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Volumn 29, Issue 3, 2010, Pages 530-536

Evidence that value-based insurance can be effective

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COST EFFECTIVENESS ANALYSIS; HEALTH CARE COST; HEALTH INSURANCE; HEALTH PROGRAM; HEALTH SERVICE;

EID: 77950787163     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2009.0119     Document Type: Article
Times cited : (86)

References (39)
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    • The disease management program was a comprehensive, telephonic, nurse-staffed program. This is a fairly typical telephonic disease management program, except for its broad scope-covering thirty-two clinical conditions-and its linkage to a system of "clinical alerts, " in which medical, drug, and lab claims; lab results; and a large electronic database of clinical recommendations from the medical literature are used to identify opportunities to improve clinical care. When the clinical data provided indication for the use of a specific test or medication (or a contraindication against a specific medication), the physician and patient were notified. This "clinical alerting" program was run against the employer's entire insured population several times a month. Physicians were notified of potential clinical improvement opportunities via telephone, fax, or mail, as appropriate to the urgency of the clinical alert; and members were notified by telephone and mail if enrolled in the disease management program or by mail alone if not enrolled. To permit physicians to respond first to any clinical alerts, member notification was lagged by two to three weeks.
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    • The ratio of adherer to non-adherer costs (adherence effectiveness) that would allow the firm to break even can be computed by simultaneously solving the equations for the following: (1) pre-VBID cost, (2) post-VBID cost, (3) the percentage who adhere post-VBID, (4) an effectiveness impact equation that produces dollars spent on adherers, and (5) increased drug cost. Complete equations are available in an Online Appendix; to access this appendix, click the Online Appendix link in the box to the right of the article online.
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* 이 정보는 Elsevier사의 SCOPUS DB에서 KISTI가 분석하여 추출한 것입니다.