Report Promotes Integration of Medical Home, Value-Based Insurance

Value-based insurance design is included in health reform. It allows the Secretary of Health and Human Services to develop guidelines to permit health plans to use the concepts in providing coverage, according to Sherman.

"From an employer's point of view, PCMH and VBID are complementary, used to simultaneously change provider and patient behaviors," the report added. "The PCMH creates a system of healthcare delivery that offers high-value service. That value can be realized only if members use the medical home."

Health plans, employers, and public purchasers who have adopted one or both strategies include: the city of Battle Creek, MI; IBM; Geisinger Health Plan; Roy O. Martin, the small private company; and the Whirlpool Corp.

"While there is little agreement on the specific mechanisms, there is general consensus that the healthcare system is not delivering acceptable value in clinical outcomes, for the dollars spent. Many of the solutions proposed are highly consistent with the underlying principals of VBID and PCMH.

The systems provide:

• Better delivery of evidence-based practices
• Increased reliance on information management in healthcare.
• Cost sharing and reimbursement aligned with high value services.
• Coordinated multidisciplinary care
• Increased engagement of and attention to patients

"Although employers often implement VBID and PCMH initiatives in sequence, they see the logic for using them in tandem," the report stated. "From an employer's point of view, PCMH and VPID are complementary, used to simultaneously change provider and patient behaviors."