Health Care Costs
Linking health insurance premiums to a cost-benefit ratio for health care services could encourage more appropriate use of the U.S. health care system, according to a paper in Health Affairs.
The authors claim that the design would encourage the use of services when the benefits to a patient exceed the costs, and discourage the use of services when the benefits do not justify the cost. Payments for services would vary depending upon patients' unique clinical situations.
The authors conclude that value-based insurance design could alleviate some problems with other systems, such as pay-for-performance, by evaluating services based on overall clinical value, not just cost (Chernew et al., Health Affairs, 1/30).