In an invited commentary in JAMA Internal Medicine, the University of Michigan's Mark Fendrick, M.D., and Harvard University's Michael Chernew, Ph.D., put forth the framework for what they call a "high-value health plan."
It's the first peer-reviewed publication to put forth the idea, which has also appeared in a bipartisan U.S. House bill introduced in the last Congress.
Idea - Concepts - Health - Plans - Health
The idea combines the consumer-driven, market-based concepts of high deductible health plans linked to health savings accounts, with exemptions that enhance coverage for the clinical services that have been proven to benefit patients the most.
Currently, all HDHPs must cover certain preventive services without asking patients to pay for them out of their deductible. But existing regulations do not allow these plans to cover services to manage chronic disease.
Result - Patients - Illnesses - Diabetes - Depression
As a result, patients with chronic illnesses such as diabetes, depression, or heart disease must pay the entire cost of their tests, appointments, and prescriptions until they meet their plan's deductible. Many of these services are proven to keep their condition from getting worse, and in some cases have been found to lower total health care spending.
About 40 percent of privately insured Americans under age 65 have HDHPs, including many people who have bought insurance on the Healthcare . gov marketplace. Each year, these plans require an individual to pay at least $1,300 -- and a family the first $2,600 -- of their health costs before their benefit...
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