Patient Engagement
Clip
Value-Based Insurance Design: The Patient’s Role (03:06)

What’s the role of consumers and patients in discussions about creating value-based insurance?

There are several ways to deconstruct that question, according to Niteesh Choudhry, the Founding Executive Director of the Center for Healthcare Delivery Sciences at Brigham & Women’s Hospital. The first is, “what do we mean by value? Is my value the same as your value?” The easiest conceptualization of value-based insurance design is clinical value. It’s supposed to be objective, notes Choudhry, but patients may value different clinical outcomes. In this context, “the idea that consumers have a voice in setting value-based insurance design is almost certainly true.”

Consumers may also have a voice in saying they don’t want insurance at all, and with high-deductible health plans, they can pay out of pocket until insurance kicks in. But this can have adverse consequences for patients. “So we’re left with this frame that we want to give patients choices — to [help them] make choices that are good for them — that are congruent with their values,” says Choudhry, “but also with the observation that those choices sometimes lead to health care outcomes that are not entirely congruent with their likely values or with societal goals as a whole.”

“The complexity of plans is crushing now,” adds NEJM Catalyst Founding Advisor Thomas Lee. “For everyone who practices, January was just a terrible month, with patients coming in completely confused.” According to Lee, the non-standardization of benefits and design threatens the Affordable Care Act. “I do think that consumers and patients should be complaining about the complexity, and on the health plan side, benefits people should be standardizing, and they should be trying to create the Apple version of health plans.”

From the NEJM Catalyst event Patient Engagement: Behavioral Strategies for Better Health at the University of Pennsylvania, February 25, 2016.

More From Patient Engagement
Steps for Deploying Nudge Unit in Health Care

Nudge Units to Improve the Delivery of Health Care

Key information and important choices are constantly being presented in health care. Yet often the frames or default options used are selected without attention to strategic goals.

Example Cost of Custom-Built PRO Collection Platform

The Cost of Patient-Reported Outcomes in Medicine

Implementation of routine PRO collection is paramount to measuring and maximizing value in health care.

Mentoring, Education, and Engagement: An Employee Training Technique to Improve Patient Experience and Employee Satisfaction

How open communication and one-to-one mentoring generated team spirit and a learning environment.

Face-to-Face Group Sessions Are the Most Useful Mode of Communication in Health Social Networks

Survey Snapshot: Patient Networks Are Important for Outcomes

NEJM Catalyst Insights Council members overwhelmingly agree that social networks can impact chronic diseases and healthy behaviors, but time commitment and funding prevent their prevalence.

Consumerism in Health Care

Will personalized interventions transform how we improve an individual’s health? A frequent-flier expert believes that it will.

Chronic Disease Management and Healthy Behavior Promotion Are the Best Uses of Health Social Networks

Patient Engagement Survey: Social Networks to Improve Patient Health

Social networks — both face-to-face and virtual — have been shown to positively impact behaviors such as weight loss and smoking cessation. Is the health care industry ready to more widely leverage this mechanism for increasing healthy behaviors among patients?

Patient Inducements — High Graft or High Value?

Can health care be more like Uber and Lyft?

Consumer Engagement: New Tools and Capabilities for Health System Marketing

Novant Health is using research and data analytics to identify and engage new consumers, develop more relevant products and services, and support its mission and brand promise.

The Patient as Consumer and the Measurement of Bedside Manner

Many physicians do not believe patient satisfaction is a legitimate pursuit. Yet they must meet consumers of health care where they are — on Internet ratings sites.

Halpern02_clip_still: A/B Testing Health Behavior Interventions

A/B Testing Health Behavior

Health care can’t implement changes overnight like Silicon Valley, but we can still learn from their version of treatment and control.

Connect

A weekly email newsletter featuring the latest actionable ideas and practical innovations from NEJM Catalyst.

Learn More »

Topics

Patients As Customers

97 Articles

Nudge Units to Improve the Delivery…

Key information and important choices are constantly being presented in health care. Yet often the…

Patient-Centered Care

194 Articles

Nudge Units to Improve the Delivery…

Key information and important choices are constantly being presented in health care. Yet often the…

Patient Incentives

57 Articles

Nudge Units to Improve the Delivery…

Key information and important choices are constantly being presented in health care. Yet often the…

Insights Council

Have a voice. Join other health care leaders effecting change, shaping tomorrow.

Apply Now