Center for Health Value Innovation Calls for More Evidence in the Success of Value-Based Designs.

ST. LOUIS -- While the successes of value-based design are now reaching benefits decision-makers nationwide, there is an ongoing need for even more evidence, both real-world and academic, asserts the Center for Health Value Innovation (www.vbhealth.org), the nation's premier organization dedicated to establishing value and producing evidence for sustainable health and financial improvement.

An industry wide call for evidence documenting the effectiveness of value-based designs to create cost savings led to the development of The Center for Health Value Innovation, a 501c3, launched in 2007. The Center identifies and interfaces with innovative employers from all market sectors who are implementing a value-based design, generally defined as re-focusing resources to support modifiable behavior change that could improve health status and reduce health cost trend.

"Value-based design, the practice of investing in the most vulnerable populations that could benefit from modifiable behavior change strategies, is not simply a cost-reduction strategy," says Cyndy Nayer, president of The Center for Health Value Innovation. "The tenets of value-based design differ markedly from a cost compression model which has proven to actually drive costs, because cost-based efforts limit access to care rather driving behavior change. It is clear that benefits payers can reduce health cost trends by creating incentives and removing barriers to appropriate care."

Nayer emphasizes that the investment in appropriate lab testing, physician visits, and treatments - including but not limited to pharmaceutical treatments - has resulted in the total cost trend reduction over time.

"For those companies which have innovated over multiple years, this trend reduction appears sustainable, based upon their reports to the Center," she says. "What we need is more evidence, whether it is academic-based, business-based, or actuarially reviewed, as these are the dimensions of evidence that will sustain the movement."

While the market has equated value-based designs, also known as value-based benefit designs, with removal of barriers to pharmaceutical products and the expected-return-on-investment, this is not the total picture.

Jack Mahoney MD, CMO of the Center, former global health strategist for Pitney Bowes, and a national thought leader for value-based designs, adds, "Reducing Rx access is not a stand-alone initiative for driving sustainable cost trend reduction. A value-based design uses data to drive decisions for investing in modifiable behavior change. But this must be married to condition or disease management and tightly controlled, and it must have a comprehensive communication strategy focused on the goals of the person and aligned with the corporate growth strategy."

Mahoney advises that change happens at the person and population level, confirming the need to set goals at the appropriate level and communicate these objectives to all the stakeholders - including physicians - in order to generate improved outcomes.

"Once the health status begins to improve, the reduction in cost trends accumulates since there is a reduction in the inappropriate use of services," he adds. "The ROI of value-based design can be measured with tangible results in the flattening of the health cost curve -- including total health care costs spanning disability, workers' comp, and unscheduled absences."

About The Center for Health Value Innovation:

Launched in 2007, The Center for Health Value Innovation is a not-for-profit (501c3) organization representing industry stakeholders committed to sharing the evidence that value-based health designs improve health status and reduce health cost inflation. Visit www.vbhealth.org.