December 6, 2016 – Senate Finance Committee Chairman Orrin Hatch, R-Utah, and Ranking Member Ron Wyden, D-Ore., along with Senators Johnny Isakson, R-Ga., and Mark Warner, D-Va., co-chairs of the Finance Committee Chronic Care Working Group introduced S. 3504, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2016, a bipartisan bill 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:
BILL SEC. 301. ADAPTING BENEFITS TO MEET THE NEEDS OF CHRONICALLY ILL MEDICARE ADVANTAGE ENROLLEES. (h) NATIONAL TESTING OF MODEL FOR MEDICARE ADVANTAGE VALUE-BASED INSURANCE DESIGN – (1) IN GENERAL – In implementing the model described in paragraph (2) proposed to be tested under section 1115A(b), the Secretary shall revise the testing of the model under such section to cover, effective not later than January 1, 2019, all States. (2) MODEL DESCRIBED – The model described in this paragraph is the testing of a model of Medicare Advantage value-based insurance design that would allow Medicare Advantage plans the option to propose and design benefit structures that vary benefits, cost-sharing, and supplemental benefits offered to enrollees with specific chronic diseases proposed to be carried out in Oregon, Arizona, Texas, Iowa, Michigan, Indiana, Tennessee, Alabama, Pennsylvania, and Massachusetts.
A summary of the CHRONIC Care Act of 2016 can be found here.
We are pleased to recognize the further expansion of the CMS MA V-BID demonstration to all states by January 1, 2019, and the inclusion of funding to design, implement, and evaluate the model test. This growing bipartisan support and expanded role of V-BID principles in public and private payers builds on the TRICARE V-BID demonstration included in the National Defense Authorization Act for fiscal year 2017, and H.R. 5652 “Access to Better Care Act of 2016.” This bipartisan bill provides high-deductible health plans the flexibility to provide coverage for services that manage chronic disease prior to meeting the plan deductible.
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. Learn more about V-BID in Medicare Advantage here.