Press Releases

  Washington, D.C.-- Representatives Diane Black (R-TN) and Earl Blumenauer (D-OR) introduced H.R. 5652 "Access to Better Care Act of 2016."  This bill provides high deductible health plans the flexibility to provide coverage for services that manage chronic disease prior to meeting the plan deductible.    The bipartisan bill amends Section 223(c)(2) of the Internal Revenue Service (IRS) Code.  Currently, in health savings account-qualified high deductible health plans (HSA-HDHPs), services meant to treat "an existing illness, injury or condition" are excluded from coverage  before the plan deductible is met.  Evidence is accumulating that individuals enrolled in high deductible plans may not utilize essential services to manage chronic conditions due to the high cost.  As chronic conditions make up 75 percent of total U.S. health spending, appropriate disease management is an important tool to improve patient-centered outcomes and, in some cases, lower long-term health care costs.  As the market for HSA-eligible HDHPs grows, it is important that [...]

Today, the House Republicans released their Report from the Health Care Reform Task Force, a white paper outlining a number of policy proposals they believe will lower health care spending and deliver higher quality care.  Notably, the proposal recommends allowing for the implementation of value-based insurance design (V-BID) throughout Medicare Advantage (see full text below) as a potential solution to 'one-size-fits-all' deductibles, copayments, and coinsurance. This expanded role of V-BID in the Medicare Program builds on bipartisan legislation that passed in the House last summer (HR 2750), the CMS MA-VBID demonstration project set to begin in seven states this January, and the inclusion of V-BID principles in Section 2713 of the Patient Protection and Affordable Care Act that requires the elimination of consumer cost-sharing for specified preventive care services. Report Language Page 33:  "Today's traditional fee-for-service (FFS) Medicare program isolates beneficiaries from the true cost of health care.  For example, Medigap policies provide something called first-dollar [...]

Access to prescription drugs is a hot-button health care issue. The V-BID center proposes an innovative benefit design - 'Reward the Good Soldier'.

On Tuesday, March 8th, the Centers for Medicare and Medicaid Services (CMS) proposed a rule that would test a new way for Medicare Part B to pay for prescription drugs.  The proposal includes value-based insurance design (V-BID) principles of discounting or eliminating cost-sharing and varying payments for drugs based on clinical effectiveness for different indicators (clinical nuance). CMS Acting Administrator Andy Slavitt stated, "These proposals would allow us to test different ways to help Medicare beneficiaries get the right medications and right care while supporting physicians in the process.  This is consistent with our focus on testing value-based care models like we have been doing with physicians and hospitals in ACOs.  Models like this one can help doctors and other clinicians do what they do best: choose the medicine and treatment that keeps their patients healthy." Read more on V-BID in the Medicare program.

WASHINGTON, D.C. – The Preservation of Access for Seniors in Medicare Advantage Act of 2015 (HR 2581) was passed by the Ways and Means Committee on June 2nd.  This legislation would require the Secretary of Health and Human Services to select MA plans to begin testing V-BID methodology.  This demonstration project would allow plans to lower copayments and coinsurance for their beneficiaries, encouraging the use of high-value, evidence based medical services to better manage chronic conditions.  The legislation explicitly prevents plans from increasing beneficiary cost-sharing on any service. This bipartisan legislation will be discussed on the floor of the House of Representatives as part of a package of bills aimed to strengthen the Medicare Advantage program.  A bipartisan companion bill,  Value-Based Insurance Design Seniors Copayment Reduction Act of 2015 (S.1396), was introduced to the Senate on May 20th.  

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 [...]