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Related Concept Videos

Methods Of Healthcare Delivery System01:26

Methods Of Healthcare Delivery System

At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Health Information Technology and Healthcare Information System01:30

Health Information Technology and Healthcare Information System

Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Preventive Healthcare Services01:30

Preventive Healthcare Services

Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
Actuarial Approach01:20

Actuarial Approach

The actuarial approach, a statistical method originally developed for life insurance risk assessment, is widely used to calculate survival rates in clinical and population studies. This method accounts for participants lost to follow-up or those who die from causes unrelated to the study, ensuring a more accurate representation of survival probabilities.
Consider the example of a high-risk surgical procedure with significant early-stage mortality. A two-year clinical study is conducted,...
Traditional Level Of Health Care System01:26

Traditional Level Of Health Care System

The levels of care describe the services provided in the healthcare system. Accordingly, there are six levels of the traditional healthcare system in the US: preventive, primary, secondary, tertiary, restorative, and continuing healthcare. A nurse must understand how the healthcare industry organizes and provides services within these levels of care.
The preventive healthcare service includes tests for screening. Preventive health care services include identifying and reducing disease risk...
Issues And Trends In Healthcare Delivery System01:29

Issues And Trends In Healthcare Delivery System

The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...

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Updated: Jun 13, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
14:32

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Published on: February 16, 2011

Low-value services in value-based insurance design.

Peter J Neumann1, Hannah R Auerbach, Joshua T Cohen

  • 1Center for the Evaluation of Value and Risk in Health, Tufts Medical Center, Boston, MA 02111, USA. pneumann@tuftsmedicalcenter.org

The American Journal of Managed Care
|April 17, 2010
PubMed
Summary
This summary is machine-generated.

Identifying low-value healthcare services for value-based insurance design (VBID) programs is challenging but crucial. VBID programs must target both low-value and high-value care to improve health outcomes and control costs.

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Area of Science:

  • Health economics
  • Health services research
  • Clinical decision-making

Background:

  • Value-based insurance design (VBID) programs aim to incentivize efficient healthcare utilization.
  • Identifying and excluding low-value services is key to maximizing VBID program effectiveness.
  • Previous research has not comprehensively identified low-value services for VBID inclusion.

Purpose of the Study:

  • To identify potentially low-value healthcare services for inclusion in VBID programs.
  • To explore the challenges associated with incorporating low-value service identification into VBID initiatives.

Main Methods:

  • Systematic literature review of cost-effectiveness analyses from the Tufts Medical Center Cost-Effectiveness Analysis Registry (since 2000).
  • Definition of low-value services: interventions worsening health without cost savings or exceeding $100,000/QALY.
  • Supplementation with services rejected by the UK's National Institute for Health and Clinical Excellence.

Main Results:

  • Identified low-value services include certain cancer drugs, left ventricular assist devices, and lung volume reduction surgery.
  • Challenges in VBID implementation include identifying eligible services, defining the scope (drugs, devices, procedures, diagnostics), and targeting specific patient subgroups.

Conclusions:

  • Identifying noncontroversial low-value services for VBID programs presents significant difficulties.
  • To achieve their goals of enhancing value and moderating cost growth, VBID programs must actively target low-value care alongside high-value care.