Low-Value Services in Value-Based Insurance Design
Building negative incentives into value-based insurance design programs to discourage use of low-value care will involve a number of challenges.
Objectives: To identify potentially low-value services for inclusion in value-based insurance design (VBID) programs and to discuss challenges involved in incorporating such information.
Methods: We searched the Tufts Medical Center Cost-Effectiveness Analysis Registry (
Results: The list of potentially low-value services includes several drugs to treat cancer, as well as other therapies such as left ventricular assist devices and lung volume reduction surgery. Building negative incentives into VBID programs to discourage use of low-value care will involve a number of challenges, including identification of appropriate candidates; the scope of services to be covered (ie, whether VBID should be expanded beyond drugs to address medical devices, procedures, and diagnostics); and whether VBID programs should target specific subgroups.
Conclusion: Identifying noncontroversial low-value services and designing VBID programs to discourage their use will not be easy. However, to fulfill their promise of improving value and moderating cost growth, VBID programs should target low-value as well as high-value care.
(Am J Manag Care. 2010;16(4):280-286)
Articles in this issue
over 15 years ago
Knowledge of Cost Sharing and Decisions to Seek Careover 15 years ago
Getting the Right Services Covered by Health Insuranceover 15 years ago
Economic Evaluation of an Internet-Based Weight Management ProgramNewsletter
Stay ahead of policy, cost, and value—subscribe to AJMC for expert insights at the intersection of clinical care and health economics.
Related Articles
- Overcoming Weight Bias in Health Care Systems
September 15th 2025