| Evaluation of value-based insurance design with a large retail employer. | |
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MedLine Citation:
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PMID: 22106461 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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OBJECTIVES: To measure adherence and assess medical utilization among employees enrolled in a disease management (DM) program offering copayment waivers (value-based insurance design [VBID]). STUDY DESIGN: Retrospective matched case control study. METHODS: Cases were defined as those enrolled in DM, of whom 800 received health education mailings (HEMs) and 476 received telephonic nurse counseling (NC). Controls were eligible for the DM program but did not enroll. Cases and controls were matched 1:1 based on propensity score (n = 2552). Adherence, defined by proportion of days covered, was calculated for 4 diseases using incurred drug claims 1 year before and after the DM program was implemented. Unadjusted and adjusted linear regression compared changes in adherence. Costs and utilization were compared at 1 year and 1.5 years after versus 1 year before implementation. RESULTS: Members receiving NC had improved adherence for antihypertensives, diabetes medications, and statins (β = 0.050, P = .025; β = 0.108, P < .001; β = 0.058, P = .017). Members receiving HEMs had improved adherence only for diabetes medications (β = 0.052, P = .019). Total healthcare costs for NC members increased by $44 ± $467 versus $1861 ± $401 per member per year (PMPY) for controls (P = .003) at 1.5 years post-implementation. Total healthcare costs for HEM members significantly increased ($1261 ± $199 vs $182 ± $181 PMPY for controls; P < .001) at 1.5 years. CONCLUSION: VBID may be effective in improving medication adherence and reducing total healthcare costs when active counseling is provided to high utilizers of care. |
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Authors:
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Yoona A Kim; Aimee Loucks; Glenn Yokoyama; James Lightwood; Karen Rascate; Seth A Serxner |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of managed care Volume: 17 ISSN: 1936-2692 ISO Abbreviation: Am J Manag Care Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-11-21 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9613960 Medline TA: Am J Manag Care Country: United States |
Other Details:
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Languages: eng Pagination: 682-90 Citation Subset: H |
Affiliation:
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School of Pharmacy, University of California, San Francisco, CA 94143, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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