lowered the insulin individual copay amount from its preferred formulary cost of USD 30 per 30-day supply to USD 15 and allowed for 100-day supply.
Affordability becomes an issue for costlier medications that often are not part of VBID
programs, such as those that treat hepatitis C, multiple sclerosis, and rheumatoid arthritis.
is still an emerging best practice in both the public and private sectors.
So she and her colleagues enrolled active University of Michigan employees and their dependents with diabetes into a VBID
program that reduced their co-pays for antihypertensive, lipidlowering, and glucose-lowering agents starting in July 2006.
proposes is this: By customizing benefits so that the most valuable services for any one condition cost less to the employee than services of lesser value, companies can make healthcare dollars go farther.
Benefits advisors who promote a VBID
approach can encourage the use of services when the clinical benefits exceed the costs.
Because of this, clinically-nuanced VBID
approaches have generally not been incorporated into MA or MA-PD plans.
The merits of such VBID
benefit packages depend on the welfare gain associated with exploiting beneficial moral hazard, relative to the costs of designing, implementing, and maintaining such programs.
For example, patients in a VBID
plan who have a chronic disease such as high blood pressure could have their out-of-pocket costs (e.
Drafters of the Patient Protection and Affordable Care Act (PPACA) tried to build a little VBID
goodness into the law by including a section that requires all non-grandfathered individual policies and group plans to cover a package of high-value preventive services, such as checkups, and vaccinations for children, without imposing any co-payment requirements, deductible requirements or other out-of-pocket costs on the patients.
Growing employer interest in VBID
creates an opportunity for payers to gain a competitive edge in the market, but only if health plans manage member benefits cost-effectively and measure results accurately.
and Brigham and Women's Hospital, VBID
plans take a different approach by reducing the cost to the patient for medications that offer higher clinical benefit--with the intent that increased medication use will improve health outcomes and reduce overall health care spending.