Adult-Gerontology Clinical Nurse Specialist (CNS) Practice Exam

Which of the following statements about value-based insurance design (VBID) is least accurate?

1. VBID acknowledges and addresses the homogeneity of patients and clients

2. There are two models of VBID

3. VBID calculates both benefit and cost

4. VBID copayments are set based on the value of the clinical services

The correct answer is: VBID acknowledges and addresses the homogeneity of patients and clients

Value-based insurance design (VBID) is a strategy aimed at improving the quality of care while managing costs. It does so by aligning patients' cost-sharing (like copayments and deductibles) with the value of treatments and services. In the context of this question, the statement about VBID acknowledging and addressing the homogeneity of patients and clients is the least accurate. VBID is based on the understanding that patients are diverse and have different needs, conditions, and preferences. Instead of treating patients as a homogeneous group, VBID recognizes the variability among patients and tailors insurance benefits to better meet the needs of different individuals. Therefore, stating that VBID acknowledges and addresses the homogeneity of patients contradicts the foundational principles of the VBID approach. The other aspects of VBID are accurate: there are indeed two models of VBID typically involving either a reduction in patient cost-sharing for high-value services or an increase in cost-sharing for low-value services. Additionally, VBID takes into account both the cost and the benefit of clinical services to better align costs with the value that those services provide. Finally, VBID copayments are designed to reflect the clinical value of services, incentivizing patients to engage with high-value care while discouraging low