Grantees in the News

In a blog post on price transparency tools, Devon Herrick of the National Center for Policy Analysis discusses findings from a recent RWJF-funded study from Jon Gabel, M.A., and colleagues at NORC, that foun

As retail clinics grow in number, they are also expanding the services they offer, going beyond urgent care toward population health and chronic disease management services. As Jeff Lagasse discusses in Healthcare Finance, some hospitals and health systems have looked to partner with retail clinics while others have opted to compete with them directly, opening up their own clinics.

Under reference pricing, insurers set a reimbursement limit for medications and services, and patients pay out-of-pocket anything above that limit. In the United States, some health plans are using reference pricing for surgical and diagnostic procedures.

Commonly used in Europe for medications, reference pricing is a mechanism by which insurers reimburse a patient’s medication or health care service up to a certain limit, and the patient pays the rest out of pocket if the price charged is higher. The mechanism incentivizes patients to choose medications or services as close to the reference price as possible to reduce their own spending.

In a recent piece for The American Journal of Managed Care, Niteesh Choudhry, M.D., Ph.D., Harvard Medical School, discusses how high-deductible health plans (HDHP) can benefit from the use of value-based insurance design (VBID). He explains that one of the desirable effects of HDHPs is a shift among patients away from expensive medications to lower-cost medications like generics.