Health plans have historically used cost-sharing as a means of controlling healthcare spending. Under this traditional approach, health plans drive their expenditures down by increasing the out-of-pocket costs of their members for certain services. In an effort to save money, members may forgo care, both necessary and unnecessary. As a result, members put off preventive screenings and timely interventions until an acute event triggers more costly, invasive care.
While traditional cost-sharing is a start towards matching the member and health plan financial incentives, the agnostic approach to covered services prevents individuals from selecting care that truly drives meaningful clinical change. Alternatively, the Value-based Insurance Design (VBID) Model offers a complimentary approach to the cost-sharing paradigm by shifting financial incentives towards members.
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