V-BID Center Spring Update 2018
This update features policy developments, media reports, and events supporting continued momentum for multiple V-BID Center initiatives from the first quarter of 2018.
V-BID Op-Ed Featured in Morning Consult: Star Wars vs. Flintstones
On March 28, 2018, the Morning Consult featured an op-ed written by V-BID Director, Dr. A. Mark Fendrick. The article, titled “The Health Care Spending Disconnect: Star Wars vs. Flintstones,” highlights the discrepancy between groundbreaking innovations in medical treatments and America's stone age care-delivery model. The disconnect between medical advancements available to patients and their ability to pay for them is addressed by the V-BID Center's Precision Benefit Design initiative, which recognizes that individualized therapies are often needed to achieve desired health outcomes. This proposed benefit design plan lowers consumer cost-sharing for patients who required a more costly targeted or alternative therapy for their condition. For the full article and more information on precision benefit design, click the buttons below.
Michigan Radio’s Stateside Podcast Features V-BID
On March 1, 2018, Michigan Radio's Stateside podcast featured an interview with V-BID Center Director, Dr. A. Mark Fendrick. The podcast focused on the widespread popularity and bipartisan support of the V-BID concept and touched on multiple V-BID Center initiatives, including clinical nuance, Precision Benefit Design, and Low-Value Care. As Americans are being asked to pay more for their health care -- the good stuff and the bad stuff -- we decided that instead of having Americans pay less for the inexpensive things and more for the expensive things, we should design an insurance product that actually makes it easy for patients to get the services that make them healthy, and maybe a little be harder for the services that don’t... -Dr. A Mark Fendrick, V-BID Center Director A. Mark Fendrick, MD, developer of the V-BID concept and Director of the University of Michigan V-BID [...]
Press Release: President’s Cancer Panel Report Includes Recommendation for Value-Based Drug Pricing
On March 16, 2018, the President's Cancer Panel released a report to the President titled "Promoting Value, Affordability, and Innovation in Cancer Drug Treatment." The report addresses the rising cost of cancer drugs and includes a recommendation for "value-based pricing and use of cancer drugs." Such a recommendation aligns with the core principles of value-based insurance design and supports the V-BID Center's Precision Benefit Design initiative. PART 2: Taking Action to Promote Value, Affordability, and Innovation in Cancer Drug Treatment "V-BID may be well suited to cancer care due to the increasing role of high-cost specialty drugs and the growing capability to use biomarkers to match drugs with patients most likely to benefit. Public and private payers should develop and test V-BID programs that promote patients’ use of high-value cancer drugs." (p.15) Specific recommendations made by the President's Cancer Panel to promote value-based pricing and [...]
Press Release: Government Funding Bill Expands MA V-BID Model Test to All 50 States
Government Funding Bill Expands MA V-BID Model Test to All 50 States 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 [...]
Press Release: Chronic Disease Management Act of 2018 Introduced in Congress
On Thursday, February 8th, 2018, Senators John Thune (R-SD) and Tom Carper (D-DE), and Representatives Diane Black (R-TN) and Earl Blumenauer (D-OR), introduced the Chronic Disease Management Act of 2018 (S.2410 and H.R. 4978) in the House of Representatives and the Senate. The bipartisan bill states, "Allowing health savings account-eligible high-deductible health plans to cover chronic disease prevention and treatment on a pre-deductible basis promotes the concept of Value-Based Insurance Design, which is an effective tool to improve the quality and reduce the cost of care for Americans with chronic diseases, with improved outcomes via increased medication adherence, reduced complications, and decreased emergency department visits."The bill amends IRS Section 223 (c)(2)(C):(a) IN GENERAL—Section 223(c)(2) of the Internal Revenue Code of 1986 is amended by redesignating subparagraph (D) as subparagraph (E) and by inserting after subparagraph (C) the following new subparagraph: ‘‘(D) SAFE HARBOR FOR ABSENCE OF DEDUCTIBLE FOR [...]
V-BID Center Winter Update 2018
This update features policy developments, media reports, and events supporting continued momentum for multiple V-BID Center initiatives from the second half of 2017.
