On Friday, September 13th, 2019, Dr. A. Mark Fendrick, MD, Director of the Center for Value-Based Insurance Design (V-BID), spoke on the AHA CEO Roundtable conference call.
On Friday, September 6th, 2019, Dr. A. Mark Fendrick, MD, Director of the Center for Value-Based Insurance Design (V-BID), spoke at the SCV Employer Task Force meeting in Henrico, VA.
Lowering health care expenditures and ensuring access to high quality medical care for Medicare beneficiaries is a health policy priority. Value-Based Insurance Design (V-BID) is an innovative approach to consumer cost-sharing that can improve quality of care and potentially lower costs in the Medicare Program. V-BID plans are designed with the tenants of clinical nuance, recognizing that the clinical benefit derived from a specific service depends on the consumer using it, as well as when, where and by whom the service is provided. The most significant opportunity for V-BID implementation lies in the Medicare Advantage (MA) program.
On July 24th, 2019, the V-BID Center co-hosted the webinar VBID X: A New Plan Option for the Individual Health Insurance Market, with the Harvard Healthcare Markets & Regulation Lab.
White House Report Urges Broader Coverage for Chronic Diseases in HSA-Qualified High-Deductible Health Plans
White House Report Urges Broader Coverage for Chronic Diseases in HSA-Qualified High-Deductible Health Plans On December 3rd, 2018, the White House released its 119-page report, Reforming America's Healthcare System Through Choice and Competition. In this report, HHS, in collaboration with the Department of Treasury, Labor, the FTC, and the White House, sets forth many formal recommendations aimed toward developing a better health care system. The report highlights the need for HSA reform and, more specifically, advocates for the expansion of the scope of preventive care and chronic condition services covered before the minimum deductible is met. An excerpt from pages 82 and 83 is included below: "As noted above, an additional constraint on the availability and use of HSAs is the requirement that HSA-qualified plans can only provide certain preventive care benefits before the minimum deductible is met. Reconsideration of the scope of [...]
December 6, 2016 - Senate Finance Committee Chairman Orrin Hatch, R-Utah, and Ranking Member Ron Wyden, D-Ore., along with Senators Johnny Isakson, R-Ga., and Mark Warner, D-Va., co-chairs of the Finance Committee Chronic Care Working Group introduced S. 3504, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016, a bipartisan bill to strengthen and improve health outcomes for Medicare beneficiaries living with chronic conditions. Among the recommendations is the expansion of the Medicare Advantage V-BID demonstration to plans in any state: BILL SEC. 301. ADAPTING BENEFITS TO MEET THE NEEDS OF CHRONICALLY ILL MEDICARE ADVANTAGE ENROLLEES. (h) NATIONAL TESTING OF MODEL FOR MEDICARE ADVANTAGE VALUE-BASED INSURANCE DESIGN - (1) IN GENERAL - In implementing the model described in paragraph (2) proposed to be 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, 2019, [...]
Thursday, November 3, 2016: Vision Summit – Transforming Healthcare in an Evolving Political Landscape
On Thursday, November 3, Dr. A. Mark Fendrick, Director of the Center for Value-Based Insurance Design (V-BID), spoke at the 2016 Executive Vision Summit: Transforming Healthcare in an Evolving Political Landscape in Washington, DC. The Summit, which was sponsored by TriZetto Corporation, provided the opportunity to explore consumer-focused strategies in the shifting healthcare landscape, understand the importance of digital transformation and its impact on the healthcare industry, and gain insights from Washington on the political landscape for 2016 and beyond. Dr. Fendrick's presentation, titled "Value-Based Collaborative Care: Trends, Issues, and the Paths to Success," and the event agenda can be found below. Presentation Vision Summit Agenda
On August 10, the Centers for Medicare & Medicaid Services (CMS) announced refinements to the design of the second year of the Medicare Advantage Value-Based Insurance Design (MA V-BID) model. The MA-V-BID model is an opportunity for Medicare Advantage plans, including MA plans offering Part D benefits, to offer clinically nuanced benefit packages aimed at improving quality of care, while also reducing costs. In the second year of the model, beginning January 1, 2018, CMS will 1) open the model test to new applicants; 2) conduct the model test in three new states - Alabama, Michigan, and Texas; 3) add rheumatoid arthritis and dementia to the clinical categories for which participants may offer benefits; 4) make adjustments to existing clinical categories; and 5) change the minimum enrollment size for some MA and MA-PD plan participants. Value-Based Insurance Design (V-BID) generally refers to health insurers’ efforts to structure [...]
V-BID aligns patients' out-of-pocket costs with the value of services. These innovative plans are designed with the tenets of "clinical nuance", recognizing that 1) clinical services differ in the benefit health produced, and 2) the clinical benefit derived from a specific service depends on who receives it, who provides it, where it is provided. Our new video offers a visual guide to better understand clinical nuance.
Washington, July 13, 2016 - According to the American College of Physicians (ACP), consumer cost-sharing, particularly deductibles, may cause patients to forgo or delay care, including medically necessary services. ACP's position paper, "Addressing the Increasing Burden of Health Insurance Cost-Sharing," recommends the implementation of value-based insurance design (V-BID) as a potential solution to make patient cost-sharing more equitable. The ACP's endorsement of V-BID builds on multi-stakeholder and bipartisan support, including the incorporation of V-BID principles in Section 2713 of the Patient Protection and Affordable Care Act requiring the elimination of consumer cost-sharing for specified preventive care services, the CMS MA-VBID demonstration project set to begin in seven states in January 2017, and the H.R. 5652, "Access to Better Care Act of 2016," that allows high deductible health plans the flexibility to provide coverage for services that manage chronic disease prior to meeting the plan deductible. Each of these programs align with the ACP's [...]
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.
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 [...]
Dr. A. Mark Fendrick, Director of the Center for Value-Based Insurance Design (V-BID), recently traveled to mainland China to present at the Chinese Economic Society's Roundtable Discussion on precision medicine, the China-US Precision Medicine Industry and Policy Forum, and Beijing Hospital. For more information about each of these events, please follow the links below. Dr. Fendrick addressing the Chinese Economic Society about key tenets of V-BID strategy.
On Thursday, June 16, V-BID Center Director, Dr. A. Mark Fendrick, will present at Beijing Hospital in China. His presentation is titled "Value-Based Insurance Design: How to Improve Health and Be Able to Afford It." Dr. Fendrick's slide presentation is available via the link below: Dr. Fendrick with Dr. Sang Zhicheng of Beijing Hospital
On Monday, June 13th, Dr. A. Mark Fendrick, Director of the Center for Value-Based Insurance Design (V-BID), spoke at the China-US Precision Medicine Industry and Policy Forum. The Forum is part of a larger event, titled "The Fourth Shenzhen International Low Carbon City Forum," and took place in Shenzhen, Guangdong Province, China. Dr. Fendrick also participated in an additional roundtable event held on Sunday, June 12th. The 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, including the Chinese translation, can be found below. Dr. Fendrick presenting about the key tenets of V-BID strategy in China. [...]