Chernew Michael E, Rosen Allison B, Fendrick A Mark
Harvard University, Boston, Massachusetts, USA.
Health Aff (Millwood). 2007 Mar-Apr;26(2):w195-203. doi: 10.1377/hlthaff.26.2.w195. Epub 2007 Jan 30.
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.
当每个人都被要求为受益取决于患者特征的医疗服务支付相同的自付费用时，存在过度使用和使用不足的巨大可能性。与大多数当前的健康计划设计不同，基于价值的保险设计（VBID）明确承认并应对患者的异质性。它鼓励在临床益处超过成本时使用服务，同样在益处不足以证明成本合理时不鼓励使用服务。本文阐述了支持VBID的理由，并概述了私营部门当前的VBID举措以及进一步采用的障碍。
