16 Pages Posted: 28 Feb 2006
This paper summarizes the history of benefit design in the U.S. approach to health care; the state of research evidence currently available for use in benefit design; and past and current efforts to integrate evidence into benefit design, including the barriers encountered in these efforts and suggestions for overcoming them. It focuses especially on the need for a different benefit design language that would enable an explicit linkage between evidence and benefits. This analysis is based on a review of the literature; on one of the author's experience, which includes executive service in a BlueCross/BlueShield plan; on policymaking in state government; and on interviews with health care leaders in both the public and private sectors.
Keywords: Evidence-based medicine, Health care cost containment, Health care delivery, Health care quality, Health insurance coverage
JEL Classification: I11
Suggested Citation: Suggested Citation
Santa, John and Gibson, Mark, Designing Benefits with Evidence in Mind. EBRI Issue Brief, No. 290, February 2006. Available at SSRN: https://ssrn.com/abstract=887311