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Media Coverage on CMS MA V-BID Model Expansion CMS Lets MA Plans Vary Benefits More Via Expanded Demo, Proposed Rule Inside Health Policy CMS recently announced it will expand the Medicare Advantage Value-Based Insurance Design demonstration in 2019 to an additional 15 states and let plans choose which conditions to structure benefit variations around, coming shortly after the agency proposed similar flexibilities for all MA plans. Full Article Medicare Advantage Value-Based Insurance Design Expanded for 2019 Health Exec | John Gregory Fifteen new states will participate in the Medicare Advantage (MA) Value-Based Insurance Design (VBID) model for 2019, allowing insurers in a total of 25 states to enter the program aimed at encouraging enrollees to focus on services that are of the highest clinical value to their specific chronic conditions. Full Article Medicare Advantage Value-Based Insurance Design Updates for 2019 Health Payer Intelligence | Thomas Beaton New [...]

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Related Media Coverage on Alexander-Murray Bill Alexander, Murray strike bipartisan Obamacare deal providing subsidies, state flexibility   Politico- Jennifer Haberkorn Sens. Lamar Alexander and Patty Murray say they have reached an agreement on a bipartisan Obamacare deal to fund a key insurance subsidy program and provide states flexibility to skirt some requirements of the health care law. Full Article   Another last-ditch effort to tackle Obamacare stalls within hours of its release   Washington Post- Juliet Eilperin, Amy Goldstein, and Sean Sullivan Yet another last-ditch effort to tackle the nation’s health-care system stalled within hours of its release by a bipartisan pair of senators Tuesday, with President Trump sending mixed signals and Republicans either declining to endorse the proposal or outright opposing it. Full Article   Bipartisan Deal to Stabilize ACA Insurance [...]

Related Media Coverage on LVC Study Low-Cost, High-Volume Services Make Up Big Portion of Spending on Unneeded Health Care   UCLA Health - Enrique Rivero Low-cost, high-volume health services account for a high percentage of unnecessary health spending, adding strain to the health care system, new UCLA-led research suggests. Full Article   Emergency Departments, Behavioral Health and More   Health Affairs Blog In the United States, a substantial proportion of health care costs is allocated to low-value care: patient care providing no net health benefit, such as early diagnostic imaging for uncomplicated low-back pain. Full Article   High-Volume, Low-Cost Services Reflect Most Unnecessary Medical Spending, Study Suggests Becker's Healthcare - Morgan Haefner Healthcare services costing $538 or less were administered much more frequently than services exceeding that cost. For the [...]

2017 V-BID Summit Sponsorship Opportunities The 2017 V-BID Summit: V-BID at the 'Big House’ will be held as a two-day event at the University of Michigan on March 13/14. The Summit invites stakeholders to engage in a highly interactive all-day discussion to address the opportunities and challenges that arise from the conceptual design to the implementation of clinically nuanced payment reform and benefit design strategies across some of today’s most relevant and challenging health care topics. A draft agenda will soon be available for dissemination. All donations/sponsorships will be gratefully accepted, including amounts lower and higher than those listed below.  Special consideration will be given to non-profit organizations.  For more information, please contact Susan Lynne Oesterle at 734-615-9635 or vbidcenter@umich.edu.   Platinum sponsorship includes six invitations to the following: V-BID Summit evening reception Evening welcome dinner Networking breakfast Summit discussions Networking lunch [...]

In late June, a draft of an executive order, entitled "Reducing the Cost of Medical Products and Enhancing American Biomedical Innovation", emerged that would update IRS Section 223 (c)(2)(C).  Section 6 of the order states: "The Internal Revenue Service shall update the preventive care safe harbor under Section 223 of the Internal Revenue Code to include services or benefits, including medications, intended to prevent chronic disease progression or complications, for the purpose of helping patients adhere to clinical regimens and thereby reducing costs of healthcare." This amendment to the IRS code would provide health savings account eligible high-deductible health plans (HSA-HDHPs) the flexibility to cover services and drugs used to treat chronic diseases before meeting the plan deductible. What does this mean, and why is it important? This executive order would allow for the development and implementation [...]

Related Media Coverage on Executive Order Conduent:  Administration Eyes Expanding HDHP Pre-Deductible Coverage to Chronic Disease Managment   Julia Zuckerman & Richard Stover A recent draft executive order would direct the IRS to expand the list of preventive care services that an HDHP plan can cover before the participant or beneficiary has met the plan's deductible.  Specifically, it would update the preventive care rules for HDHPs to include services or benefits, including medications, relating to care for chronic disease management. Full Article   Kaiser Health News:  Trump Plan Might Cut Expenses For Some Insured Patients With Chronic Needs   Michelle Andrews Out-of pocket expenses could shrink under a Trump administration draft executive order that would change the Internal Revenue Service rules about what care can be covered before the deductible is met in plans linked [...]

External Resources & Links: Health Savings Account-Eligible High-Deductible Health Plans Expand the health savings account 'safe harbor' to reduce health costsThe Hill - A. Mark Fendrick, MDFull ArticlePrecision Benefit Design - Using "Smarter" Deductibles to Better Engage Consumers and Mitigate Cost-Related NonadherenceJAMA - A. Mark Fendrick, MD & Michael E. Chernew, PhDFull Article General: HSA-HDHPs Value-Based Insurance Design Benefit Offsets Reductions In Medication Adherence Associated With Switch To Deductible Plan Health Affairs - Mary E. Reed, E. Margaret Warton, Eileen Kim, Matthew D. Solomon, and Andrew J. Karter Full ArticleRepublicans Want You in a Health Savings Account. So Now What?The New York Times - Ron Lieber Full Article With a High Deductible, Even a Doctor Can Shortchange His HealthThe Washington Post - Dan Gorenstein Full Article Health Savings Accounts Are Back In The Policy SpotlightNPR - Julie ApplebyFull Article Trump Plan To Increase Health Savings Accounts Should Ensure That They Do Not Only Benefit [...]

National Defense Authorization Act for Fiscal Year 2018 The 2018 NDAA  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.   Full Text Press Release   National Defense Authorization Act for Fiscal Year 2017 The pilot includes an evaluation of how reducing or eliminating the cost-sharing for specified high-value medications and services impacts:  (I) adherence to medication regimens; (II) quality measures; (III) health outcomes; and (IV) beneficiary experience. Full Text V-BID Pilot Text [Section 701] Press Release      

S. 1424 and H.R. 3563 - Chronic Disease Management Act of 2021Builds upon previous versions of CDMA and follows guidance issued by the US Department of Treasury in 2019 to further increase the flexibility of HSA-HDHPs to cover chronic disease services on pre-deductible basis.  Full Text Summary Press Release S. 3200 - Chronic Disease Management Act of 2020A bill to amend the Internal Revenue Code of 1986 to permit high deductible health plans to provide chronic disease prevention services to plan enrollees prior to satisfying their plan deductible. Full Text Summary Press Release S. 1948 - Chronic Disease Management Act of 2019A bill to amend the Internal Revenue Code of 1986 to permit high deductible health plans to provide chronic disease prevention services to plan enrollees prior to satisfying their plan deductible. Full Text Summary Press Release S. 2410 and H.R. 4978 - Chronic Disease Management Act of [...]

Bipartisan Budget Act of 2018 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 Full Text Summary Press Release   S. 870 - Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 Seeks 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. Full Text Summary Press Release   H.R. 1995 - V-BID for Better Care Act of 2017 Seeks to amend title XVII of the Social Security to provide for national testing of the Medicare Advantage V-BID model. Full Text Summary Press Release   S. [...]