pocket cost was associated with lower adherence and lower odds of refilling the prescription.
PLOS:  Systematic review of cost-sharing in patients with chronic diseasePLOS

A systematic review of studies examining eleven policy changes found that drug insurance may increase appropriate use and adherence to drugs.  Authors advise that policymakers be aware that while copayments and deductibles reduce cost for the payer, these costs may impact medication adherence and health outcomes, especially for those of lower socioeconomic status who must manage a chronic condition.
Aflac:  Companies increase worker cost-sharingAflac

A new study from Aflac surveyed 5,209 employees and 1,856 U.S. companies and reported that 56% of participating employers increased workers' cost-sharing.  The study also found that 19% of employers have shifted from traditional health coverage by instead offering health savings accounts along with high-deductible plans.

NYT:  As cost-sharing increases, focus on those with chronic conditionshigh_value

Contributors Austin Frakt and Aaron Carroll comment in the New York Times on the challenges of higher cost-sharing, particularly for those living with chronic conditions.  Additionally, an
Academy Health blog discusses how V-BID plans can enhance value by improving patient adherence and reducing expensive complications in this vulnerable population, even if cost savings do not result. 
V-BID white paper on HSA-HDHPs continues to generate publicityWP_publicity

With nearly 1500 downloads and multiple media references since its release in early May,
the V-BID Center's white paper continues to draw attention to how expanding the definition of prevention for HSA-eligible HDHPs can improve the appeal of these plans.  Read more about the larger initiative, research partners, and ongoing policy efforts. 
Choosing Wisely's impact on unnecessary servicesCW

According to results from qualitative surveys, nearly 85 percent of physicians interviewed say that having evidence-based recommendations and treatment guidelines, such as those indicated by the Choosing Wisely campaign, to use with patients is an effective tool to reduce unnecessary tests and procedures.  In addition, a majority note that having more time with patients and changing the financial rewards system for providers is critical to a high performing health system.
NIHCR:  Collective bargaining units innovate rather than increase cost-sharing to membersNIHCR 

A new research brief from The National Institute for Health Care Reform found that instead of increasing cost-sharing to members in response to the rising cost of health care, collective bargaining units are negotiating volume discounts on unit services, reducing utilization through improved care coordination, and using wellness programs aimed at improving workers' health and controlling longer-term costs.
May infographic:  Preventive Services for Women and the ACAInfo

This month's infographic from the Kaiser Family Foundation explores preventive health services for women post-ACA.  Additionally, an accompanying survey reports that more than a quarter of women ages 18-64 delayed care in the past year because of cost; 20% also reported skipping recommended tests or treatment and prescription medicines; and 28% reported difficulty paying medical bills.  
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.


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