Healthcare Reform – Value Based Insurance Designs

Summaries based on the original text of the Patient Protection and Affordable Care Act (Passed by the US Senate 12-24-09. Passed by the US House of Representatives 3-21-10. Summary is for informational purposes only. Actual provisions and any amended portions of the bills apply).

Value Based Insurance Designs

  • The Secretary can develop or create guidelines which will allow an insurer to create “value based insurance designs” (pp. 22, lines 5 -9).
  • Value based insurance designs vary pricing based on outcomes derived in “population studies.”
  • The more effective a particular procedure or intervention, the lower the price. The less effective the procedure or intervention, the higher the price.

More information on “value based insurance designs” can be found at: http://www.sph.umich.edu/vbidcenter/about.htm