Dr Mark Fendrick Suggests Additional VBID Elements to Be Adopted in Health Policy

Congress should build on the value-based insurance design (VBID) elements included in the Inflation Reduction Act (IRA) to further alleviate the burden of health care costs on Americans, said A. Mark Fendrick, MD, co–editor in chief of The American Journal of Managed Care® and director of the V-BID Center at the University of Michigan.

Transcript

What additional VBID elements would you like to see the government adopt?

Well, while we were very pleased to see the insulin out-of-pocket cap of $35
implemented for Medicare, we fell just a few votes short of having this as a national policy for all plans. So it is our hope that Congress will revisit the commercial plan out-of-pocket cap and then we could see insulin out-of-pocket cost no longer be such a burden for everyone who is insured.

Another area that we’re working on is to expand the Internal Revenue Service list of chronic disease services that could be covered on a predeductible basis. We were happy to see the codification of predeductible coverage for insulin in the IRA. We would like to see this to include many other highly valuable evidence-based services used to manage and prevent the complications of chronic conditions that are not included in the 14 services that already have this allowable predeductible coverage.