In the proposed 2021 Notice of Benefit and Payment Parameters rule, released on January 31, 2020, the Department of Health and Human Services (HHS) declared broad support for the inclusion of V-BID principles in marketplace health plans.
This week, the cost-saving principles of V-BID have made headlines. Fortune Magazine highlights how the V-BID Center‘s successes in policy enable high-deductible insurance plans to cover the cost of essential services. Reuters News reports on how CVS is putting V-BID principles into practice with the launch of a new program.
This week’s episode of IlluminateHR, an engaging Human Resources podcast, features the innovative concept that is value-based insurance design.
January 15, 2020-- Today, Senators John Thune (R-SD) and Tom Carper (D-DE), re-introduced the Chronic Disease Management Act in the United States Senate. Co-sponsored by Senators Kevin Cramer (R-ND), Martha McSally (R-AZ), Kyrsten Sinema (D-AZ), and Tina Smith (D-MN), this bill builds upon its previous version (S. 1948) and includes criteria from the 2019 IRS guidance and further increases the flexibility of HSA-HDHPs to cover chronic disease services on pre-deductible basis.
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.
This week’s episode of TradeOffs, a new national podcast that brings listeners engaging stories about our toughest health policy challenges, will highlight the V-BID story, from its conception at an Ann Arbor restaurant to major policy achievements in Washington, DC.
July 17, 2019 — In response to a June Executive Order, the U.S. Department of the Treasury released Notice 2019-45, a guidance allowing HSA-HDHP plans the flexibility to cover specified medications and services used to treat chronic diseases prior to meeting the plan deductible.
Senators John Thune (R-SD) and Tom Carper (D-DE), introduced the Chronic Disease Management Act of 2019 in the Senate (S. 1948), followed by the introduction of the companion bill in the House of Representatives (H.R. 3709) by Representatives Earl Blumenauer (D-OR) and Tom Reed (R-NY).
On June 24, 2019, President Trump signed an executive order, and Senators John Thune (R-S.D.) and Ben Carper (D-DE) introduced bipartisan legislation that allow health savings account eligible high-deductible health plans (HSA-HDHPs) the flexibility to cover essential medications and services used to treat chronic diseases prior to meeting the plan deductible.
Introducing V-BID 2.0: CMS Announces Updates to Medicare Advantage V-BID Demo January 18, 2019 - The Centers for Medicare and Medicaid Services (CMS) announced transformative updates to the Medicare Advantage Value-Based Insurance Design (MA V-BID) model. These changes aim to increase choice, lower cost, and improve the quality of care for Medicare beneficiaries. The model launched on January 1, 2017, and has since been expanded to include 25 states, 9 chronic conditions, Chronic Condition Special Needs Plans, and allows participants to propose their own systems or methods for identifying eligible enrollees. Riding on the heels of the Bipartisan Budget Act of 2018, which included a directive to expand the model to all 50 states by 2020, today's release makes sweeping changes to the CY2020 model, including: Allows plans to provide reduced cost-sharing and additional benefits to enrollees in a more targeted fashion Bolsters rewards and incentives programs that plans can offer beneficiaries to [...]
Press Release: V-BID Improves Medication Adherence Without an Increase in Total Health Care Spending
Basing patients' medication costs on the health benefits they'll get from a drug, rather than its price, means they're more likely to take it Excerpt from IHPI press release:"Taking a medicine every day in the hopes that it will prevent some long-range potential health catastrophe -- like a heart attack or kidney failure -- isn’t easy.Many people skip doses, or don’t refill their prescriptions on time, or at all. And plenty of studies have shown that the more patients have to pay for those prescriptions, the less likely they are to take them as directed.But new evidence shows the power of a method aimed at changing this behavior: insurance plans that charge patients less for the medicines that could help them most. Some plans even make some of the medicines free to the patients with certain conditions.In an article published in the July issue of Health [...]
Press Release: V-BID Highlighted at Two Congressional Hearings The Health Subcommittee of the Congressional Committee on Ways & Means and the Joint Economic Committee held hearings on lowering health care costs and expanding access to health care. Value-Based Insurance Design principles were highlighted at both hearings as a potential cost-saving, health-improving measure. June 6, 2018: Ways and Means Hearing on Consumer-Directed Health Plans "How do we lower costs and expand access to health care?" The Health Subcommittee of the Congressional Committee on Ways & Means held a hearing on lowering costs and expanding access to health care through Consumer-Directed Health Plans. Value-Based Insurance Design principles were highlighted as a promising reform to high-deductible health plans, particularly in chronic disease management and HSA rule flexibility. Matt Eyles, President and CEO of America’s Health Insurance Plans (AHIP), highlighted that HSAs should have more [...]
Trump Administration "American Patients First" Drug Pricing Blueprint Includes V-BID "Value-Based transformation of our entire healthcare system is a top HHS priority" On May 11, 2018, President Trump gave a speech introducing his administration's "American Patients First" drug pricing plan, which strongly reflected V-BID concepts. The 44-page blueprint includes lowering out of pocket costs, implementing value-based purchasing in federal programs (including indication-based pricing and long-term financing), instructing CMS to create demonstration projects to encourage value-based care and lower drug prices, and considering adjustments to HHS regulations regarding drug copay discount cards. "FDA also announced it will facilitate opportunities for enhanced information sharing between manufacturers, doctors, patients and insurers to improve patient access to medical products, including through value-based insurance." 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 [...]
Meeting the Opioid Challenge: Getting Naloxone to Those Who Need it Most In April 2018, the US Surgeon General recognized the gravity of the US opioid epidemic and issued a rare public health advisory calling for increased availability of naloxone. This policy explicitly acknowledges that naloxone—a rescue medication that temporarily reverses the effects of an opioid overdose—does not cure opioid addiction. However, by preventing immediate harms such as death, naloxone use offers the survivor an opportunity to enter treatment when ready.Unfortunately, national implementation of a policy aimed to enhance access to naloxone faces many practical barriers, including identifying those most likely to benefit, deciding how and where to distribute the medication, and ensuring affordability. Naloxone prices have increased markedly over the past few years and range between $20 for a generic vial to $4,500 for an easy to use auto injector. Separate from drug acquisition costs, high consumer out-of-pocket costs [...]
On April 16, 2018, CMS officially published their new rule for the Medicare program contract year 2019. This rule includes a reinterpretation of the Medicare Advantage (MA) uniformity requirement that will allow for more flexibility in benefit design for MA enrollees with specified chronic conditions. CMS determined that... providing access to services (or specific cost sharing) that are tied to health status or disease state in a manner that ensures that similarly situated individuals are treated uniformly is consistent with the uniformity requirement in the Medicare Advantage (MA) regulations Beginning in 2020, CMS will wave the uniformity requirement for MA plans that provide additional supplemental benefits to chronically ill enrollees. This change paves the way for the further incorporation of V-BID principles into the Medicare Advantage program. While the ongoing MA V-BID Model Test will continue, plans outside of the demo will now have the flexibility to offer [...]