Press Release: New V-BID Center Video, “Precision Co-Pay Assistance Programs”
New V-BID Center Video Details How Precision Co-Pay Assistance Programs Enhance Access to Clinically Indicated Therapies Consumer cost-sharing for prescription drugs is high and getting higher. To address the high out-of-pocket medication costs, patient assistance programs, such as co-pay cards, have become available to reduce consumers' financial liability. However, the use of co-pay assistance for medications for which there is an effective, lower-cost alternative is deemed as financially burdensome to the healthcare system. To counteract this inefficiency, Accumulator Adjuster Programs - which prevent co-pay assistance funds from being applied to patients' deductibles - are increasingly being implemented, resulting in greater patient financial responsibility and potential disruption of recommended treatments. Our new "Precision Co-Pay Assistance Program" whiteboard video introduces a clinically nuanced solution designed to ensure access to clinically indicated therapies. V-BID Center Director, A. Mark Fendrick, MD, is available for questions or comments at vbidcenter@umich.edu or (734) 615-9635. [...]
2018 NDAA Supports Precision Benefit Design for Pharmaceuticals
2018 NDAA Supports Precision Benefit Design for Pharmaceuticals On Tuesday, December 12, 2017, the President signed the $700 billion National Defense Authorization Act for fiscal year 2018. The defense bill includes the incorporation of V-BID principles within Section 702 - Modifications of cost-sharing requirements for the TRICARE Pharmacy Benefits Program and treatment of certain pharmaceutical agents. Sec 702 (C) (b) (1) reads: This major policy milestone builds on growing bipartisan support and the expanded role of V-BID in public and private payers, including the recent expansion of the CMMI Medicare Advantage V-BID demonstration to 25 states and Congressional and Trump Administration efforts to allow high-deductible health plans the flexibility to provide coverage for services that manage chronic disease prior to meeting the plan deductible.View the resources below to learn more about V-BID in TRICARE and Precision Medicine. V-BID in TRICARE One-Pager TRICARE Infographic Precision Medicine Infographic Precision Medicine 1-Pager Precision Medicine White Board Video [...]
Press Release: NAM Report Includes Key Recommendation to the V-BID Center
On November 30, 2017, the National Academy of Sciences, Engineering, and Medicine released a long awaited report on access and affordability of prescription drugs. The report, "Making Medicines Affordable: A National Imperative", includes a key recommendation to the V-BID Center: Congress also should direct the Centers for Medicare & Medicaid Services to modify the designs of plans offered through Medicare Part D and government health insurance exchanges to limit patients’ out-of-pocket payments for drugs when there is clear evidence that treatment adherence for a particular indication can reduce the total cost of care, as determined by HHS. To read more about V-BID and Medicare Advantage, view the resources below.
Press Release: CMS Expands MA-VBID Model Test in 2019
CMS ANNOUNCES UPDATES TO MA V-BID MODEL TEST On November 22, 2017, the Centers for Medicare and Medicaid Services (CMS) announced updates to the Medicare Advantage Value-Based Insurance Design (MA-VBID) model. The model launched on January 1, 2017, at which time select MA plans in 7 states were permitted to offer varied benefit designs for enrollees diagnosed with specified clinical conditions. In 2018, the model will expand to three new states and will add two clinical categories. Beginning in 2019, the V-BID model will expand to an additional fifteen new states for a total of 25 states, allow Chronic Condition Special Needs Plans to participate, and allow participants to propose their own systems or methods for identifying eligible enrollees. The MA-VBID 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 [...]
Press Release: “Top Five” Low-Value Services Identified for Purchaser Action
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 [...]
V-BID Center Fall Update 2017
This update features policy developments, media reports, and events supporting continued momentum for multiple V-BID Center initiatives.
V-BID Center Receives the 2017 National Forum Public Policy Award
V-BID Center Director, A. Mark Fendrick, MD, and Executive Director of the National Forum, John Clymer The National Forum for Heart Disease & Stroke Prevention annually recognizes individuals and organizations who have made exceptional contributions to heart disease and stroke prevention by effecting policy change on a national, state, or local level. The V-BID Center was recently honored with the 2017 National Forum Public Policy Award for “advancing value-based care and prevention through legislation and executive policy making. The Center’s development of policy proposals and persistence in educating policy makers has led to action by both Congress and the Administration, resulting in more people benefiting from high-value health care.” Previous recipients of the award include Partnership for Prevention, Claudia Louis of the American Heart Association, and Senator Tom Harkin.
Alexander-Murray Bipartisan Bill
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 [...]