Legislation based on U-M concept introduced in House
Representatives Diane Black (R-Tenn.) and Earl Blumenauer (D-Ore.) recently introduced bill H.R. 5652, entitled the “Access to Better Care Act of 2016.”
This bill provides high-deductible health plans the flexibility to provide coverage for services that manage chronic disease prior to meeting the plan deductible.
The bipartisan bill amends Section 223(c)(2) of the Internal Revenue Service (IRS) Code. Currently, in health savings account-qualified high-deductible health plans (HSA-HDHPs), services meant to treat “an existing illness, injury or condition” are excluded from coverage before the plan deductible is met. Evidence is accumulating that individuals enrolled in high-deductible plans may not utilize essential services to manage chronic conditions due to the high cost.
U-M professor A. Mark Fendrick, M.D., worked closely with congressional staff on the proposed legislation.
“Since chronic conditions make up 75 percent of total U.S. health spending, appropriate disease management is an important tool to improve patient-centered outcomes and, in some cases, lower long-term healthcare costs,” says Fendrick, who directs the U-M Center for Value-Based Insurance Design. “As the market for HSA-eligible HDHPs grows, it is important that these plans maintain the flexibility to allow for effective health management.”
The V-BID Center believes a targeted strategy allowing coverage for certain high-value, clinically-indicated health services prior to meeting the deductible will produce more effective “high value health plans” without fundamentally altering the original intent and spirit of these consumer-directed plans.
For more information on V-BID and HDHPs, visit the V-BID center website or contact the center at 734-615-9635 or firstname.lastname@example.org.