Value Based Insurance Design


Value Based Insurance Design Employer Manuals

The SIM Program Management Office and the Office of the State Comptroller released streamlined Value-Based Insurance Design Employer Manuals for Self-Insured and Fully-Insured Employers. The manuals contains templates and supporting documentation for employers interested in developing value based insurance design plans.

Public Comment Sought for Value-Based Insurance Design Manuals.

The SIM PMO and Office of the State Comptroller (OSC) have released updated versions of the Value-Based Insurance Design (VBID) templates previously designed in 2016. The updated templates streamline the recommendations of the VBID Consortium, a multi-stakeholder group that met in early 2016 to develop templates for health insurance plans with VBID components, such as reduced cost sharing for chronic condition management. In order to support Connecticut employers in implementing VBID plans for their employees, the PMO and OSC worked with a consultant, Freedman Healthcare, to develop both VBID templates and implementation manuals. Based on feedback from employers over the past year, the templates have been updated to increase usability and ultimately encourage the update of VBID plans in Connecticut.

Value-based insurance design (V-BID) is an innovative insurance strategy that seeks to improve health and control rising health care costs by promoting the use of high value services and providers through consumer incentives. High-value services are those that have a strong evidence-base, enhance clinical outcomes, and increase efficiency. V-BID plans utilize “clinical nuance”, a concept that recognizes that medical services differ in the benefit provided, and that the clinical benefit derived from a specific service depends on the patient using it, as well as when, where, and by whom the service is provided. The aim of V-BID is to increase healthcare quality and use healthcare dollars more effectively by implementing differential cost sharing for consumers to promote use of high value services and providers, and decrease use of low value services.

Click below to access the manuals:

Value Based Insurance Design Employer Manual for Self-Insured Employers

Value Based Insurance Design Employer Manual for Fully-Insured Employers