This new approach to managing costs focuses on improving the health of members who have chronic conditions.
Value-based benefit enhancements target savings for members in areas of care shown to deliver improvements in health, lower cost, and compliance with treatment programs.
Starting January 1, 2012, these changes apply to most standard New England managed care and PPO plans available to groups with 1-99 employees enrolled. Larger employers can opt to include the Value Based Benefits in their plans.
They focus on two key areas:
Lower member cost for certain chronic disease medications. This will help minimize complications associated with non-adherence to treatment plans and to lower plan costs over the long term. It will apply to the following conditions:
Eliminate cost sharing on two diabetic monitoring visits to encourage regular, proactive treatment and avoid high-cost complications.
The Power of Value-Based Benefit Enhancements
1. Chernew, Michael E., Shah, Mayur R., Wegh, Arnold, et al. "Impact of Decreasing Copayments on Medication Adherence Within a Disease Management Environment," Health Affairs, (2008) 27: 1; and Blue Cross Blue Shield of Massachusetts 2008 data.
2. Blue Cross Blue Shield of Massachusetts 2008 data.
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