Fendrick stresses that VBID programs focus on removing barriers for treatments that are proven to be effective. When costs are reduced, patients are more likely to use high value services. For those with lower co-payments, the percentage of patients not taking their medication declined by about 10 percent in 4 of the 5 drug classes.

The financial impact of behaviors resulting in improved health can be measured in terms of savings on both medical [such as fewer emergency room visits and hospitalizations] and non-medical [such as fewer disability days, less absenteeism and greater worker productivity] spending, Fendrick says.

Fendrick and Chernew currently are working with Congressional leaders on incorporating VBID concepts in health care reform. Language encouraging the use of VBID concepts is in the bill being negotiated in conference committee.

"The clinical benefits of removing barriers to high value services were clear, but before this paper, the economic ramifications of VBID programs were uncertain. We can now say, at worst, VBID programs are cost neutral from a total cost perspective," Fendrick says.

Chernew adds. "Payers are facing tremendous pressure to reign in health care costs. Compared to the status quo, we are confident that, if carefully designed, VBID programs can produce more health at any price." "We believe that VBID should remain an integral part of ongoing health care reform discussions."

Source: University of Michigan