We hope you enjoy this month's newsletter. For additional information on the stories included below, please feel free to contact us at (734) 615-9635 or [email protected].
|
September newsletter highlights:
|
AJMC: Editorial on 'generic drug cost sharing' generates attention across stakeholder groups
The American Journal of Managed Care published an editorial by Dr. Gerry Oster, Vice President of Policy Analysis Inc. and V-BID Center director, Dr. A. Mark Fendrick. The piece, also featured in the New York Times Upshot and others, details a recent trend in which prominent health plans are forcing consumers to assume the burden of their health care costs by placing generic drugs into "preferred" and "non-preferred" tiers. This designation may result in lower rates of medication and treatment adherence and runs counter to ongoing efforts by payers and providers to improve treatment adherence and health outcomes. Listen to a podcast to learn more.
|
EBRI: Patients enrolled in CDHPs receive less preventive care
A five-year study of a large full-replacement CDHP found that participants utilized fewer preventive services than traditional plan holders, perhaps due to initial higher out-of-pocket costs. V-BID's white paper on HSA-eligible HDHPS offers a framework for CDHPs to offer preventive services before the deductible.
|
Business Roundtable & ABC align with V-BID on HSA-HDHPs
Business Roundtable's September report cites V-BID's white paper on expanding the definition of prevention in HSA-eligible HDHPs and the American Benefits Council has identified 46 policy recommendations for employer-sponsored benefit programs including allowing employers greater flexibility regarding prescription drug coverage that may be covered before the deductible in HSA-eligible HDHPs. Read more about this issue.
|
AJMC: Using meta-analysis to simulate V-BID plans
Using claims data from a large California health plan, a new study published in the American Journal of Managed Care uses network meta-analysis to generate evidence and rank osteoporosis treatments in order of efficacy. The piece illustrates the value of network meta-analysis in the absence of clinical trials and provides a framework for using evidence synthesis methods in value-based insurance design.
|
CHCD: Findings from California Medicare Chat include V-BID
As part of the California Medicare CHAT Collaborative, groups of voluntary participants use a computer-based simulation program to design a Medicare benefits plan. In addition to adding several new coverage options, participants would require enrollment in a provider network, reduce coverage of low-value care, change coverage of end-of-life care, apply penalties and rewards to urge patients' compliance, and charge higher-income seniors more for Part B premiums. The full report is available.
|
Healthcare Payer: States regulate cost-sharing for specialty drugs
As specialty drug costs continue to rise, states impose limits to cost-sharing to regulate drug copayments, alleviate costs, and improve adherence. However, these state regulations will only apply to individual and small group plans. Insurers need to think about their specialty medication strategies in the context of their value-based strategies. Read V-BID's white paper on specialty medications to learn more.
|
Towers Watson: 2015 health care changes include V-BID
According to a recent Towers Watson survey, employers plan major changes to sponsored coverage in response to ACA regulations. The use of value-based designs and benefit differentials that drive employees to high-performance or narrow networks for medical care is projected to rise. One in seven organizations will use value-based designs by 2015, and another 34% are considering them for 2016 or 2017.
|
SF Gate/M-LIVE: Price transparency enables consumers to spend less
When given a choice between two procedures that achieve the same health quality outcome, the majority of people tend to choose the least expensive procedure. In today's era of high health care spending, when comparing two treatments that differ in price, V-BID principles of clinical nuance can be applied to encourage high-value health care and discourage wasteful spending.
|
Fierce Health Payer: Bundled payments focus on cost, not value
Critics of bundled payments argue that the reimbursement strategy is just another method of price control, which may discriminate against high-risk patients and discourage utilization of new drugs, devices, and procedures. Utilizing V-BID principles of clinical nuance rather than a one-size-fits-all reimbursement strategy can align care cost, delivery, and value.
|
|
|
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.
|
|
|
|
|