Private Implementation Value-Based Insurance Design

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1 private implementation

1.1 pitney bowes
1.2 mayo clinic
1.3 novartis
1.4 sponsors of blue cross blue shield of north carolina administered plans





private implementation
pitney bowes

one of earliest implementations of v-bid concept occurred in 1990s @ pitney bowes. wall street journal ran article. in 2004 detailing fortune 500 company s implementation of v-bid principles employee health-insurance plans. pitney bowes experienced $1 million savings reduced complications after lowering copayments asthma , diabetes medication.


in 2007, pitney bowes eliminated copayments cholesterol-lowering statins employees , beneficiaries diabetes or vascular disease , lowered copayments employees , beneficiaries prescribed clot-inhibiting drug clopidogrel. policy associated immediate 2.8 percent increase in adherence statins relative controls. clopidogrel, policy associated immediate stabilizing of adherence rate , four-percentage-point difference between intervention , control subjects year later.


mayo clinic

in 2004, mayo clinic s self-funded health plan increased cost sharing employees , dependents specialty care visits , other services such imaging, testing , outpatient procedures. plan removed cost sharing visits primary care providers , preventive services such colorectal screening , mammography. result large decreases in use of diagnostic testing , outpatient procedures sustained 4 years, , immediate decrease in use of imaging. beneficiaries decreased visits specialists did not make greater use of primary care services.


novartis

on january 1, 2005, novartis pharmaceuticals implemented value-based insurance program medications used treat 3 chronic conditions: asthma, hypertension, , diabetes. program employees , dependents enrolled in company s self-insured health benefit plan. part of program, copayments eliminated, , members paid 10% , 7.5% of cost of retail , mail order prescriptions, respectively, drugs used in treatment of asthma, hypertension, , diabetes. program resulted in increase in net payments drugs used in treatment of asthma, hypertension, , diabetes, increase offset decrease in net payments medical services specific or related these conditions. offset sufficient in asthma , diabetes cohorts produce net savings in 2007 compared 2004.


sponsors of blue cross blue shield of north carolina administered plans

in january 2008, blue cross blue shield of north carolina instituted value-based insurance design program medications treat diabetes, hypertension, hyperlipidemia, , congestive heart failure. copayments brand-name medications lowered of insurer s enrollees, while generic copayments waived employers opted program. adherence improved enrollees, ranging gain of 3.8 percentage points patients diabetes 1.5 percentage points taking calcium-channel blockers, when compared others employers did not offer similar program.








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