Dr. Mark Fendrick Explains VBID Implementation in Commercial Markets

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Most implementations of value-based insurance design (VBID) in commercial markets involve prescription drugs, but some plans are beginning to incorporate cost-sharing offsets, said A. Mark Fendrick, MD , co-editor of The American Journal of Managed Care ® and director of the Center for Value-Based Insurance Design at the University of Michigan.

Most implementations of value-based insurance design (VBID) in commercial markets involve prescription drugs, but some plans are beginning to incorporate cost-sharing offsets, said A. Mark Fendrick, MD , co-editor of The American Journal of Managed Care® and director of the Center for Value-Based Insurance Design at the University of Michigan.

Transcription

How is VBID implemented in commercial markets?

Well, the concept of value-based insurance is now well into its third decade. It has been implemented by hundreds of public and private insurers, and there is no real out-of-the-box VBID implementation. The most common approach is primarily prescription drugs for chronic conditions, such as diabetes, cardiovascular disease, mental health disorders, and hypertension. We are seeing many large employers and plans go beyond drugs to include cost-sharing compensation for certain visits, diagnostic tests and procedures that are considered high value.

It is important to note that almost all studies on the impact of cost sharing have found that people of color and low income people are disproportionately affected by cost sharing. And that a review of studies that have removed cost-sharing shows, unsurprisingly, that these same populations — black and brown communities, low-income people, and, in some situations, women — disproportionately benefit from programs. that eliminate or reduce cost sharing with consumers.

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