Applying value-based insurance design to low-value health services.
Value-based insurance design improves health care quality and efficiency by reducing cost sharing for services that have strong evidence of clinical benefit. The same goals can also be accomplished by increasing cost sharing for low-value services, which would ensure more effective care and achieve net cost savings. However, there are challenges in defining what is meant by "low-value services" and implementing programs to restrict such services' use. This paper argues that investments in processes to define low-value care, comparative effectiveness research to identify services that produce harm or marginal clinical benefit, and information technology to implement findings can facilitate applying value-based insurance design to the low-value realm.
Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA. amfen@umich.edu
A Mark
AM
Fendrick
Dean G
DG
Smith
Michael E
ME
Chernew
D003363:Cost Control / Q000191:economics / Q000458:organization & administration; D017047:Cost Sharing / Q000191:economics*; D006296:Health Services / Q000191:economics*; D007348:Insurance, Health / Q000458:organization & administration*; D017146:Models, Organizational; D014481:United States