ORLANDO, Fla.--(BUSINESS WIRE)--Reducing employee out-of-pocket costs for certain high-value treatments increases drug adherence and lowers overall health costs for individuals with chronic diseases, according to new research published today by the Florida Health Care Coalition.
The paper, Value-Based Insurance Design: Perspectives, Extending the Evidence, and Implications for the Future, which was published today in the American Journal of Managed Care, evaluates the impact of value-based benefit design on employer health costs and employee drug utilization among diabetes and asthma patients. Value-based benefit (insurance) design is a medical benefit plan design that aligns patient cost-sharing with the clinical value of a health services, providing lower out-of-pocket costs for proven, high value services and higher out-of-pocket prices for lower value services.
Among diabetes patients, the Florida Health Care Coalition study found that individuals enrolled in value-based benefit designs over a three year period had higher adherence rates for antidiabetic medications, while overall employer healthcare costs declined. Among asthma patients, adherence rates for reliever medications among those enrolled in value-based benefit designs increased during the three year study period, however, adherence to controller medications stayed flat. Total employer health costs also held steady for the full study period. These findings in the asthma population are consistent with previously reported studies.
“It has been more than 10 years since I helped launch the first-ever value-based benefit design at Pitney-Bowes and the concept has now evolved to become one of the most effective population health strategies practiced by many large employers,” said John “Jack” Mahoney, MD, Florida Health Care Coalition chief medical officer and lead author of the study. “With this study, we’ve been able to quantify the impact of value-based design on two common, chronic diseases so that we may better understand the specific nuances of these programs and fine tune them for optimal performance.”
Andrew Webber, president, National Business Coalition on Health (NBCH) commented on the study: “NBCH has advocated value based strategies in both benefit design and purchasing as a means for employers to improve access to high quality care for their employees. The Florida Health Care Coalition, a NBCH member, has done pioneering work on value based insurance design for a number of years.” He added: “The results of their multi-year study presented in this paper deliver clear-cut evidence of the power of value-based design to decrease access barriers to effective care. We believe these findings will be of assistance to our membership as they pursue the goal of high quality, cost effective care.”
This study was conducted by the Florida Health Care Coalition as part of its mission to educate employers, consumers, health plans and providers on proven methods and strategies for improving the quality of healthcare. Initiated under the leadership of Becky J. Cherney, former president and CEO of the Florida Health Care Coalition, the study expands the current research base on value-based benefit design.
Data for the study were derived from a literature review of recent studies on value-based benefit design and drug adherence along with two new investigations conducted on diabetes and asthma populations at a large employer. The Truven Health Advantage Suite and the Truven Health MarketScan Research Databases, which contain de-identified healthcare claims data reflecting the real-world medical care of over 180 million unique patients across the U.S. since 1995, were used to conduct this analysis. The Truven Health Analytics team was led by Teresa Gibson, PhD, vice president, health outcomes and co-author of the study. Insurance claims data for more than 150,000 employees and their dependents were analyzed over a three year period between 2005 and 2008. Funding for the research was provided by Merck.
To read the complete study in the American Journal of Managed Care, click here.
About the Florida Health Care Coalition
The Florida Health Care Coalition is a non-profit group of employers from Florida representing nearly two million covered lives. The mission of the coalition is to educate employers, consumers, health plans and providers and bring them together as one to help improve the quality of health care not only in Florida but nationwide. Staffed by a team of experts in benefit design and population health and wellness, the Florida Health Care Coalition also counts among its board members representatives from Walt Disney Parks & Resorts, Universal Orlando, the City of Orlando, Miami Dade Public Schools, Lockheed Martin, Orange County Public Schools and many other large employers. For more information on the Florida Health Care Coalition, please visit us on the web: www.flhcc.org.