Oregon's test of value-based insurance design in coverage for state workers.

In 2010 two Oregon public employee benefit boards implemented value-based insurance design programs for state workers. The plans increase copayments for overused or preference-sensitive services of low relative value, and they cover preventive and high-value services at low or no cost. So far, the results have been promising. This article describes Oregon's recent experience designing and implementing these value-based insurance design programs for state workers. It illustrates the need to balance optimal policies on coverage and payment with what is politically acceptable to those covered, not only in the state, but also nationwide.