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Value-Based Health Management
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What Is VBHM?

Value-Based Health Management (VBHM) is a strategic approach to employee benefits. VBHM is the planning, design, implementation, administration, and evaluation of health management practices that are grounded in evidence-based guidelines across the healthcare continuum.

Principles of Value-Based Health Management

These principles define how VBHM helps control company healthcare costs by focusing on employee benefits.

  • Remove barriers
    Barriers to access such as out-of-pocket costs (i.e., copays, coinsurance) and limited formulary coverage can keep people from getting the care they need, potentially leading to disease progression and more costly interventions. Providing access and incentives by waiving or reducing out-of-pocket costs can help people get the treatment they need and stay with it. Access to care can keep people healthier longer and keep chronic diseases from getting worse and more expensive.
     
  • Integrate Care Management
    Create and integrate “care teams”—physicians, pharmacists, nurses, and health coaches who support employees in wellness, medical decision-making, and care/disease management. This approach helps employees and their dependents better manage their health conditions, reduce excess health risks, achieve desired clinical outcomes, and improve quality of life.
     
  • Focus on prevention
    Provide employees access to preventive care such as smoking cessation programs, weight management and nutrition classes, vaccination programs, and screenings to help prevent chronic health problems before they start.  

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Why VBHM Matters

VBHM is critical to the reduction of cost and/or access barriers. When the appropriate investments in health management practices are made, there's a greater total value to the organization. This can help reduce trends in direct healthcare spending and productivity-related losses due to:

  • Sick days
  • Disability
  • Workers' compensation
  • Employee turnover
  • Presenteeism

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Review the monograph Total Value, Total Return™ and the seven-rule foundation for creating a VBHM strategy.