Pitfalls in Linking Cost Sharing to Value

TO THE EDITOR:

Braithwaite and Rosen (1) present an intriguing argument for enhancing patient adherence to “high-value” medical therapies, namely removal (or reduction) of cost-share obligations by the third party bearing risk. The authors correctly identify a major barrier to implementing their proposal—actuarial amortization of the added cost to the payer, when the “payback” (medical offset) from reduction in service utilization may occur with an uncertain time horizon, if at all.

Payers in North America, Europe, …