Group Health gets $2 million to study value-based insurance

The effectiveness of Total Health, a benefits program for Group Health Cooperative employees, is the subject of a four-year study that the federal Agency for Health Research and Quality (AHRQ) recently funded. It's part of a trend to integrate care, insurance, and wellness programs and base them on research findings. The goal is to help people stay healthier and control health care costs.

Launched in January 2010 and available to all 9,000 Group Health employees, the Total Health benefits program is an example of "value-based insurance design." Employers are using financial incentives in a "carrot and stick" approach to nudge employees toward those treatments and preventive measures that research has proven work best. David Grossman, MD, MPH, Group Health's medical director of preventive care and a senior investigator at Group Health Research Institute, is leading the multidisciplinary evaluation of the program.

As Dr. Grossman helped develop Total Health, he recognized a chance to conduct a natural experiment on the plan's implementation. He got Group Health Research Institute funding early on to collect preliminary baseline data on participants. With the AHRQ-funded evaluation, scheduled to begin this fall, he can now see how Total Health affects factors such as chronic disease control and quality of life among its enrollees.

The study will compare Total Health participants both to the preliminary "before" information and to a control group of Kaiser Permanente Colorado employees who have a conventional, non-values-based health plan.

"If the program proves to be in (participants') best interests - and in the best interests of Group Health, as an employer that sponsors health insurance for thousands of employees as well as their dependents and spouses - then Group Health will likely offer similar programs to other clients and customers," says co-investigator Paul Fishman, Ph.D., an associate investigator at Group Health Research Institute

"Our goal is to disseminate the results of the value-based insurance product - whatever they turn out to be - as widely as possible, so that our evidence is accessible to the entire industry," Fishman says.