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Fendrick Elected to Institute of Medicine

Monday, October 20, 2014. Washington, DC. Today, the Institute of Medicine (IOM) announced that V-BID Center Director, A. Mark Fendrick, MD, has been elected to join its membership. Election to the IOM is considered one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated outstanding professional achievement and commitment to service. Established in 1970 by the National Academy of Sciences, IOM has become recognized as a national resource for independent, scientifically informed analysis and recommendations on health issues. For additional details, read the official University of Michigan Health System press release.

Vbidcenter2019-10-30T18:17:00+05:00October 21st, 2014|News, Press Releases|

Seizing Opportunity to Provide Clinical Nuance in Medicare Advantage

Medicare provides health insurance to 54 million elderly and disabled Americans. Enrollment is expected to increase rapidly in coming years, as 10,000 baby boomers becoming eligible for Medicare each day. However, without action, the costs of Medicare—both per enrollee and growth in spending—threaten the program’s solvency. While predictions are less dire than previously expected, there is still much work to be done to align spending, quality, and care. Currently, enrollees in Medicare fee-for-service (FFS) face a “one-size-fits-all” approach to cost sharing. However, Medicare Advantage (MA) plans offer a unique opportunity to break out of the current mold of fee-for-service delivery and payment. As outlined in a V-BID brief on Medicare Advantage, private health plans have flexibility to use care management techniques to promote evidence-based, high value network formation, high performing provider-facing interventions (e.g., bonuses for quality and high performance), and utilization management programs to identify under-utilization as [...]

Vbidcenter2019-10-30T18:17:00+05:00October 18th, 2014|News|

V-BID included in CMS Request for Information to Innovate Medicare

Thursday, October 2, 2014, Washington, DC.  The Centers for Medicare & Medicaid Services (CMS) released a request for information to innovate Medicare Prescription Drug Plans (PDP), Medicare Advantage (MA) and Medicare Advantage Prescription Drug Plans (MA-PD), Medicaid managed care plans (Medicaid plans), Medigap plans, and Retiree Supplemental health plans.  Specifically, CMS requests information on innovations in: ●   Plan design, including but not limited to value-based insurance design ●   Care delivery; ●   Beneficiary and provider incentives and engagement; ●   Network design. This request coincides with the recent introduction of bipartisan, bicameral legislation to authorize a V-BID demonstration project in Medicare Advantage.    

Vbidcenter2020-01-06T16:55:32+05:00October 2nd, 2014|News, Press Releases|

AJMC Editorial on Generic Cost Sharing Generates Attention

On Wednesday, September 17, 2014, The American Journal of Managed Care published an editorial by Dr. A. Mark Fendrick, V-BID Center Director, and Dr. Gerry Oster, Vice President of Policy Analysis Inc. The piece, also featured in the New York Times Upshot, details a recent pharmacy benefits management trend in which several prominent health plans are forcing consumers to assume more of the burden of their health care costs by placing generic drugs into "preferred" and "non-preferred" tiers.  This parallels the split that one typically finds with branded drug pricing.  As a result, many patients now face substantially higher co-pays for various generic drugs -- many of which are recommended as first-line treatments for several chronic conditions and auto-immune diseases. The authors contend that the designation of these generic drugs as "non-preferred" based on cost alone may result in lower rates of medication and treatment adherence, which runs counter [...]

Vbidcenter2019-10-30T18:17:01+05:00September 17th, 2014|News|

V-BID for Better Care Act of 2014 Introduced in US Senate: “Transformative” Idea Attains Bipartisan, Bicameral Support

  Washington, D.C. September 11, 2014 - U.S. Senators John Thune (R-South Dakota) and Debbie Stabenow (D-Michigan) introduced bipartisan legislation The Value-Based Insurance Design (V-BID) for Better Care Act of 2014 (S.2783).  A summary of S.2783 is available.  A companion bill, H.R. 5183, was introduced by House Representatives Diane Black (R-Tennessee) and Earl Blumenauer (D-Oregon) in July. Specifically, the bipartisan, bicameral bills direct the Secretary of Health and Human Services to establish a three-year demonstration program allowing participating Medicare Advantage plans to test V-BID principles of reduced copayments and coinsurance for high-performing providers, evidence-based medications, or clinical services related to specific chronic disease care, while explicitly prohibiting plans from increasing copayments or coinsurance to discourage use of services. The clinical and economic impact of the demonstration project will be evaluated.  Expansion of the project depends on whether implementing V-BID plans that provide clinically nuanced incentives for beneficiaries with chronic conditions [...]

