On February 9, 2018, President Trump signed the Bipartisan Budget Act of 2018.  The funding bill incorporates the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017, which includes the expansion of the CMMI Medicare Advantage Value-Based Insurance Design (V-BID) Model to all 50 states.  The model allows Medicare Advantage plans the flexibility to reduce cost-sharing or offer supplemental benefits to enrollees with specified chronic conditions, focusing on the services that are of highest clinical value to them.

SEC. 50321: Adapting Benefits to Meet the Needs of Chronically Ill Medicare Advantage Enrollees.

“(h) National Testing of Medicare Advantage Value-Based Insurance Design Model-

“(1) In General – In implementing the Medicare Advantage Value-Based Insurance Design model that is being tested under section 1115A(b), the Secretary shall revise the testing of the model under such section to cover, effective not later than January 1, 2020, all States.

“(2) Termination and Modification Provision Not Applicable Until January 1, 2022 – The provisions of section 1115(b)(3)(B) shall apply to the Medicare Advantage Value-Based Insurance Design model, including such model as revised under paragraph (1), beginning January 1, 2022, but shall not apply to such model, as so revised, prior to such date.

“(3) Funding – The Secretary shall allocate funds made available under section 1115(f)(1) to design, implement, and evaluate the Medicare Advantage Value-Based Insurance Design model, as revised under paragraph (1).”

The nationwide expansion of the CMS MA V-BID demonstration by January 1, 2020, demonstrates growing bipartisan support for the expanded role of V-BID principles in public and private payers including the TRICARE program, and most recently, the introduction of the Chronic Disease Management Act of 2018.  This bipartisan bill provides high-deductible health plans the flexibility to provide coverage for services that manage chronic disease prior to meeting the plan deductible.

A. Mark Fendrick, MD, developer of the V-BID concept and Director of the University of Michigan V-BID Center, is available for questions or comments.

View the resources below to learn more about V-BID in Medicare Advantage.

Medicare Advantage White Paper        Medicare Advantage Infographic        V-BID Medicare Advantage Brief        History of V-BID in Medicare Timeline