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CMS Expands Value-Based Insurance Program

Posted in Hospitals and Institutions, Medicare and Medicaid, Reimbursement Matters

On January 18, the Centers for Medicare & Medicaid Services (CMS) published a fact sheet announcing a broad array of Medicare Advantage (MA) health plan innovations that will be tested in the Value-Based Insurance Design (VBID) model for CY 2020. The VBID model is designed to reduce Medicare program costs, enhance the quality of care for Medicare beneficiaries, including dual-eligible beneficiaries, and improve the coordination and efficiency of health care service delivery. For CY 2020, and consistent with the requirements of the Bipartisan Budget Act of 2018, the scope of eligible plans for the VBID model has been expanded to include: Regional Preferred Provider Organizations and all Special Needs Plan (SNP) types – Chronic Condition SNPs, Dual Eligible SNPs, and Institutional SNPs. For the CY 2020 VBID application period, which is open now through March 1, 2019, eligible Medicare Advantage organizations may apply to test one or more of the following new interventions:

  • Value-Based Insurance Design by Condition, Socioeconomic Status, or Both
  • Medicare Advantage and Part D Rewards and Incentives Programs
  • Telehealth
  • Wellness and Health Care Planning

In order to be able to sufficiently evaluate the impact on cost and quality of these different approaches, CMS is extending the performance period of the VBID model by an additional three years, through 2024.

See the VBID CY 2020 Request for Applications for additional detail on 2020 interventions, as well as how to apply at https://innovation.cms.gov/initiatives/vbid.

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