To answer your questions on the latest developments in the health care industry, we've asked our expert Jennifer Boehm, a Principal and member of the Design and Development group within Hewitt's Health Management Practice, to share her insights. If you'd like to ask a question on health care, consumer-driven health plans, or any other pressing human resources challenges you might be facing, email us, and we'll share responses to selected questions on a regular basis.
Some traditional plan designs may be creating barriers to improved health and health care. A growing body of evidence suggests that a high level of employee cost-shifting reduces utilization of both low-value and high-value services. Employers should seek to create plan designs that effectively support and influence positive patient behaviors and encourage use of high-value services.
Value-based designs (VBDs) set cost sharing on the clinical value of a service, not on the price. In a VBD model, an employer designs the plan to reduce or remove financial barriers that hinder compliance with highly-valued services — such as critical medications for chronically ill patients — to support employee compliance and help them manage chronic conditions more effectively and help mitigate the risk of adverse health in the future.
Hewitt's video Webcast "The Road Ahead: A Holistic Approach to Improving Health and Health Care", featured two of Hewitt's health care thought leaders, Jennifer Boehm and Jeff Munn. During this Webcast, Jennifer shared the latest thinking on the growing use of incentives in health care programs, value-based design, and practical ways to reduce cost and improve health care outcomes. A question and answer session was held at the end of the Webcast.
Question: With value-based design, will a reduction in cost sharing get you to your desired outcome?
Answer: The quick answer to this question is no. We recognize that even with a value-based design, we're never going to get 100% compliance in any given population because there are many reasons a patient may not be compliant with their treatment. Noncompliance may be tied to issues such as medication side effects, level of health care literacy, cultural differences, or language barriers. Coaching and disease management programs are a couple of examples of ways to support value-based designs.
PODCAST:
Listen to the entire question and answer session from "The Road Ahead: A Holistic Approach to Improving Health and Health Care" webcast. Running time for this podcast is 10:40 minutes. If you experience a slow connection, please right-click this link and download the podcast.
About Our Expert
Jennifer Boehm is a principal in Hewitt's Health Management Consulting business. She leads Hewitt's effort on a diabetes care solution for clients. Jennifer also leads the design and development team and is Hewitt's national thought leader for innovative health plan design. Jennifer also led Hewitt's efforts to collaborate with A. Mark Fendrick, M.D. of the University of Michigan, and Professor Michael E. Chernew of Harvard to develop the first model in the industry to help employers quantify the cost impact of implementing a value-based health plan design.
Jennifer is frequently quoted in various publications and presents at several conferences each year. In 2007, Business Insurance magazine named Jennifer one of its 50 "Women to Watch". Jennifer earned a BBA from Georgia State University and has been with Hewitt for 12 years.
