Value-Based Insurance Design

Value Based Insurance Design

UHCAN Ohio’s Affordability Project exists to learn from consumers managing chronic illness how their health insurance does or doesn’t protect them from high co-pays and deductibles. With the Affordable Care Act, the insurance market has changed dramatically. People who used to be priced out of the insurance market altogether due to a “pre-existing condition” are now able to secure coverage. However, both Marketplace (“Obamacare”) plans and other health plans in the individual, employer/retiree, and self-insured markets shift more of their costs to people they are insuring. Co-pays and deductibles run so high that the insured consumer still struggles to get the care they need.

We hope to change insurance company benefit design systems so that people with chronic illness can better manage their illness.  We are focusing on a concept called Value-Based Insurance Design (V-BID).  V-BID is an approach to designing a health insurance plan so that what the insured person should do (such as taking medicine and seeing their primary care doctor) is more affordable. V-BID is catching on around the country.


    • Identify the coverage-related costs and other costs that have the greatest impact on the insured’s management of their chronic illness.
    • Persuade at least two insurance companies doing business in Ohio to make the commitment in 2016 to implement V-BID in their insurance design. We will consider this objective met if the insurance companies that commit to doing V-BID implement it for at least 3-4 chronic illnesses, such as diabetes, asthma, depression, etc.

Robert Wood Johnson Foundation.

Staff Contact
Kathleen Gmeiner
[email protected]
614-456-0060 x223

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