CMS Medicare Advantage V-BID Demo:
2020 Enrollment Numbers Triple and New Opportunities for 2021

December 19, 2019 –  Today, the Centers for Medicare and Medicaid Services (CMS) announced strong participation in the Medicare Advantage Value-Based Insurance Design (MA V-BID) model and released information on Medicare hospice benefits in CY 2021. 

View the excerpt below for details:

“CMS is today announcing that the number of MA enrollees in VBID-participating plan benefit packages (PBPs) more than tripled from 2019 to 2020, up to approximately 1.2 million beneficiaries in 2020. These over 1.2 million beneficiaries are enrolled in MA plans offered by 14 participating MA organizations across 30 states and Puerto Rico, up from only seven states in 2019.”

“As recommended by the Medicare Payment Advisory Committee (MedPAC) and others, this Model test recognizes that the Medicare hospice benefit has not been significantly updated since it was added as a Medicare covered benefit 36 years ago… If beneficiaries elect the hospice benefit provided by their MA plan, they will maintain the broad access they have today to the complete Medicare hospice benefit covered by Medicare FFS, as well as additional access to palliative care services, transitional concurrent care services, and hospice-specific supplemental benefits…”

The model launched on January 1, 2017, and has since been expanded to include all 50 states, 9 chronic conditions, Chronic Condition Special Needs Plans, Medicare Advantage and Part D Rewards and Incentives Programs, Telehealth Networks, Wellness and Health Care Planning, and allows participants to propose their own systems or methods for identifying eligible enrollees.  

The MA V-BID model test aims to assess the utility of structuring consumer cost-sharing and plan elements to encourage the use of high-value clinical services and providers for beneficiaries with specified chronic conditions.  V-BID approaches have increasingly been used in the commercial market, and the inclusion of clinically nuanced V-BID elements may be an effective tool to improve the quality of care and reduce the cost of care for Medicare Advantage enrollees with chronic diseases.

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 the MA V-BID Model.