April Health Affairs features CT state employee VBID plan results

An evaluation of CT’s state employee Health Enhancement Program (HEP) published in Health Affairs found improved access to primary care, reductions in ED use, and better medication adherence but has not produced savings. HEP is an early adopter of the Value-Based Insurance Design (VBID) model, linking consumer costs to the value of care. Implemented in 2011, HEP encourages preventive care and chronic care disease management with lower premiums and deductibles combined with $35 copays for non-emergency ED visits. Before HEP, per person spending in CT’s program was $7,914, far higher than a matched comparison group from other state employee programs at $4,375, almost three times as many CT state employees had high health costs (over $50,000), and ED use was 56% higher. Over 98% of members enrolled in HEP and utilization of preventive care rose significantly. ED visits dropped by a modest amount while visits in the comparison group rose. Results for members with chronic conditions were mixed and modest. Not unexpectedly, in the first two years costs per person rose – by $730 in the first year and $961 in the second. The authors suggest that this is due to increases in use of preventive care and plan administrators expect to benefit in the long term from this investment in the health of employees.