Value-Based Health Insurance Design: How Much Does Socioeconomic Status Matter?

AJMC July 18, 2018
Bruce W. Sherman, MD, and Carol Addy, MD, MMSc

Socioeconomic status may significantly influence enrollee response to value-based benefit design approaches. Evaluating the association of wage status with claims experience may yield actionable insights.

ABSTRACT

Socioeconomic status (SES), an important determinant of individual health status, has not been widely incorporated into employer benefits strategies. Recent research has characterized significant differences in healthcare utilization patterns and cost among workers in different wage categories, raising the possibility that SES does influence individual healthcare utilization behaviors. In particular, SES may have appreciable impact on the effectiveness of benefits tactics, including value-based insurance design (VBID).

This paper sets forth a hypothesis that low wage status negatively influences individual receptivity to VBID offerings, which may blunt the impact of current VBID initiatives. In contrast,...

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