Redefine prevention to reduce chronic condition costs
By applying value-based insurance design to high-deductible health plans, insurers can better aid patients with chronic conditions while also reducing costs, according to a new report released today from the University of Michigan Center for Value-Based Insurance Design and Harvard University Medical School.
HDHPs continue to be a crucial factor in the growing healthcare industry. In 2013, more than 15 million Americans received health coverage through an HDHP, notes the study. In 2014, roughly 80 percent of large employers may offer an HDHP.
Chronic diseases--such as heart disease, stroke, cancer and diabetes--are some of the most preventable health issues in the United States but they cost more than $2 trillion a year, according to the study announcement. Moreover, a previous study found chronically ill patients who use an HDHP are more likely to go without care due to high costs, leading to higher aggregate costs.
Preventive care has no real clear definition, but can refer to one-time initial Medicare exams, such as vaccinations and screenings for certain cancers, cardiovascular problems and diabetes, the study notes. So the researchers sought to redefine and expand the definition of prevention, and looked to HDHP plans to better understand how an updated definition would affect outcomes and costs.
They found that by incorporating secondary prevention of chronic diseases into the overall definition of prevention, HDHPs could provide coverage for services that prevent the progression of chronic diseases without a deductible, ultimately creating a more efficient healthcare spending model.
"Our goal was to find ways to enhance the ability of high-deductible health plans to improve clinical outcomes of the chronically ill while reducing costs," A. Mark Fendrick, M.D., director of the University of Michigan Center for Value-Based Insurance Design, said in the announcement. "We were pleased to discover that expanding the definition of 'prevention' to include evidence-based services that slow chronic disease progression and prevent related complications could potentially benefit millions of Americans."
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