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Value-based benefit design: using a predictive modeling approach to improve compliance.

John J Mahoney¹

¹Strategic Health Innovations, Pitney Bowes, Stamford, CT 06926, USA. jack.mahoney@pb.com

Journal of Managed Care Pharmacy : JMCP

|October 3, 2008

Summary

This summary is machine-generated.

Value-based benefit design improves medication compliance and clinical outcomes. This approach, integrating disease management, offers significant savings by focusing on total health value beyond drug costs.

Related Experiment Videos

Area of Science:

Health Economics
Pharmacy Benefit Management
Clinical Outcomes Research

Background:

Improved medication compliance correlates with better clinical outcomes and reduced healthcare spending.
Managed care stakeholders should adopt a total value approach, considering all medical costs, not just pharmacotherapy expenses.

Purpose of the Study:

To outline the value-based benefit design strategy implemented by Pitney Bowes, utilizing predictive modeling.
To assess the impact of this intervention on medication compliance rates and overall healthcare costs.

Main Methods:

Implementation of a value-based benefit design program at Pitney Bowes.
Utilized predictive modeling to identify patient needs.
Integrated disease management and preventive care programs.
Strategically adjusted copayments to encourage adherence and appropriate medication use.

Main Results:

The value-based benefit design initiative at Pitney Bowes demonstrated notable success.
Patients were enrolled in targeted disease management or preventive care programs.
Selective copay reductions were implemented as part of the strategy.
The total value approach resulted in significant cost savings.

Conclusions:

Value-based benefit design, when combined with effective pharmacy management and interventions like disease management, shows considerable promise.
This strategy allows for optimized medication allocation to appropriate patients.
Evidence suggests that high coinsurance levels can negatively impact outcomes, supporting value-based designs.
Successful value-based design requires a holistic program addressing barriers to positive health outcomes.