Library

Library

Ethical Physician Incentives—From Carrots and Sticks to Shared Purpose

For ACOs to be successful, they must improve the efficiency of care, meet patients’ expectations for care and clinical outcomes, and attract and retain top-quality professionals. Incentives like pay-for-performance bonuses are key management tools for achieving these goals. Taken alone,…

March 22, 2013

Payments in Support of Effective Primary Care for Chronic Conditions

The researchers used Capital District Physicians’ Health Plan, a nonprofit network-model HMO in New York, as a test case. In January 2009, the plan launched a pilot program in three primary care practices where providers received bundled payments, adjusted to…

March 22, 2013

At Pitney Bowes, Value-Based Insurance Design Cut Copayments and Increased Drug Adherence

By eliminating or reducing copayments for key drugs prescribed for employees at risk for cardiovascular disease, a value-based health insurance program at the U.S.-based firm Pitney Bowes led to modest increases in medication adherence rates compared with a control group.…

March 22, 2013

Full Coverage for Preventive Medications After Myocardial Infarction

Heart attack patients discharged from the hospital were more likely to take prescription medications for their condition when copayments were eliminated, compared with patients who had copayments. Patients who had their copayments waived also experienced fewer heart attacks, strokes, and…

March 22, 2013

Full Coverage for Preventive Medications After Myocardial Infarction

Heart attack patients discharged from the hospital were more likely to take prescription medications for their condition when copayments were eliminated, compared with patients who had copayments. Patients who had their copayments waived also experienced fewer heart attacks, strokes, and…

March 22, 2013

The Impact of Reducing Cardiovascular Medication Copayments on Health Spending and Resource Utilization

Insurers impose copayments to reduce overall health care spending, but these higher out-of-pocket expenses can also prompt patients to reduce their use of essential medications. Previous studies have shown that reducing or eliminating copayments for cardiovascular medications prescribed after heart…

March 22, 2013

A Hospital System’s Wellness Program Linked to Health Plan Enrollment Cut Hospitalizations but Not Overall Costs

Employers are increasingly looking to wellness programs to encourge healthy behaviors among their employees and control health care spending. A study examining the effects of a wellness program on workers’ health service use found a substantial decrease in hospitalizations for…

March 22, 2013

Lessons from Medicare’s Demonstration Projects on Value-Based Payment

A summarization of the results of Medicare demonstrations of value-based payment systems, which give providers financial incentives to improve the quality and efficiency of care.  http://www.cbo.gov/sites/default/files/cbofiles/attachments/WP2012-02_Nelson_Medicare_VBP_Demonstrations.pdf

March 21, 2013

Rapidly Evolving Physician-Payment Policy — More Than the SGR

An analysis and discussion of innovations and challenges in payment reform initiatives. http://www.nejm.org/doi/full/10.1056/NEJMhpr1004028

March 21, 2013

The Evidence for V-BID: Validating an Intuitive Concept

A sample of peer-reviewed research providing evidence, examples and insights on value-based insurance design. http://www.sph.umich.edu/vbidcenter/publications/pdfs/V-BID%20brief%20Evidence%20Nov2012.pdf

March 21, 2013

Assessing The Evidence For Value-Based Insurance Design

A study of value-based insurance design strategies including a description of implementations and results. (Abstract only, full text requires subscription) http://content.healthaffairs.org/content/29/11/1988.abstract

March 21, 2013

Choice Architecture Is A Better Strategy Than Engaging Patients To Spur Behavior Change ABSTRACT Patient engagement is increasingly seen as

Research on whether and in what settings patient engagement is or isn't effective.  (Abstract only. Full text requires subscription.) http://content.healthaffairs.org/content/32/2/242.abstract

March 21, 2013

Evaluating and negotiating payment options

A Guide for Providers

A resource guide for providers for evaluating and negotiating payment options. http://www.ama-assn.org/ama/pub/physician-resources/practice-management-center/claims-revenue-cycle/managed-care-contracting/evaluating-payment-options.page?

March 20, 2013

Purchaser-Provider Synergies Overview

Fact Sheet

In this program, the Agency for Healthcare Research and Quality (AHRQ) helps purchasers and providers enhance quality improvement, public reporting, and pay-for-performance programs. The effort is designed to help purchasers and providers understand the science behind early efforts and benefit…

March 20, 2013

Pay for Performance (P4P): AHRQ Resources

A compilation of Pay for Performance and other purchaser strategies, research and tools that are supported by the Agency for Healthcare Research and Quality http://www.ahrq.gov/legacy/qual/pay4per.htm

March 20, 2013

101 Economic Incentives for Preventive Care: Summary

Provider and Patient Incentives in Preventive Care

A compilation of literature and evidence on the impact of economic incentives targeted at motivating providers and consumers to adopt preventive health behaviors. http://www.ncbi.nlm.nih.gov/books/NBK11845/

March 20, 2013

Insurer Provides Financial Incentives, Infrastructure, and Other Support to Stimulate Provider Participation in Quality Improvement Collaborations

Policy Innovation Profile

A case study of insurer provided financial incentives, infrastructure and other support to stimulate provider participation in quality improvement collaborations http://www.innovations.ahrq.gov/content.aspx?id=3641

March 20, 2013

Innovative Policies: Using ACO Principles and Financial Incentives to Improve Health Outcomes

Webinar Series January 29 2013

Web seminar materials on innovative policies using ACO principles and financial incentives to improve health outcomes http://www.innovations.ahrq.gov/webevents/index.aspx?id=46

March 20, 2013

Consumer Financial Incentives: A Decision Guide for Purchasers

This Guide reviews the application of incentives to five types of consumer decisions: (1) Selecting a high value provider, (2) Selecting a high value health plan, (3) Deciding among treatment options, (4) Reducing health risks by seeking preventive care, and…

March 20, 2013

Benefit Design Innovations: Implications for Consumer-Directed Health Care

A description of various innovations in benefit design for consumer directed health care and their policy implications http://www.hschange.com/CONTENT/913/#ib3

March 20, 2013

Using Evidence to Design Benefits

Research Insights

A research brief describing the use of evidence about medical effectiveness to design value-based benefit design. http://www.academyhealth.org/files/publications/RschInsightsDesignBenefit.pdf

March 20, 2013

Value-Based Purchasing Guide

An overview of various value-based benefit design strategies focusing on health behaviors, chronic condition management, medications, and provider choice http://www.nbch.org/VBBD-Introduction

March 20, 2013

Value-Based Ecosystem: value-based benefit design and outcomes-based contracting

Highlights and insights nto new efforts in outcomes-based design and value based benefit design to improve prevention and wellness, chronic care management, and care guidance/management. http://www.cyndynayer.com/value-based-ecosystem-brief/  …

March 20, 2013

Report Card on State Price Transparency Laws

March 18, 2013

Dear Colleagues, As health care costs continue to rise, consumers are increasingly being required to take on a growing share. To underscore that point, the most recent survey by Mercer shows that close to two-thirds of all large employers offer…

March 17, 2013

Copayment Reductions Generate Greater Medication Adherence in Targeted Patients

Value-based insurance design program via BCBSNC eliminated generic medication copayments for brand name meds and improved adherence to meds for diabetes, hypertension, hyperlipidemia, and CHF. http://www.rwjf.org/en/research-publications/find-rwjf-research/2010/11/copayment-reductions-generate-greater-medication-adherence-in-ta.html

March 11, 2013