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Health Aff (Millwood). 2007 Mar-Apr;26(2):w195-203. Epub 2007 Jan 30.

Value-based insurance design.

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  • 1Harvard University, Boston, Massachusetts, USA.


When everyone is required to pay the same out-of-pocket amount for health care services whose benefits depend on patient characteristics, there is enormous potential for both under- and overuse. Unlike most current health plan designs, Value-Based Insurance Design (VBID) explicitly acknowledges and responds to patient heterogeneity. It encourages the use of services when the clinical benefits exceed the cost and likewise discourages the use of services when the benefits do not justify the cost. This paper makes the case for VBID and outlines current VBID initiatives in the private sector as well as barriers to further adoption.

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