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THE NATIONAL VALUE-BASED INSURANCE DESIGN SUMMIT OVERVIEW

Employers and insurers have been increasing consumer cost sharing under health insurance policies in the effort to moderate the rate of growth in use and costs of care. Leading firms have also been adjusting these cost sharing requirements to reduce financial barriers to using treatments known to be especially effective and cost effective, under the rubric of "value-based insurance design" (VBID). Most VBID initiatives to date have focused on low-cost treatments for chronic illnesses. New initiatives are expanding VBID principles to include high-cost treatments such as specialty drugs as well as to preventive and wellness programs. What employers can and cannot do increasingly will be determined by the "essential benefits" provisions of the Affordable Care Act (ACA). The conference will provide insights and stimulate discussions concerning:

  • What have been the principal applications of VBID programs in health insurance to date? What have been their successes and what challenges of implementation have they faced?
  • How can drug formularies be restructured to promote use of effective medications and discourage use of inappropriate medications? In particular, how can this be done for high-cost specialty drugs that currently face coinsurance requirements for patients?
  • How are employers and insurers altering cost sharing to channel enrollees towards lower cost hospitals and provider organizations? To what extent are quality data being included in these incentives? ow should they be included?
  • How can benefit be designed to motivate consumers to take more active roles in preventive and wellness programs? Which programs have shown the most promise, in terms of improving outcomes and/or reducing costs?
  • How do the "essential benefits" provisions of the ACA limit the type and level of consumer cost sharing that may be included in insurance products to be sold through exchanges? What is the current state of the debate with respect to state and employer flexibility on benefit coverage?

Who Should Attend?

Anyone interested in the trend towards rising consumer cost sharing in health insurance and in ways to influence benefit design to promote use of effective treatments and efficient care providers.





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