A. Mark Fendrick, MD, professor of Medicine in the School of Medicine, professor of Health Management and Policy in the School of Public Health, and director of the VBID Center at the University of Michigan, discusses how low or no cost sharing for high-value services is particularly important for public health issues or epidemics, such as HIV.
A. Mark Fendrick, MD, professor of Medicine in the School of Medicine, professor of Health Management and Policy in the School of Public Health, and director of the VBID Center at the University of Michigan, discusses how low or no cost sharing for high-value services is particularly important for public health issues or epidemics, such as HIV.
How is low/no cost sharing for high-value services particularly important for public health issues or epidemics, such as HIV, where there is often access issues for those affected?
My mother always said, “I can’t believe you had to spend $1 million to show that if you make people pay more for something they’ll buy less of it,” and as we move through value-based insurance design, now almost on 20 years, we’ve also shown that if we reduce barriers—financial and otherwise—to high-value care, people will use more of these services more often. It’s important to note that when you make something free, it doesn’t mean that 100% of the people who should be getting the care, whether it be HIV testing or PrEP [pre-exposure prophylaxis] or mammograms or hepatitis C screening, to 100%.
We do know that as we’ve studied the evaluations of decreased cost sharing for high-value services, the rates of these services go up. But, they go up in a modest way. They don’t get anywhere near where I’d hope, meaning that we need not only cost-sharing reform but healthcare literacy issues, access, and many other levers we think we should pull to ultimately spend more money to get more folks the services we know will make them healthier. And the way we figured out to pay for these efforts is to attack the estimated $1 trillion in healthcare spending in the US that doesn’t make Americans any healthier.
It’s very fortunate for me and maybe unfortunate for the payers that there is such an excess of low-value care in this country. And luckily enough for us, everyone agrees there’s enough money in the system, we just spend it in the wrong places, and hopefully we’ll spend more on preventive care services like those covered by Section 2713 and HIV screening and PrEP, specifically, and less hopefully on those low-value services that have been identified by the task force as D rated or those identified by the Choosing Wisely Campaign.
Dr Dalia Rotstein: Physicians Must Be Aware MS Affects People of All Backgrounds
April 24th 2024Dalia Rotstein, MD, MPH, emphazises the importance of awareness that multiple sclerosis (MS) impacts patients from various backgrounds as clinicians think through ways to improve access to care and research efforts in MS.
Read More
Empowering Community Health Through Wellness and Faith
April 23rd 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In the third episode, Camille Clarke-Smith, EdD, MS, CHES, CPT, discusses approaching community health holistically through spiritual and community engagement.
Listen
Overcoming Employment Barriers for Lasting Social Impact: Freedom House 2.0 and Pathways to Work
April 16th 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our second episode, in which we learn all about Freedom House 2.0 and the Pathways to Work program.
Listen
What We’re Reading: Abortion Privacy Rules; Alzheimer Drug Hurdles; Nursing Home Staffing Overhaul
April 23rd 2024New health privacy rules aim to protect patients and providers in an evolving abortion landscape; some physicians express concerns about efficacy, risks, and entrenched beliefs in treating Alzheimer disease; CMS addresses longstanding staffing deficits in nursing homes.
Read More
Award-Winning Poster Presentations From AMCP 2024
April 23rd 2024At the Academy of Managed Care Pharmacy (AMCP) 2024 annual meeting, multiple poster presentations concerned with health equity, data collection, glucagon-like peptide-1 agonists, and more were acknowledged for their originality, relevance, clarity, bias, and quality.
Read More