Proponents say that effective VBID programs will increase near-term costs for employers, heath plans, and pharmacies in that they lose the copay revenue and there will is greater utilization as more patients take medications consistently. However, healthcare costs will theoretically decrease over the long term because improved adherence should translate into better control of chronic conditions.
"In turn, this better disease control should reduce avoidable healthcare utilization, such as ER visits and hospital admissions," authors of the BCBSNC study Dr. Matt Maciejewski and Dr. Daryl Wansink, PhD, say.
They admit it's still a theory, and that there has been no definitive study that has shown that it actually decreases cost.
The VBID principle replaces the common "one-size-fits-all" approach to coverage in favor of plans that help nudge people to get services that produce high value for the money, Fendrick says.
But Fendrick argues that the VBID shouldn't just apply to high-value prescriptions and medical services. "We need to apply the same transparent processes to how we define a low-value service," he says.