Vbidcenter2019-10-30T18:17:01+05:00September 11th, 2014|News, Press Releases|

Value-Based Insurance Design Better Care Act Introduced to Congress

July 23, 2014Washington, D.C. - Representatives Diane Black (R-TN) and Earl Blumenauer (D-OR) introduced H.R. 5183 - The V-BID for Better Care Act of 2014 to establish a regional demonstration program for Medicare Advantage plans that allows the utilization of Value-Based Insurance Design (V-BID) to reduce beneficiary cost-sharing for selected high-value prescription medications, providers, and clinical services related to chronic disease care.  A summary of the bill and official release are available.  A companion bill, S.2783 was introduced in the Senate in September of 2014.Specifically, the bipartisan, bicameral bills direct the Secretary of Health and Human Services to establish a three-year demonstration program allowing participating Medicare Advantage plans to test V-BID principles of reduced copayments and coinsurance for high-performing providers, evidence-based medications, or clinical services related to specific chronic disease care, while explicitly prohibiting plans from increasing copayments or coinsurance to discourage use of services.Evidence is accumulating that V-BID programs improve quality, reduce disparities, and in some circumstances, lower [...]

Vbidcenter2020-07-27T23:18:41+05:00July 23rd, 2014|News, Press Releases|

CMS Medicare Advantage Call Letter encourages V-BID Demo

Washington, D.C. February 21, 2014 -- The CMS Innovation Center issued a 2015 call letter seeking to partner with private payers to test innovations including - but not limited to - V-BID, beneficiary engagement, incentives, and/or care coordination to lower costs and improve quality for Medicare, Medicaid and CHIP beneficiaries (Section begins on page 113).  A new blog post from the Association of Health Care Journalists (AHCJ) is available. The University of Michigan Center for Value-Based Insurance Design leads in research, development, and advocacy for innovative health benefit plans.

Vbidcenter2020-01-03T17:55:27+05:00February 21st, 2014|News, Press Releases|

Value-Based Insurance Design Congressional Briefing on Medicare

February 21, 2014 - We are pleased to announce that Representatives John Dingell (D-MI) and Diane Black (R-TN) will convene a briefing on the role of V-BID in Medicare on Capitol Hill, Friday, February 28th.  Center Director, A. Mark Fendrick, MD, will present V-BID as an incremental solution to the health and economic well-being of Medicare Beneficiaries and all Americans. Understanding how the Medicare system could spend more efficiently and improve the health of beneficiaries offers an important step forward to ensure the program's solvency.  V-BID has been included in major bipartisan health reform proposals, including a prominent role in the Wyden-Isaacson 'Better Care, Lower Cost Act' introduced last month. Value-Based Insurance Design (V-BID) programs are designed with the tenets of clinical nuance in mind.  Clinical nuance recognizes that 1) medical services differ in the amount of health produced, and 2) the clinical benefit derived from a [...]

Vbidcenter2020-01-03T17:57:20+05:00February 21st, 2014|Briefings, News, Press Releases|

V-BID Concepts included in new Medicare Legislation to Improve Care and Lower Costs

January 15, 2014 WASHINGTON, D.C. - Today, U.S. Senators Ron Wyden, D-OR, and Johnny Isakson, R-GA, and U.S. Representatives Erik Paulsen, R-MN, and Peter Welch, D-VT, introduced legislation to improve care coordination for the millions of Medicare beneficiaries with multiple chronic conditions and to expand the use of multi-disciplinary health teams to keep patients as healthy as possible in their homes and communities. The Better Care, Lower Cost Act of 2014 (S.1932) creates the voluntary "Better Care Program" (BCP) that is open to Medicare enrollees suffering from chronic conditions.  BCPs have the ability to lower cost-sharing on services and provider visits that provide the most value for an enrollee's chronic conditions, the basic premise of Value-Based Insurance Design (V-BID).  Participating plans and practices would receive newly calculated risk-adjusted, capitated payments rewarding better health outcomes for enrolled beneficiaries.  A press packet and summary of the bill are also available. The University of Michigan Center for Value-Based Insurance [...]

