Value-Based Insurance Design

The Alliance is engaged in a Value-Based Insurance Design (VBID) pilot in which participating employers examine their data and look for ways to “tweak” their benefit plans to meet specific goals.

In the first phase of the pilot, employers focused on small but meaningful changes with the potential to reduce ongoing health costs. They aimed to get more people to attend smoking cessation programs, for example, and to persuade more employees to receive preventive screenings such as colonoscopies and mammograms. They encouraged these changes with incentives such as paid time off or other rewards.

Participants also learned how to hold a vendor summit to bring all the vendors serving a company into one room. That made it possible for vendors to work together to assist members to meet their benefit goals.

The second phase began in mid-2013 with four employers. These employers are exploring value-based benefit designs, which use rewards or penalties to encourage employees to make choices that lead to both better health and better use of health resources.

A value-based approach may target chronic conditions such as diabetes or coronary disease by reducing or eliminating copays for prescriptions; primary care and specialist visits; lab tests; and other care related to the chronic condition.

The goal of VBID pilot projects is to develop strategies that can be offered to all Alliance members.

Further reading:

Infographic from the Center for Value-Based Insurance Design

Infographic from the Center for Value-Based Insurance Design