Value Based Insurance Design (VBID) Concept

According to the University of Michigan VBID Center, the basic premise of value-based insurance design is to remove barriers to essential, high-value health services. Value based insurance design acknowledges and responds to the fact that not all patients and services should be treated equally. VBID places an emphasis on evidence-based care and a movement away from a fee-for-service payment model.

Under value based benefit designs, the patient is encouraged to seek services where the clinical value outweighs the cost and is discouraged on seeking services where the cost far outweighs the clinical value.

At the Maine Health Management Coalition, we believe that all parties (consumers, employers/purchasers, doctors/hospitals, insurers and the Coalition) have unique responsibilities when it comes to implementing value based benefit strategies:

Consumers: Examine available options, choose high-quality providers, make healthy lifestyle choices

Employers/Purchasers: Purchase benefits based on value, support wellness/self-management in the work site, reward high-performing providers, services and employees

Doctors/Hospitals: Improve effectiveness and affordability of health care, share quality and cost information

Insurers: Reward outcomes not outputs, promote high-value services and informed decision making, share data, minimize unnecessary administrative transactions, compete on subscriber health outcomes and satisfaction

MHMC: Measure and publicly report health system performance, identify collaborative opportunities for improvement, encourage aligned incentives, provide information to providers and employers/purchasers to promote improvement

The Maine Health Management Coalition supports its members’ efforts to implement value-based benefit strategies.