Value-Based Benefits: Are We There Yet?

Based on empirical evidence around VBBD, health plans are increasingly providing employers the option of these programs as part of their benefits packages. Since 2007, Highmark Blue Cross Blue Shield has offered some type of VBBD program, beginning with prescription drugs for the "eight usual suspects," of primary disease management conditions found in disease management: asthma, coronary artery disease, congestive heart failure, depression, diabetes, hypertension, high cholesterol, according to Marcia Bondi, director of new product implementation.

Bondi admits that there was very little initial interest in VBBD products. "A lot of employers viewed it as an increase in payer costs," she said. "They wanted to wait and see if would have the expected down the road impact."

Among the factors influencing their hesitation, employers noticed that while members participated in various wellness programs, few were actually engaged in taking steps to improve their health. As a result, many employers took to offering cash rewards for employees who took a health risk assessment, for example, and even engaged in wellness program. However, employers realized the need for results if they were to continue a value-based program, leading to member disincentives for noncompliance.

"After several years, its time to put the notice on the employee that if you want to keep your benefits at the level they have, they must show they are doing something to get their condition under control," Bondi said.

View All Comments Make a Comment

Comments are moderated. Please be patient.