One important goal of early value-based insurance models has been to identify patients who truly require chronic drug therapy and offer them significant discounts, so as to lower their stress levels and keep them productive and healthy.

Marriott International, a hotel chain with 2,800 properties worldwide, has embraced VBID plans and successfully managed to lower drug costs. 

"Medical benefits are an important part of our total compensation benefit package to attract and retain talent," Karen Graham, vice president for Marriott International, said at the 12^th Annual National Business Coalition on Health conference in Phoenix last week. 

As part of its VBID plan, Marriott has developed benefit design strategies to address immediate issues and is also working on longer-term strategies to manage high-risk illnesses, improve patient safety and increase productivity. 

Graham discussed preliminary findings of Marriott's VBID program, which started in 2005. In the short-term, the program appears to be improving employee adherence to prescription drug regimens.

Copayments were reduced to encourage members in a clinical group to continue or begin taking important medications to better manage chronic conditions. The copay for tier 1 drugs in Marriott's formulary was reduced from $5 to $0, and the copays for tier 2 and 3 drugs were reduced by 50%. In addition, Marriott waived copayments for generic drugs related to heart disease, diabetes and asthma. 

Marriott also monitored a control group where copayments weren't offered and drugs weren't covered. 

Marriott found that adherence increased significantly among the clinical group in most of the generic drug categories where copayments were waived. Out-of-pocket costs for the targeted generic drugs fell 65%, while control members' costs fell only 1%. In addition, out-of-pocket costs for brand-name targeted drugs decreased 27%, while control group members' costs went up 4%. 

Graham noted that overall, Marriott's costs for health care did not change significantly despite waiving copayments for some drugs and lowering copayments for others. 

Active Health Management, a health data technology unit of the insurance company Aetna, helped Marriott identify workers who could be eligible for the program. 

The company, which presented with Graham at the NBCH conference, said VBID programs create financial benefits for members, employers and health plans alike by providing individualized copay reductions based on medication needs. The result is a win-win situation that results in improved patient health and a reduction in sponsor costs, ActiveHealth concluded.