Harvard Medical School, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Health Aff (Millwood). 2010 Nov;29(11):1988-94. doi: 10.1377/hlthaff.2009.0324.
High copayments for medical services can cause patients to underuse essential therapies. Value-based health insurance design attempts to address this problem by explicitly linking cost sharing and value. Copayments are set at low levels for high-value services. The Mercer National Survey of Employer-Sponsored Health Plans demonstrates that value-based insurance design use is increasing and that 81 percent of large employers plan to offer it in the near future. Despite this increase, few studies have adequately evaluated its ability to improve quality and reduce health spending. Maximizing the benefits of value-based insurance design will require mechanisms to target appropriate copayment reductions, offset short-run cost outlays, and expand its use to other health services.
高额的医疗服务自付费用可能导致患者无法充分使用基本疗法。基于价值的健康保险设计试图通过明确关联成本分担和价值来解决这个问题。高价值服务的自付费用设定在较低水平。美世国家雇主赞助的健康计划调查显示，基于价值的保险设计的使用正在增加，81%的大型雇主计划在不久的将来提供这种保险。尽管这种情况有所增加，但很少有研究充分评估其提高质量和降低医疗支出的能力。最大限度地发挥基于价值的保险设计的好处将需要有机制来针对适当的自付费用降低、抵消短期成本支出，并将其扩展到其他医疗服务。
