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05/10/2012    3:30 pm - 4:30 pm

Value Based Insurance: Why it's Important, Its Prevalence, Employer Goals and Market Barriers

Erin O'Connor (Cammack Larhette Consulting)

This session will provide an overview of why and how value based insurance design (VBID) can help employers lower healthcare costs while at the same time maximizing care for their employees. As employers face increased pressure to control health costs, they're turning to VBID as a viable and effective option for cost-savings. VBID attempts to align patient costs with the value of the health services provided. It uses both incentives to reduce the barriers to high-value services and disincentives to discourage low-value services. The reduction of barriers leads to increases in patient compliance and decreases in costs. Both private and public employers are embracing VBID to save money and provide better care for their employees. In addition, VBID was included in the 2010 healthcare reform law and the U.S. Department of Health & Human Services featured it in their National Quality Strategy.

Attendees will also learn about two models of collaborative care used to achieve high-quality and high-value healthcare: Patient Centered Medical Homes (PCMH) and Accountable Care Organizations (ACOs). PCMH is a team-based approach to healthcare delivery in which accessible, comprehensive, longitudinal care leads to maximized health outcomes. A team of health professionals, led by a personal physician, takes responsibility for providing all of a patient's healthcare needs, including arranging care with outside specialists and providers. An ACO is a payment and delivery model that ties provider reimbursement with both quality metrics and cost reductions. The ACO, often a group of healthcare providers, is accountable to the patient and to the third-party payer.

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