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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

September newsletter highlights:

 AJMC:  Editorial on 'generic drug cost sharing' generates attention across stakeholder groupseditorial

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.
V-BID for Better Care Act of of 2014:  "Simple, yet transformative" idea attains bipartisan, bicameral supportact

This month, U.S. Senators John Thune (R-South Dakota) and Debbie Stabenow (D-Michigan) introduced
bipartisan legislation S.2783The Value-Based Insurance Design (V-BID) for Better Care Act of 2014.  A companion bill, H.R. 5183, was introduced in July by House Representatives Diane Black (R-Tennessee) and Earl Blumenauer (D-Oregon).  A summary of the bill, additional research and an infographic on the impact of Medicare Advantage plans are available.
HIN Blog: V-BID featured in healthcare infographic series

V-BID's infographic, which defines and describes V-BID concepts of clinical nuance, is featured as the top healthcare infographic by Healthcare Intelligence Network's 'Eye on Infographic'
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.cdhp
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. BRTABC
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.meta
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. california
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.specialty
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. towers 

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.gate    
NYT Upshot:  Workplace wellness options that work

Employers of all sizes use financial incentives to motivate employees to achieve better health with a range of success.  However, studies tend to find that wellness programs don't save money and generally do not appreciably improve health.  However, workplace wellness efforts that encourage consumer responsibility focused on chronic illness prevention and management have shown positive outcomes. NYT
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.


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