Vbidcenter2020-01-03T17:58:41+05:00January 15th, 2014|News, Press Releases|

V-BID Summit 2013: Volume to Value, Infusing Clinical Nuance into Health Care Transformation

The 2013 summit invited policymakers, state health commissioners, plan directors, and health system leaders to engage in a highly interactive format to address supply- and demand-side innovations in numerous payer settings including state health insurance exchanges, Medicaid and Medicare plans, accountable care organizations and commercial insurance plans.

Vbidcenter2020-01-30T01:10:14+05:00December 30th, 2013|V-BID Summits|

V-BID in Action: Preventive Care Coverage in the Patient Protection and Affordable Care Act (ACA)

Originally Produced:  November 2013   Updated:  July 2019 Protecting Preventive Care Coverage in the Post-ACA Era Preventive Care Coverage in the ACA: Section 2713 of the Public Health Service Act as amended by the Patient Protection and Affordable Care Act (ACA) requires that issuers offering group or individual health insurance plans must provide coverage for specified preventive services without a beneficiary copayment or a contribution toward a deductible.  This elimination of consumer cost-sharing applies only when these services are delivered by a network provider. Determining Covered Preventive Services: Congress selected three organizations to determine covered preventive services with the intent to include all segments of the population.  These organizations are the United States Preventive Services Task Force, the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices, and the Health Resources and Services Administration.  The current list of preventive services includes a variety of counseling [...]

Vbidcenter2020-01-06T17:07:10+05:00November 1st, 2013|Briefs|

JAMA: Reform Proposals from Seven National Policy Centers and Stakeholder Coalitions Endorse V-BID

October 23, 2013 - Over the past year, diverse policy centers and stakeholder coalitions including the Bipartisan Policy Center, Brookings Institution, The Commonwealth Fund, Kaiser Family Foundation, National Coalition on Health Care, Partnership for Sustainable Health Care, and Urban Institute presented plans for reforming the US health care system.  In a recent JAMA analysis of proposals from these respected organizations, Value-Based Insurance Design (V-BID) and value-based payment reform were unanimously included as key elements for sustainable health care.  Administrative efficiency, spending limits, and Medicare reforms were also identified.  The inclusion of V-BID in each proposal demonstrates the growing multi-stakeholder and bipartisan political consensus among experts that V-BID is essential to a high-performing health care delivery system. Policy Comparisons Table, The Journal of the American Medical Association Developed by a multi-disciplinary team at the University of Michigan, the premise of Value-Based Insurance Design (V-BID) is to reduce barriers to high-value health services and providers and discourage [...]

Vbidcenter2020-01-06T17:22:58+05:00October 23rd, 2013|Press Releases|

V-BID Plays Key Role in Michigan Medicaid Expansion

August 1, 2013 LANSING, MI - Yesterday’s 20-18 Senate vote made Michigan the 25th state in the nation to expand Medicaid under the Affordable Care Act.  The new plan—Healthy Michigan—will provide coverage to an additional 470,000 residents over the next several years.  Among the provisions of the Senate version of House Bill 4714, Healthy Michigan relies on Value-Based Insurance Design (V-BID) to improve access, control costs, and enhance personal responsibility. Section 105d(1)(e) permits health plans to waive copays “to promote greater access to services that prevent the progression and complications related to chronic disease.”  Health plans may also reduce enrollee contributions for meeting certain healthy behavior goals or addressing unhealthy behaviors such as alcohol and tobacco use, substance use disorders, and obesity.  Moreover, Section 105d(1)(f) of the new law explicitly calls for the creation of a clinically nuanced value-based design:  “By July 1, 2014, design and implement a [...]

Vbidcenter2020-01-06T17:43:38+05:00August 1st, 2013|News, Press Releases|
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