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V-BID Better Care Act introduced to CongressCongress

Washington, D.C. -- Reps. Diane Black (R-TN-06) and Earl Blumenauer (D-OR-03), both members of the House Ways and Means Committee, introduced H.R. 5183 -- the Value-Based Insurance Design (VBID) for Better Care Act of 2014 -- a bipartisan measure that would establish a regional demonstration program for high-quality Medicare Advantage (MA) plans to utilize V-BID to reduce the copayments or coinsurance for beneficiaries with specific chronic conditions.

A summary of the bill is available.


An Alliance July blog post summarizes several changes for employers who want to apply V-BID to  their health plan designs.  Recommendations include replacing "one-size-fits-all" cost-sharing with V-BID clinically nuanced approaches for certain types of diagnostic visits and medications, including specialty medications, and addressing the top chronic conditions in insured populations.

A recent CDC study concluded that non-infectious conditions are the main cause of illness and disability in the United States and are responsible for the bulk of healthcare spending, while a new study by the University of Michigan School of Public Health shows that for people suffering with chronic disease, a fear of finance-related challenges may be just as detrimental to their health as actual out-of-pocket costs.   
IOM: Growing problems in patient access to cancer drugsIOM


At a recent Institute of Medicine (IOM) National Cancer Policy Forum workshop, V-BID Center Director, Dr. A. Mark Fendrick and colleagues discussed cancer patients' rising out-of-pocket costs.  To control spending, many payers have established requirements for high cost-sharing that result in some patients having to eschew beneficial but expensive drugs. The V-BID Center and NPC have released a new white paper on using V-BID principles to address clinical and economic effects of higher cost-sharing for specialty medications.  A full summary, short video, related commentary, and more are available. 

AHIP: New survey shows continued growth in HSA enrollmentAHIP

According to a census released by AHIP, HSA-HDHP plan enrollment has grown approximately 15 percent annually since 2011 and is the only type of plan that grew in 2013.  Enrollment levels in both HSA and HRA plans are increasing as employers and employees become more familiar with the models.  Read more about V-BID in HSA-eligible HDHPS. 

NYT: The price of prevention - Vaccine costs are soaringNYT

The increase in vaccine pricing over the last two decades is so severe that some doctors have refrained from offering vaccinations entirely, citing prohibitive provision costs and inadequate insurer reimbursement.  Despite no improvements in vaccines and ACA-mandated coverage, pharmaceutical companies defend their prices, ensuring that the financial burden remains on physicians and patients.  

Dobson/DaVanzo: Health care spending slows, but consumers pay more for careDOBSON   


A new report from Dobson/DaVanzo shows that while overall health care spending is slowing, nearly 77% of companies have increased cost-sharing to consumers through a combination of higher deductibles, co-payments, or premium contributions.  The change in benefit design has been swift and steady, touching the majority of employer-based coverage. 

2015 ACA plans show inconsistent out-of-pocket cost trends  

HealthPocket examined major out-of-pocket cost categories within public rate filings for 2015 ACA metal level plans in nine states.  When compared to out-of-pocket costs for 2014, deductibles in the early public rate filings decreased, with the exception of platinum plans (43% increase).  For bronze plans, the decrease was <1%, as compared to 9% and 12% decreases for silver and gold plans.

Kaiser: Trends in out-of-pocket spending for Medicare beneficiariestrends


 A new Kaiser Family Foundation analysis highlights variations in out-of-pocket costs for Medicare beneficiaries based on service use, age, gender, and other characteristics, including hospital re-admissions.  On average, patients with a hospital re-admission spent roughly $1,200 more on services than those with only one inpatient stay in 2010.  These findings suggest that preventing avoidable hospital re-admissions could significantly lower beneficiaries' out-of-pocket spending.

V-BID in Action: The role of cost-sharing in disparitiesbrief  

Cost related non-adherence is a growing problem and is responsible for a significant decline in self-reported health among vulnerable populations. July's issue brief explores how the implementation of clinically nuanced V-BID programs that reduce out-of-pocket costs and increase access to evidence-based services can improve quality of care, enhance the patient experience, lower costs, and reduce disparities.
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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