Here's something rare in health care policy in 2018: an idea that can help chronically ill patients and save money for both patients and, ultimately, insurers.
And here’s the real shocker: it's an idea with bipartisan support.
It's an insurance concept called Value-Based Insurance Design, or V-BID, and it originated at the University of Michigan.
Dr. A. Mark Fendrick came up with the concept.
He’s director of the U of M Center for Value-Based Insurance Design. He's also a professor of internal medicine at the medical school, and a professor of health management and policy at the School of Public Health.
Listen to the full interview above.
Fendrick says V-BID makes sense because it can help keep people healthy without costing more money.
“As Americans are being asked to pay more for their health care -- the good stuff and the bad stuff -- we decided that instead of having Americans pay less for the inexpensive things and more for the expensive things, to design an insurance product that actually makes it easy for patients to get the services that make them healthy, and maybe a little be harder for the services that don’t make Americans any healthier.”
V-Bid works by lowering the cost of routine, preventative treatments, and raising the price on more superfluous procedures.
This would especially help patients with chronic illnesses, who need preventive procedures to avoid emergency hospital stays that can be expensive, not to mention mentally and emotionally draining.
“The fact that price has driven how Americans seek healthcare as opposed to what drives me as a physician, the health of my patients. It seems intuitive. The things I would beg my patients to do should be the things that are easy for them to access.”
Clinical nuance is the basic element of value-based insurance design.
“It gets to the point that no clinical service is always high-value or low-value. It depends on who gets it, who provides it, and where.”
For example, colonoscopies are high-value for someone over 50 or a person with a family history of colon cancer. But they’re low-value for a 38 year old with no family history of colon cancer.
Fendrick says the scientific advancements being made are amazing, and expensive. But the delivery side has not kept up with innovation. (Fendrick calls this “Flintstones delivery.”)
“And the way to get our delivery from Bedrock to the space age is to understand that we should buy more of the things that make Americans healthier…”
“We have to bring much more attention to the billions of dollars that we spend now that don’t make Americans any healthier. By removing these low-value services, we’ll provide headroom for us to spend more on these amazing, galactic services that can change a life in an extraordinary, meaningful way.”