Breaking: V-BID Included in Biden-Sanders Unity Task Force Recommendations
Washington, DC — On Wednesday, the Biden-Sanders Unity Task Force released a 110-page document detailing recommendations for key issues, including health care.
Press Release: HHS Proposed Rule Offers Support for V-BID X Health Plans
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.
BREAKING NEWS: New CMS Model Dramatically Reduces Insulin-Related Out-of-Pocket Costs
Today, the Centers for Medicare & Medicaid Services announced a new model, Part D Senior Savings, dramatically reducing insulin-related out-of-pocket costs for 3 million Medicare beneficiaries.
BREAKING NEWS: IRS Responds to COVID-19 by Eliminating Cost-Sharing for Screening, Testing, and Vaccination
Breaking News: On March 11, 2020 IRS issued guidance (Notice 2020-15, High Deductible Health Plans and Expenses Related to COVID-19) confirming that health plans and employers may reduce or eliminate cost-sharing for COVID-19 screening, treatment, and vaccination, including for Americans enrolled in high-deductible health plans coupled with Health Savings Accounts.
V-BID Principles Save Diabetics Over $1K
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.
CMS Announces Transformative Updates to MA V-BID Demo
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 [...]
New CMS Rule Provides More Flexibility for V-BID Benefits in Medicare Advantage
New Cms Rule Provides More Flexibility for V-BID Benefitsin Medicare Advantage 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: 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) regulationsBeginning 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 [...]
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 [...]
June 7, 2017: Committee on Ways and Means Medicare Advantage Testimony
On Wednesday, June 7th, Dr. A. Mark Fendrick, V-BID Center Director, testified before the Committee on Ways and Means, Subcommittee on Health hearing on Promoting Integrated and Coordinated Care for Medicare Beneficiaries. Dr. Fendrick discussed how the principles of value-based insurance design (V-BID) and clinical nuance can contribute positively to Medicare Advantage. Learn more about V-BID in Medicare Advantage To view the full hearing, click here. Additional testimony materials available below: Learn more about V-BID in Medicare Advantage
V-BID Congressional Briefing, February 7, 2017
Value-Based Insurance Design: An Innovative Approach to Improve Medicare Advantage, Health Savings Accounts, and TRICARE Washington, DC: On Tuesday, February 7, Representatives Diane Black (R-TN) and Earl Blumenauer (D-OR) convened a bipartisan briefing on the role of Value-Based Insurance Design (V-BID) in Health Savings Accounts, Medicare Advantage, and Tricare. V-BID Center Co-founders A. Mark Fendrick, MD, and Michael Chernew, PhD, discussed the role of V-BID as a bipartisan, multi-stakeholder solution to improve quality, enhance consumer experience, and lower costs. In their introductory remarks, Congressmen Black and Blumenauer highlighted the rare bipartisan support for V-BID and praised its role in improving the health of Americans and lowering health care spending. Both were enthusiastic about partnering on bipartisan legislation to expand V-BID in private and public payers. Access to quality medical care and containing health care expenditures are among the most pressing issues for our military personnel, our national well-being and economic security. Understanding how commercial [...]
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 [...]
February 23, 2016: US Senate Committee on Armed Services
On Tuesday, February 23rd, Dr. A. Mark Fendrick, V-BID Center Director, 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.https://youtu.be/zprEwpVgXCo Additional testimony materials available below:
CMS Announces Medicare Advantage V-BID Model Test
News Update: CMS Announces Medicare Advantage V-BID Model Test On September 1, 2015, the Centers for Medicare and Medicaid Services (CMS) announced a program to test Value-Based Insurance Design (V-BID) in Medicare Advantage (MA) plans. The program will examine the utility of structuring patient cost-sharing and other health plan design elements to encourage patients to consume high-value clinical services, thereby improving quality and reducing costs. The model test is scheduled to begin on January 1, 2017. CMS will conduct the model test in Arizona, Indiana, Iowa, Massachusetts, Oregon, Pennsylvania, and Tennessee. "The Medicare Advantage Value-Based Insurance Design Model fills an immediate need for testing ways to improve care and reduce cost in Medicare Advantage Plans and offers the prospect of lower out-of-pocket costs and premiums along with better benefits for enrollees in Medicare Advantage," said Patrick Conway, MD, MSc, CMS deputy administrator and chief medical officer. For additional information about the CMMI [...]
NEWS UPDATE: V-BID Medicare Advantage Bill Passes House of Representatives
Washington, DC – The Strengthening Medicare Advantage through Innovation and Transparency for Seniors Act of 2015 (HR 2570) was passed by the US House of Representatives on June 17th. This bipartisan legislation includes a V-BID demonstration project that would allow Medicare Advantage plans to lower copayments and coinsurance for their beneficiaries, encouraging the use of high-value, evidence-based medical services to better manage chronic conditions. The legislation explicitly prevents plans from increasing beneficiary cost-sharing on any service. A bipartisan companion bill, Value-Based Insurance Design Seniors Copayment Reduction Act of 2015 (S.1396), was introduced to the Senate on May 20th. This legislation coincides with a CMS Request for Information to Innovate Medicare that explicitly included V-BID.
UPDATE: MA V-BID Bill Passes Key House Committee
WASHINGTON, D.C. – The Preservation of Access for Seniors in Medicare Advantage Act of 2015 (HR 2581) was passed by the Ways and Means Committee on June 2nd. This legislation would require the Secretary of Health and Human Services to select MA plans to begin testing V-BID methodology. This demonstration project would allow plans to lower copayments and coinsurance for their beneficiaries, encouraging the use of high-value, evidence based medical services to better manage chronic conditions. The legislation explicitly prevents plans from increasing beneficiary cost-sharing on any service. This bipartisan legislation will be discussed on the floor of the House of Representatives as part of a package of bills aimed to strengthen the Medicare Advantage program. A bipartisan companion bill, Value-Based Insurance Design Seniors Copayment Reduction Act of 2015 (S.1396), was introduced to the Senate on May 20th.