20 Years of impact

V-BID Policy Achievements

To celebrate the 20th anniversary of the first V-BID publication, we have highlighted key V-BID policy developments over the last two decades.
 

Scroll through the following list to see how V-BID policies have improved quality, enhanced patient experience, and promoted cost-containment.  

Sections 2713 and 4105 of the Affordable Care Act

The Affordable Care Act (ACA) requires that health plans must provide coverage for specified evidence-based and preventive services without a copay or contribution toward a deductible. The Secretary of Health and Human Services was also given the authority to develop guidelines allowing employers and health insurers to utilize V-BID.

Read More March 2010

CMS Final Rule 2334-F

CMS finalizes rules giving state Medicaid programs greater flexibility to vary enrollee cost-sharing, allowing the possibility to implement a clinically nuanced cost-sharing model.

Read More January 2014

CMS Announces Medicare Advantage
V-BID Model Test

The 5-year demo will test the utility of structuring consumer cost-sharing to encourage patients to use high-value clinical services and providers. Scheduled to begin on January 1, 2017, CMS will conduct the model test in Arizona, Indiana, Iowa, Massachusetts, Oregon, Pennsylvania, and Tennessee.

Read More September 2015

CMS Expands MA V-BID Model Test

CMS announced that it would expand the MA V-BID Model Test to 3 new states and 2 new conditions for model years two through five (contract years 2018 through 2021). The 3 states added are Alabama, Michigan, and Texas. The 2 new conditions are Rheumatoid Arthritis and Dementia.

Read More August 2016

V-BID Pilot in TRICARE

The National Defense Authorization Act (NDAA) for fiscal year 2017 authorizes a demonstration using Value-Based Insurance Design in the TRICARE program.

Read More December 2016

CMS Launches MA V-BID Model Test

On January 1st, 2017, CMS launched the MA V-BID Model Test to assess the utility of structuring consumer cost-sharing and plan elements to encourage the use of high-value clinical services and providers.

Read More January 2017

CMS Expands MA V-BID Model Test

CMS announced that, beginning January 1, 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.

Read More November 2017

2018 NDAA Section 702(C)(b)(1)(B)

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.

Read More December 2017

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 CMS Medicare Advantage V-BID Model to all 50 states.

Read More February 2018

Chronic Disease Management Act of 2018

The bipartisan bill would amend IRS Section 223 (c)(2)(C). 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.

Read More February 2018

CMS Final Rule 16440

This rule includes a reinterpretation of the Medicare Advantage (MA) uniformity requirement that will allow for more flexibility in benefit design and pave the way for the further incorporation of V-BID principles into MA.

Read More April 2018

Updated MA V-BID Model: "V-BID 2.0"

CMS announces transformative updates to the MA V-BID model that aim to increase choice, lower cost, and improve the quality of care for Medicare beneficiaries.

Read More January 2019

Executive Order 13877

President Trump signed an executive order that will allow HSA-HDHPs the flexibility to cover essential medications and services used to treat chronic diseases prior to meeting the plan deductible.

Read More June 2019

Chronic Disease Management Act of 2019

This bipartisan, bicameral legislation amends IRS Section 223 (c)(2)(C), HSA-HDHPs the flexibility to provide coverage for services that manage chronic diseases prior to meeting the plan deductible.

Read More June 2019

IRS Notice 2019-45

In response to a June Executive Order, the US 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.

Read More July 2019

Chronic Disease Management Act of 2020

This bipartisan legislation 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.

Read More January 2020

IRS Notice 2020-15

The guidance allows health plans and employers to reduce or eliminate cost-sharing for screening, treatment, and vaccination of COVID-19, including enrollees in HSA-HDHPs.

Read More March 2020

Medicare Part D Senior Savings Model

CMS announces the voluntary Part D Senior Savings Model, which caps 30-day insulin copays at $35 and may dramatically reduce the out-of-pocket cost of insulin for over 3 million of its Medicare beneficiaries.

Read More March 2020

Families First Coronavirus Response Act

Among other stipulations, this legislation eliminates cost-sharing for COVID-19 testing.

Read More March 2020

CARES Act

The Coronavirus Aid, Relief, and Economic Security Act allows HDHPs to cover all telehealth on a pre-deductible basis, mandates coverage of COVID-19 diagnostic testing by all plans without cost-sharing, and requires all plans to cover Coronavirus vaccine without cost-sharing.

Read More April 2020

CMS Final Rule 29164

The Department of Health and Human Services (HHS) declares broad support for the inclusion of V-BID principles in marketplace health plans. The rule includes language and research from the V-BID Center’s own guidelines for the V-BID X health plan, describing the potential for a “value-based model” qualified health plan.

Read More May 2020