Value Based Insurance Design (VBID)

Value Based Insurance Design involves designing benefit cost sharing requirements and coverage based on the ultimate evidence-based value of clinical services as opposed to strictly cost considerations. The objective is for the level of patient cost sharing to be a function of the value that the specific service provides to the specific patient. Under Value Based Insurance Design, cost sharing requirements would be delineated by specific types of recommended medications, procedures, treatment plans or even specific providers for specific conditions, as opposed to more traditional tiering of benefits solely based upon costs, such as generic vs. brand name drugs, or network vs. out of network providers.