Study: Consumers skeptical of value-based insurance design

Individual mandate
Consumers are overwhelmingly distrustful of VBIDs. (Kerkez)

As much as payers are hoping to expand the acceptance of using value-based insurance design (VBID), consumers are still distrustful of what insurance companies deem as high-quality services.

A new study, published in the March issue of Health affairs, aims to identify attributes of VBID that provoke either resistance or acceptance among customers. VBID was originally created to encourage consumers to choose high-value services and discourage the use of low-value services by aligning cost with quality.

The combined survey and research of consumers in Northern California showed that consumers favored the VBID approach known as value-based benefit design by 41%. The other two VBID approaches addressed by the study included reference pricing, favored by 28%, and narrow networks, favored by 21%. 

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The authors of the study initially expected that consumers who make informed decisions obtain higher-quality care, “but there is little evidence to support this assumption.” In fact, when faced with too much information, researchers found that consumers actually take shortcuts to reduce the burden. 

When approached with the three types of VBIDs, the smallest share of participants felt positively toward narrow networks. In addition, most consumers were skeptical of the measures used to rate the quality of providers aligned with price in a providers’ network. Many consumers placed patient-provider relationship, geographic location, appointment accessibility and language competency above clinical quality, according to the survey.

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Value-based benefit design earned the most positive feedback from participants. Discussions revealed that participants valued immediacy of treatments or tests over evidence due to mistrust and motives. People seemed minimally concerned about the overuse of unnecessary treatments and preferred having the autonomy to make their own decisions, according to the study. 

So once again, analysts found that people shopping for insurance plans might not find the available resources credible, so transparency of benefits would improve credibility. 

“Existing quality measures lack meaning to consumer,” the survey stated. Therefore, people will only be willing to consider high-value care once the credibility of the information source is established. 

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So, what’s the next step?

Participants need educational tools to help them make decisions about provider networks. Marketplaces should work with existing and credible resources, such as healthcare providers and employers, to help participants navigate choices.

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