V-BID Update: CMS Proposes V-BID Expansion, Hospital Spending Surges

In this Issue:

• Register Now! 2026 V-BID Summit
• V-BID included in 2027 Notice of Benefit and Payment Parameters Proposed Rule
• Virtual Diabetes Prevention Programs Secure Medicare Coverage
• KFF Examines Role of Hospital Spending in Growth of National Health Expenditures
• Hospitals Are Posting Prices for Patients, but It’s Mostly Industry Using the Data

V-BID included in 2027 Notice of Benefit and Payment Parameters Proposed Rule

Multiyear catastrophic plans would be permitted to use value-based insurance designs to cover preventive services over and above those that currently must be covered under certain recommendations and guidelines before an enrollee satisfies the deductible or hits the out-of-pocked maximum.

Additionally, CMS proposes to change the permissible cost-sharing parameters for bronze plans and to update cost-sharing requirements for catastrophic plans, beginning in 2027.

Story | Rule (see page 224)

Virtual Diabetes Prevention Programs Secure Medicare Coverage

The PREVENT DIABETES Act, reauthorized in the recent budget package, extends access to virtual diabetes prevention education for Medicare beneficiaries through 2029. This legislation allows certified digital health companies to participate in the Medicare Diabetes Prevention Program, enabling millions of seniors to receive online education and coaching aimed at preventing type 2 diabetes. It also permits patients to participate in the program more than once, reflecting ongoing efforts in Congress to expand preventive care options. Read more.

KFF Examines Role of Hospital Spending in Growth of National Health Expenditures

Hospital spending accounts for nearly a third of the nation’s total health expenditures, AND accounted for an even larger share (40%) of the growth in spending between 2022 and 2024, a new KFF analysis finds.

Over the two-year period, hospital spending grew by $277 billion to reach $1.6 trillion in 2024, making it by far the largest category of spending in the Centers for Medicare & Medicaid Services’ National Healthcare Expenditure estimates. It grew more quickly (20%) than total health spending (15%) over the two-year period.

Hospitals Are Posting Prices for Patients, but It’s Mostly Industry Using the Data

An NPR article reports that although federal rules now require hospitals to post their prices online, the data is often sparse, confusing, and seldom used by patients to shop for care. Instead, hospitals, insurers, and health systems are the primary users of the information for contract negotiations and competitive benchmarking. If transparency is to help reduce costs and improve decision-making for patients, policy efforts must focus on clearer, standardized pricing information.

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