CMS Expands Medicare Advantage V-BID Model; White Paper Supports Financial Feasibility
On August 10, 2016, the Center for Medicare and Medicaid Innovation announced changes to the Medicare Advantage Value-Based Insurance Design (MA-VBID) model. The MA-VBID model test is set to begin in January 1, 2017, at which time selected MA plans in designated states will be permitted to offer varied benefit designs for enrollees diagnosed with specified clinical conditions. In 2018, the model will expand to Alabama, Michigan, and Texas, and will add two clinical categories: rheumatoid arthritis and dementia. For additional information about the CMMI MA V-BID model program, please visit the model website: innovation.cms.gov/initiatives/vbid/ Our latest White Paper, supported by the Gary and Mary West Health Policy Center, draws attention to the growing problem of cost-related non-adherence in Medicare and explores how clinically nuanced cost-sharing can mitigate adverse patient-centered outcomes. Actuarial modeling reveals that Medicare Advantage plans that reduce cost-sharing for high-value services for select chronic conditions [...]
Enhancing Flexibility in HSA-HDHP Design by Applying V-BID & Clinical Nuance Principles to Better Align the “Preventive Services Safe Harbor”
Shifting the health care system from “volume-to-value” has become a common theme in health care reform discussions. Benefit designs that engage consumers in their health care, while also encouraging access to high-value and appropriate care, are of particular interest.
Health Information Technology & V-BID: A Synergistic Combination Introduction
Health Information Technology & V-BID: A Synergistic Combination IntroductionValue-Based Insurance Design (V-BID) is an innovative approach that can improve clinical outcomes and contain costs. The basic premise of V-BID is to align consumer incentives with value by reducing barriers to high-value health services and providers (‘carrots’) and discouraging the use of low-value health services and providers (‘sticks’). When ‘carrots’ are coupled with ‘sticks’ in a clinically nuanced manner, V-BID improves health care quality and controls spending growth. The concept of clinical nuance recognizes that: 1) medical services differ in the benefit provided; and 2) the clinical benefit derived from a specific service depends on the patient using it. This brief examines how the incorporation of V-BID principles into health information technology (HIT) can enhance the potential for HIT to improve quality and increase efficiency.Interoperable HIT systems, meaning systems with the capability to “talk to each other” by exchanging [...]
Press Release: Bipartisan “Access to Better Care Act” Introduced to House of Representatives
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 [...]
May 2016 News Update
This month's news update features support for V-BID on Capitol Hill, continued momentum for the alignment of payment and benefit design, and a research agenda to address low-value care.
Sunday, June 12, 2016: China’s Health Economics and Policy for “Moon Shot” Precision Medicine Roundtable Discussion
On Sunday, June 12th, Dr. A. Mark Fendrick, Director of the Center for Value-Based Insurance Design (V-BID), will speak at the Chinese Economist Society's Roundtable Discussion on precision medicine. The roundtable discussion is part of a larger event, titled "The Fourth Shenzhen International Low Carbon City Forum," and will take place in Shenzhen, Guangdong Province, China. Dr. Fendrick will also participate in an additional forum event held on Monday, June 13th. The roundtable event will bring together health economists and policy stakeholders to discuss the opportunities and challenges of using genomic science to improve the quality and efficiency of health care and public health services delivery in China and internationally. Dr. Fendrick will discuss V-BID in the context of the Chinese health system and precision medicine. Dr. Fendrick's presentation and the event agenda can be found below. Dr. Fendrick addressing the Chinese Economic [...]
Monday, May 23, 2016: Military Health System Value-Based Care Summit
On Monday, May 23rd, Dr. A. Mark Fendrick, V-BID Center Director, spoke about value-based insurance design (V-BID) at the Military Health System (MHS) Value-Based Care Summit at the Defense Health Headquarters. The event was hosted by the Defense Health Agency (DHA) and took place just outside Washington, D.C. Dr. Fendrick served as the keynote speaker for the summit, which brought together senior leaders in the Armed Services and key personnel from the DHA and TRICARE. Dr. Fendrick's presentation, "Enhancing Value in the Military Health System: Using 'Clinical Nuance' to Align Provider and Consumer Incentives," highlighted the long-term strategy, rationale, and utility for implementing V-BID in the MHS. Dr. Fendrick's presentation, as well as the detailed MHS summit brochure and agenda are available below. Presentation Summit Brochure Summit Agenda In February of this year, Dr. Fendrick testified before the US Senate Committee on [...]
V-BID Whiteboard Video: Reward the Good Soldier
Access to prescription drugs is a hot-button health care issue. The V-BID center proposes an innovative and dynamic benefit design - Reward the Good Soldier - that recognizes that individualized therapies are often needed to achieve desired health outcomes.
Narrow Networks and Value-Based Insurance Design
Narrow Networks and Value-Based Insurance DesignExecutive SummaryNarrow networks aim to improve patient outcomes and increase quality of care by establishing a pool of providers to supply consumers with high-value, evidence-based care. This concept incorporates Value-Based Insurance Design (V-BID) principles, aligning patients’ out-of-pocket costs with the clinical value of services. However, narrow networks are often a source of confusion for consumers who may struggle to understand provider groups and performance metrics. Additionally, these value-based networks face the obstacle of ensuring an adequate network of providers for their patient population. Despite these challenges, narrow networks remain a promising alternative to traditional health coverage plans that may help contain costs, while improving patient outcomes.BackgroundNarrow networks are a type of benefit design made popular by managed care organizations in the 1980s and 90s, and are gaining traction once again, in part due to the Affordable Care Act. Aimed at cost containment, narrow networks [...]
VBID: How Clinically Nuanced Care Became a Game Changer
This interactive timeline highlights the history of Value-Based Insurance Design (V-BID) from the conception of clinically nuanced cost-sharing to the implementation of V-BID principles into private and public health plans across the country.
March 2016 News Update
This month's V-BID news update discusses recent support in the US House of Representatives, a new V-BID proposal from CMS, and a myriad of academic and news publications.
The History of V-BID in the Medicare Program
This interactive timeline explores the history of Value-Based Insurance Design (V-BID) in Medicare and Medicare Advantage. It all began in 2005 with the founding of the V-BID Center. Since then, legislation has been written, public support has been strong, and V-BID has been infused into Medicare and Medicare Advantage policy.
February 2016 News Update
The February 2016 V-BID news update highlights V-BID in action in defense health care reform, Michigan Medicaid, and Medicare Advantage. The news update also features recent research and popular press publications, and three newly developed V-BID infographics.
Senate Committee on Armed Services Testimony
On Tuesday, February 23rd, Dr. A. Mark Fendrick, Director of The Center for Value-Based Insurance Design, testified before the United States Senate Committee on Armed Services Subcommittee on Personnel. Dr. Fendrick discussed how the principles of value-based insurance design (V-BID) and clinical nuance can contribute positively to defense health care reform.