Improving Quality: Disease Management and Pay for Performance

opportunity to fundamentally change the way health benefits are structured, and to reframe the national debate on healthcare to focus on the value of health services—not on cost or quality alone. In a VBID benefit, cost sharing is still utilized, but a “clinically sensitive” approach is explicitly designed to mitigate the adverse health consequences of high out-of-pocket expenditures. By aligning financial incentives, VBID can address several important inconsistencies in the current system and work synergistically with other initiatives to optimize healthcare effectiveness and efficiency.