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Area of Science:

  • Health economics
  • Health services research
  • Insurance policy

Background:

  • Value-based insurance design (VBID) aligns healthcare use with value.
  • Existing research primarily focuses on reducing cost-sharing for high-value treatments.
  • Limited but promising evidence exists for VBIDs that increase cost-sharing for low-value treatments.

Purpose of the Study:

  • To review the current landscape of VBID strategies.
  • To highlight the potential of VBIDs that address low-value care.
  • To propose future directions for VBID innovation.

Main Methods:

  • Literature review of VBID studies and federal initiatives.
  • Analysis of the impact of different VBID approaches on healthcare utilization.
  • Synthesis of findings to inform future health plan design.

Main Results:

  • VBID is gaining federal attention, with evidence from employer-sponsored plans.
  • VBIDs reducing cost-sharing for certain treatments are common.
  • VBIDs increasing cost-sharing for low-value treatments show promising results.

Conclusions:

  • Health plans should explore VBIDs that target low-value care.
  • Innovations in formulary design and health IT can support patient-specific value incentives.
  • Future VBID strategies should focus on distinguishing and incentivizing high-value care.