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Review Finds VBID Programs Improved Adherence at No Added Cost
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Understanding Clinical Nuance

Since its inception in 2005, the University of Michigan Center for Value-Based Insurance Design (V-BID) has led efforts to promote the development, implementation, and evaluation of innovative health benefit designs balancing cost and quality. A multidisciplinary team of faculty, including A. Mark Fendrick, MD and Michael E. Chernew, PhD, who first published and named the VBID concept, have guided this approach from early principles to widespread adoption in the private and public sectors. The Center has played a key role in the inclusion of VBID in national healthcare reform legislation, as well as in numerous state initiatives. The basic VBID premise is to align patients' out-of-pocket costs, such as copayments, with the value obtained from health services and providers.

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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