New Models Like V-BID Driving Value-Based Health Care

From accountable care organizations and bundled payments to patient-centered medical homes and value-based insurance design (V-BID), new delivery and care models are changing health care systems. As Dr. Chuck Shih, NPC’s former fellow in comparative effectiveness research, explained in a 2014 Pharmacy Times article, these new models could move the U.S. health care system from one that focuses on quantity of services to a system that promotes high-value care.
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From accountable care organizations and bundled payments to patient-centered medical homes and value-based insurance design (V-BID), new delivery and care models are changing health care systems. As Dr. Chuck Shih, NPC’s former fellow in comparative effectiveness research, explained in a 2014 Pharmacy Times article, these new models could move the U.S. health care system from one that focuses on quantity of services to a system that promotes high-value care.

However, there are still a number of issues that need to be addressed before these models can reach their full potential, as Dr. Shih writes. For example, appropriate quality measures need to be put in place to identify and incentivize quality, and to incorporate the value of biopharmaceuticals in the development of drug benefit designs.

Take V-BID, for instance, which encourages the use of high value therapies and services while reducing barriers to access for these services. Practically, this means that a patient’s cost share would be lower for a therapy if it is more clinically beneficial than another treatment. Under the V-BID model, a person who requires a colonoscopy because he is at high risk for colon cancer would pay less for his treatment than someone who has little or no risk factors for colon cancer.

Several companies have improved employee health via one of the four basic approaches to V-BID. And in September, the Centers for Medicare and Medicaid Services (CMS) announced the Medicare Advantage V-BID Model, which will test whether offering targeted benefits or reduced cost-sharing to people with chronic conditions leads to higher quality and more cost-efficient care. This model “offers the prospect of lower out-of-pocket costs and premiums along with better benefits for enrollees in Medicare Advantage,” Patrick Conway, CMS deputy administrator and chief medical officer, said in a statement.

As CMS monitors the ongoing impact of V-BID models, it will be important to see the effect it continues to have on the quality of care for patients when barriers are reduced to medically needed therapies and services.

Learn more about V-BID through NPC’s related research and resources. Also, be sure to follow today’s Twitter conversation around V-BID (using #VBIDSummit) as the University of Michigan’s Center for V-BID hosts its invitation-only event, “A Decade of Transforming the Health Care Cost Discussion from ‘How Much’ to ‘How Well.’”