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  New Alexander-Murray bipartisan bill includes V-BID Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) reached an agreement on Tuesday, October 17th regarding their bipartisan bill to fund key insurance subsidies.  The cost-sharing reduction payments reimburse insurance companies for lowering deductibles, co-payments and other out-of-pocket costs for low-income customers.  Page 11 of the draft bill language includes a section on value-based insurance designs: "(iii) waivers encouraging or requiring health plans in such State to deploy value-based insurance designs which structure enrollee cost-sharing and other health plan design elements to encourage enrollees to consume high-value clinical services;" Value-Based Insurance Design (V-BID) is a potential solution built on the principle of lowering or removing financial barriers to essential, high-value clinical services and providers.  V-BID plans align patients’ out-of-pocket costs, such as copayments and deductibles, with the value of services.  These innovative programs are designed with the tenets of clinical nuance in [...]

Ann Arbor, MI -- If you've tried to see a doctor, fill a prescription or get a diagnostic test lately, you've probably had to pay more out of your own pocket than you would have even a few years ago. Most insurance plans have increased [...]

September 26, 2017 - Today, the United States Senate passed S. 870,  Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017, 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 SECTION 301.  ADAPTING BENEFITS TO MEET THE NEEDS OF CHRONICALLY ILL MEDICARE ADVANTAGE ENROLLEES UNDER MEDICARE ADVANTAGE.  Under Medicare Advantage (MA) private health plans are paid a per-person monthly amount to provide all Medicare-covered benefits (except hospice) to beneficiaries who enroll. Unlike original Medicare, where providers are paid for each item or service provided to a beneficiary, an MA plan receives the same capitated monthly payment regardless of how many or few services a beneficiary actually uses. The plan is at-risk if aggregate costs for its enrollees exceed program payments and [...]

Ann Arbor, MI -- If you've tried to see a doctor, fill a prescription or get a diagnostic test lately, you've probably had to pay more out of your own pocket than you would have even a few years ago. Most insurance plans have increased [...]

As Washington grapples with the fate of the Affordable Care Act, a pair of health care researchers has proposed a new way to design health insurance plans [...]

President Signs Defense Bill Authorizing TRICARE V-BID Pilot On Friday, December 23rd, 2016, the President signed a $619 billion defense bill that calls for a pilot program to demonstrate and test the feasibility of incorporating Value-Based Insurance Design into the TRICARE program.  The pilot aims to improve health outcomes and enhance the experience of care for U.S. Armed Forces military personnel, military retirees, and their dependents. Section 701:  (1) IN GENERAL -- Not later than January 1, 2018, the Secretary of Defense shall carry out a pilot program to demonstrate and assess the feasibility of incorporating value-based health care methodology in the purchased care component of the TRICARE program by reducing copayments or cost shares for targeted populations of covered beneficiaries in the receipt of high-value medications and services and the use of high-value providers under such purchased care component, including by exempting certain services from deductible [...]

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, [...]

2017 Defense Bill Calls for Expanded Role for V-BID in TRICARE Program House and Senate conferees have agreed to an almost $619 billion defense budget that calls for a demonstration using Value-Based Insurance Design in the TRICARE program.  The National Defense Authorization Act for fiscal year 2017 is tentatively scheduled for a House vote Friday and a Senate vote soon thereafter, senior staffers told the press on December 1st.  Text of the conference report - Page 454: (1) IN GENERAL -- Not later than January 1, 2018, the Secretary of Defense shall carry out a pilot program to demonstrate and assess the feasibility of incorporating value-based health care methodology in the purchased care component of the TRICARE program by reducing copayments or cost shares for targeted populations of covered beneficiaries in the receipt of high-value medications and services and the use of high-value providers under such purchased [...]