The Patient and System Benefits of Value-based Insurance Design

The researchers examined “Medication Dedication,” a BlueCross BlueShield of North Carolina (BCBSNC) program that eliminated copayments for generic medications and reduced copayments for brand-name medications to treat hypertension, congestive heart failure, hyperlipidemia and diabetes. The researchers determined whether VBID improved medication utilization behavior among BCBSNC enrollees with hypertension during the first two years of the program and addressed the following research questions: (1) did the initiation of Medication Dedication impact medication initiation, switching and adherence among program participants with hypertension; and 2) did Medication Dedication impact inpatient, outpatient or emergency room health services utilization and expenditures among program participants with hypertension. The objective of this project was to explore the business case for value-based insurance design (VBID) and to inform benefit design changes and cost-containment strategies being considered by insurers and Medicare.