Center for Healthcare Decisions, Rancho Cordova, CA, USA.
Health Aff (Millwood). 2010 Nov;29(11):2022-6. doi: 10.1377/hlthaff.2010.0808.
Value-based insurance designs frequently lower consumers' cost sharing to motivate healthy behavior, such as adhering to medication regimens. Few health care purchasers have followed the more controversial approach of using increased cost sharing to temper demand for high-cost, low-value medical care. Yet there is evidence that when health care's affordability is at stake, the public may be willing to compromise on coverage of certain medical problems and less effective treatments. Businesses should engage employees in discussions about if and how this type of value-based insurance design should apply to their own insurance coverage. A similar process could also be used for Medicare and other public-sector programs.
基于价值的保险设计经常降低消费者的自付费用,以激励健康行为,如坚持药物治疗方案。很少有医疗保健购买者采用更具争议性的方法,即通过增加自付费用来抑制对高成本、低价值医疗的需求。然而,有证据表明,当医疗保健的可负担性受到威胁时,公众可能愿意在某些医疗问题和效果较差的治疗方法的覆盖范围上做出妥协。企业应该让员工参与讨论是否以及如何将这种基于价值的保险设计应用于他们自己的保险覆盖范围。类似的过程也可以用于医疗保险和其他公共部门计划。