Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Insurers' perspectives on MA value-based insurance design model.

Dmitry Khodyakov1, Christine Buttorff, Kathryn Bouskill

  • 1RAND Corporation, 1776 Main St, Santa Monica, CA 90401.

The American Journal of Managed Care
|July 19, 2019
PubMed
Summary

Value-based insurance design (VBID) in Medicare Advantage (MA) saw low insurer participation due to information gaps and ROI concerns. Addressing administrative hurdles and providing implementation support can boost uptake of this cost-saving healthcare model.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Factors Associated with Patient Portal Use in a Nationally Representative Sample: Demographics and Savviness with Technology Influence Use of Portals.

Telemedicine journal and e-health : the official journal of the American Telemedicine Association·2026
Same author

Do the Memory Support Intervention and Improving Memory for Treatment Facilitate Behavior Change in Cognitive Therapy?

Cognitive therapy and research·2026
Same author

When military-to-civilian transition support falls short: A qualitative assessment of transition needs among U.S. Veterans.

Military psychology : the official journal of the Division of Military Psychology, American Psychological Association·2026
Same author

State Spending Growth Benchmarks and Hospital Revenue, Hospital Prices, and Premiums.

JAMA network open·2026
Same author

Physician Preferences Regarding Integration of Life Expectancy in Prostate Cancer Management.

Journal of general internal medicine·2026
Same author

Proposal for a critical appraisal tool for studies using the Delphi method (DCAT).

BMJ (Clinical research ed.)·2025

Area of Science:

  • Healthcare economics
  • Health services research
  • Insurance policy

Background:

  • Value-based insurance design (VBID) incentivizes high-value healthcare services by reducing patient cost-sharing.
  • The Centers for Medicare and Medicaid Innovation (CMS) initiated a voluntary VBID model test within Medicare Advantage (MA) starting in 2017.
  • Understanding insurer perspectives is crucial for the successful implementation and expansion of VBID models.

Purpose of the Study:

  • To explore the perspectives of Medicare Advantage insurers regarding the VBID model test.
  • To identify perceived barriers preventing insurers from participating in the VBID model.
  • To suggest strategies for overcoming these participation barriers and increasing model uptake.

Main Methods:

  • A qualitative descriptive study employing semistructured interviews.

Related Experiment Videos

  • Interviews were conducted with representatives from both nonparticipating (n=24) and participating (n=73) MA insurers.
  • Thematic analysis was used to analyze all collected interview data.

    • Main Results:

    • Less than 30% of eligible insurers joined the VBID model test in its initial two years.
    • Key barriers included a perceived lack of information, anticipated low return on investment, administrative and IT challenges, and specific model design parameters.
    • Most participating insurers faced and successfully navigated administrative and IT hurdles, with CMS implementing adjustments to enhance participation.

    Conclusions:

    • Low initial uptake of the VBID model was influenced by implementation challenges and concerns about its effectiveness in the Medicare population.
    • CMS could enhance VBID model uptake by offering in-kind implementation assistance.
    • Insurers should proactively engage IT departments and vendors early in the process and learn from the experiences of current VBID participants.