VBID Guiding Principles
*Administrative Standardization of health plan processes can reduce healthcare costs without impacting the quality of healthcare services and health plan competitiveness. Administrative standardization shall include efficiency and quality performance metrics designed to measure provider accomphlishments.
*Patients should have unbiased accurate information about the cost and quality of the services they are offered by health care providers prior to the delivery of those services except in life-threatening situations.
*Patients should be informed of all evidence based treatment options in understandable and unbiased terms and educated about the potential harms of treatments and the lack thereof.
*Savings accrued under the Value Based Insurance Design should be returned to all the parties that made the savings possible: patients, providers, plan sponsors and health plans.
*Health plan provider networks should be formed based on provider performance and efficiency.
*Benefit designs should be clinically nuanced for each covered beneficiary and should encourage the use of high value services and providers, as well as, include patient cost sharing requirements for services that have no or very little evidence of effectiveness. In cases, where the plan design requirements (federal or state mandated benefits) limit or prevent significant cost sharing patients covered under such plans should still be informed about the lack of robust evidence/ potential harms behind any treatment plans offered to them.
*Evidence based community health improvement should be supported by health plans and/or ACO’s through per member per month investments in community initiatives in part to ensure that wellness investments made on their behalf are maximized.