Dr Mark Fendrick Explains Implementation of VBID in Commercial Markets

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 in chief of The American Journal of Managed Care® and director of the Center for Value-Based Insurance Design at the University of Michigan.

Transcript

How is VBID being implemented in commercial markets?

Well, value-based insurance design is now well into its third decade. It's been implemented by hundreds of public and private insurers, and there is no real, off-the-shelf VBID implementation. The most common approach is primarily around prescription drugs for chronic diseases, such as diabetes, cardiovascular disease, mental health disorders, and hypertension. We do see several large employers and plans going beyond drugs to include cost-sharing offsets for certain visits, certain diagnostic tests and procedures that are deemed to be high value.

It's important to note that almost all studies of the impact of cost sharing have shown that populations of color and people of low income are disproportionately negatively impacted by cost sharing. And that a review of studies that removed cost sharing show, not surprisingly, that these same populations—Black and Brown communities, low-income, and in some situations women—are disproportionately positively benefited by programs that eliminate or reduce consumer cost sharing.