How do consumers define fair benefit and network designs?

Freedom of choice is one important factor.

 
When creating benefit and network designs for consumers, it pays to know what they want. Consumers say “value-based benefit designs”—such as reference pricing arrangements (when a payer determines the therapeutic effectiveness of drugs within a disease group and reimburses based on the least expensive option) and provider tiering (classifying providers into different groups based on certain criteria)—are fair when they offer: 
 
Freedom of choice. Consumers view benefit designs that offer several options to choose from more favorably than those that do not. 
Reassurance that all choices meet a minimum quality standard. Most consumers are not opposed to benefit designs that steer them toward certain choices, as long as they can be certain they are not exposing themselves to poor-quality care by going to the least expensive option. 
 
One way some health plans and employers are encouraging consumers to engage in shared decision-making is by offering them financial incentives. Financial incentives are a form of value-based insurance design with a benefit and network design tailored to encourage the consumer to use effective services and discourage them from using ineffective services.
 
Benefit designs should offer several options and include quality information and clear language so consumers understand why the information is being provided and can feel assured they are not sacrificing quality when choosing a lower-cost provider. 
 
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