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Hail to the Frontline So many selfless people are doing truly wonderful things to successfully defeat this pandemic. Thank you.
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Reducing Lo Low Valu lue Ca Care in in a Post Pandemic World A. - - PowerPoint PPT Presentation
Reducing Lo Low Valu lue Ca Care in in a Post Pandemic World A. - - PowerPoint PPT Presentation
Reducing Lo Low Valu lue Ca Care in in a Post Pandemic World A. . Mark Fendrick, MD University of f Mic ichigan Center for Valu lue-Based In Insurance Design www.vbidcenter.org @um_vbid Hail to the Frontline So many selfless people
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- Every
ryone (a (alm lmost) ) agrees th there is is enough money in in th the US S health care system; ; we ju just sp spend it it on th the wrong se services and in in th the wrong pla laces
- Poli
licy deli liberations focus pri rimarily on alt lternative payment and pri ricing models
- Moving from a volume‐driven to value‐based system requires a change in
both how we pay for r care and how we engage consumers to se seek care Health Care Costs Are a Top Iss Issue For r Purchasers and Poli licymakers: So Solu lutions must protect consumers, reward providers and preserve inn innovation
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Th Then Ca Came Co Coronavir irus…
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- Build
ild on exis xistin ing alt lternativ ive payment models ls that base reim imbursement
- n patie
ient-centered outcomes. increase reimbursement for r high-valu lue se servi vices and reduce or r cease payment for r known lo low-valu lue care
- Le
Leverage th the wide idespread adoptio ion of f elec lectr tronic ic healt lth records (E (EHRs) ) to make it it easie ier to order hig igh-valu lue care with ith sim simpli lifie ied processes and disc iscourage th the use se of f lo low-valu lue care with ith aler lerts
- Ali
lign patie ient cost-sharin ing with ith th the valu lue of f th the underly lyin ing se servi vices; reduce out of pocket cost on hig igh valu lue se servic ices and in increase patie ient cost t on lo low valu lue care
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Paying for r More Generous Co Coverage of f Hig igh Valu lue Ca Care: Reduce Sp Spending on Low Valu lue Care
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Paying for r More Generous Co Coverage of f Hig igh Valu lue Ca Care: Reduce Sp Spending on Low Valu lue Care
- In
Increase premiums – poli litically not t feasible
- Rais
ise deductibles and copayments – ‘tax on the sick’
- Reduce sp
spending on lo low valu lue care
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https://vbidhealth.com/docs/States-LVC-Paper-FINAL-Draft(1).pdf
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V-BID X: : Be Better Co Coverage, Sa Same Premiums and Deductibles
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V-BID X: Expanding Coverage of Essential Clinical Care Without Increasing Premiums or Deductibles
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HHS 2021 Payment Rule le St Strongly ly Endorses V-BI BID X
https://www.govinfo.gov/content/pkg/FR-2020-05-14/pdf/2020-10045.pdf
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Enhancing Access an and Affordability to Ess ssential Cl Clinical Se Services: A A Need to Reduce Lo Low Valu lue Ca Care in in the ‘New Normal’
- Exp
xpand pre-deductible coverage/reduce consumer cost-sharin ing on hig igh- valu lue cli linical COVID-19 rela lated care and oth ther essential chronic dise isease se serv rvic ices
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Identify fy, measure and reduce lo low-value care to pay for r more generous coverage of f hig igh-value care
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Implement cli linically-driven pla lan payment reform, technologies and benefit it designs that in increase use of hig igh-value se services an and deter lo low valu lue care
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