Consumers’ perceptions and choices related to three value-based insurance design approaches

Susan L. Perez, Melissa Gosdin, Jessie Kemmick Pintor, Patrick S. Romano

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

The burden of rising health care costs is being shifted to consumers, and 30 percent of health care costs are attributed to wasteful spending on low- or no-value services. Value-based insurance design (VBID) is intended to encourage the use of high-value services or discourage the use of low-value services by aligning cost with quality. During the summer and fall of 2016, this mixed-methods study used focus groups and a quantitative analysis of survey data to explore consumer decision making in Northern California. When presented with three common VBID approaches, the focus groups favored value-based benefit design the most (41 percent), followed by reference pricing (28 percent) and narrow networks (21 percent). When presented with VBID scenarios, participants were skeptical of the value-based trade-offs and reported seeking information they wanted instead of relying on information that health plans provide. Engaging consumers to successfully reduce waste through VBID will require clarifying trade-offs to support consumers’ processes for arriving at high-value decisions as well as reaching out to consumers through trusted sources and networks.

Original languageEnglish (US)
Pages (from-to)456-463
Number of pages8
JournalHealth Affairs
Volume38
Issue number3
DOIs
StatePublished - Mar 1 2019

ASJC Scopus subject areas

  • Health Policy

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