Understanding Clinical Nuance

This article was collaboratively written by A. Mark Fendrick, MD, director of the V-BID Center, and several V-BID Center staff.

As Americans are asked to pay a greater percentage of their healthcare expenditures, cost-related nonadherence is an important and growing problem. A potential solution—Value-Based Insurance Design (VBID)—is built on the principle of lowering or removing financial barriers to essential, high-value clinical services and providers. VBID plans align patients’ out-of-pocket costs, such as copayments, with the value of services.  


Clinical nuance is one of the core tenets of VBID. This concept recognizes 2 important facts about the provision of medical care: 1) medical services differ in the amount of health produced; and 2) the clinical benefit derived from a medical service depends on who is using it, who is delivering the service, and where it is being delivered.

To learn more about clinical nuance, view the video below, and visit the Clinical Nuance initiative page.


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