Value-Based Insurance Design Toolkit

Employers throughout the country are increasingly concerned with improving the health and productivity of their workforces, while maximizing the value of the health care services provided. This growing interest is encouraging, given that 61.1% of Americans under 65 years of age are insured through their employers. But are employers focusing on the right health issues? And how can they design health benefit packages that will increase access to necessary treatments, improve adherence, and ensure the best clinical outcomes for employees? To answer these questions, the National Pharmaceutical Council sponsored five important studies that we encourage you to read and share with your colleagues:Synergies at Work: Realizing the Full Value of Health Investments: Through case studies, this research helps employers gain a sound understanding of the value that a healthy employee population brings to their businesses. The research notes that the benefits of employee health include the value of reduced absence and improved workplace productivity, and employers that recognize the full range of benefits can maximize the value of their investment in making employees healthier.Health and Productivity as a Business Strategy: Published in the Journal of Occupational and Environmental Medicine, this study found that health conditions with the greatest impact on employee productivity are often not the conditions with the highest medical and pharmacy costs. When productivity loss is included, the five most costly conditions are depression, obesity, arthritis, back/neck pain and anxiety. When employers focus on medical and pharmacy costs alone, they may miss an opportunity to address these potentially much more impactful conditions.Value-Based Insurance Design (VBID) Landscape Digest: One growing trend employers are focusing on is value-based insurance design (VBID), in which employer health plans are designed to ensure the best clinical outcome for employees, or get more health out of every health care dollar. Under a VBID program, the alignment of financial incentives -- for patients and providers -- encourages the use of “high-value” care, while discouraging the use of low-value or unproven services. An example of high-value care under VBID would be eliminating or lowering the co-payment for medicines used to treat a chronic condition, such as diabetes or asthma. Not everyone is familiar with the concept, which is why NPC worked with Dr. Mark Fendrick, co-director of the Center for Value-Based Insurance Design at the University of Michigan, to develop this layman’s guide to VBID. The Digest walks through key elements of the concept and demonstrates through case studies how organizations have implemented VBID programs and improved health outcomes.Employer Medication Compliance Initiatives: Working with NPC, the Benfield Group, a health care market research firm, completed an online survey and follow-up study of employers on the subject of medication compliance in the workplace. Key conclusions from the survey and study of 75 companies include: Medication compliance is among employers’ top health management concerns; analysis and programming aimed at medication compliance is on the increase and is becoming more sophisticated; and diabetes is the condition employers are most likely to target with medication compliance initiatives. After analyzing results of the 75-company survey, follow-up research was conducted with a small sample of the original survey group to learn more about how employers are responding to medication compliance issues and trends.Health Plan Capabilities to Support Value-Based Benefit Design: To assist employers in understanding how to more effectively work with their health plans to achieve more value from their health care dollars, the National Business Coalition on Health (NBCH), with funding from NPC, developed this guide around health plan capabilities to support value-based insurance design. There are a variety of value-based insurance design strategies, many of which are challenging administratively, and this report helps identify all of the important elements and profiles the ability of health plans to support this growing area for employers.These studies are just some of a wide range of resources NPC is making available to help you stay ahead of trends related to health and productivity. These publications, along with one-page executive summaries, are available in hard copy or as PDFs that can be downloaded from NPC’s website.