HCP Professor Michael E. Chernew, PhD, an economist, is playing an increasingly major role on the national health care stage. As a member of MedPAC (the federal Medicare Payment Advisory Commission), the Commonwealth Fund’s Commission on a High Performance Health System, and the Congressional Budget Office Panel of Health Advisers, Chernew is well positioned to influence the future of the nation’s health care system.
MedPAC is an independent agency whose mandate is to analyze access to care, quality of care, and other issues affecting Medicare and to advise Congress on Medicare payments to health plans and providers. The Commission on a High Performance Health System promotes a health system that “provides all Americans with affordable access to high-quality, safe care while maximizing efficiency in its delivery and administration.” The CBO's Panel of Health Advisers examines frontier research in health policy and advises the agency on its analyses of health care issues.
Along with his participation in these national discussions, Chernew is carrying out some very interesting research on the structure of health insurance. “We’re looking at practical ways to promote cost containment,” he says, “without sacrificing quality of care.” One major focus of his work is examining “value-based insurance design.” “As health care costs rise” says Chernew, “there’s an increasing move to shift the payments to patients. But medical services vary dramatically in the ‘value’ they provide, with some services being fundamental to providing good health care. Value-based insurance design tries to carve out those services that are clinically important—of high value—and keep costs for them low.”
High-value services include those important for appropriate management of chronic disease, such as cholesterol medicine, diabetes medicine, and blood pressure medicine (especially for people with diabetes), as well as certain preventive services, such as eye exams for people with diabetes and colonoscopies. Value-based insurance is designed to remove financial barriers for these high-value health care services and minimize the costs to patients.
Chernew and his colleagues are currently evaluating the effects of several value-based insurance programs offered by large employers across the country. “Most of our evaluations suggest that one can improve the quality of care through these programs,” says Chernew. “The financial effects are more difficult to assess, as they depend on the structure of the individual programs. There are, of course, some financial savings, because healthy people use fewer services, but it is less certain whether they exceed the cost of the program.”
Through his own research and his membership on “high-value” national committees, Chernew is helping lead the way to reforming the nation’s health care system.
