Screening for Free: A Value-Based Insurance Design Natural Experiment

There is increasing interest in aligning health insurance benefits with clinical goals, i.e., value-based insurance benefits. Starting in 2010, Kaiser eliminated cost-sharing for preventive services for individual Medicare Advantage subscribers; other Medicare beneficiaries are subject to these changes in 2011. Eliminating cost-sharing for preventive services could align patient financial incentives better with clinical goals and remove potential financial barriers to care. The net clinical and economic effects of these policies are less certain. This study will examine whether the elimination of cost-sharing for cancer screening is associated with 1) increases in cancer screening that is recommended and not recommended by the USPSTF; 2) changes in clinical event rates including hospitalizations, outpatient visits, and prescription drug use; and 3) changes in total medical spending and its components, i.e., inpatient, outpatient, and drug spending.

0