In 2017, the Center for Medicare and Medicaid Innovation announced the launch of the Medicare Advantage Value-Based Insurance design Model (MA-VBID demo). Through the MA-VBID demo, CMS is testing ways to improve quality and reduce spending through innovative benefit designs that lower cost-sharing for high-value services and drugs for chronic disease management. The Coalition has worked closely with CMMI and CMS to develop policies and best practices around value-based insurance design. The Coalition believes that reducing financial barriers to high-value services helps align incentives that promote healthy behaviors and reduced system spending.

For the CY 2020 VBID application period, which is open now through March 1, 2019, eligible Medicare Advantage organizations may apply to test one or more of the below new interventions:

Recent Updates

Letter to Ways and Means Committee in support of the Treat and Reduce Obesity Act - June, 2022

The Coalition submitted a letter to Chairman Richard Neal and Ranking Member Kevin Brady advocating for the passage of the Treat and Reduce Obesity Act (H.R. 1577). The Treat and Reduce Obesity Act would enhance Medicare beneficiary access to health care providers providing intense behavioral therapy for obesity and allow Medicare Part D to cover FDA-approved obesity drugs.

The Centers for Medicare and Medicaid Services announce substantial expansion of Value-Based Insurance Design Medicare Advantage Demo- January, 2019
The CMS MA-VBID Demo will get another expansion as of January, 2019. The demonstration was expanded to include all 50 states starting in 2020, as part of the Bipartisan Budget Act of 2018, but CMS announced in January that the demonstration would include a number of new elements to be introduced in 2020.

• Value-Based Insurance Design by condition, socioeconomic status, or both

• Medicare Advantage and part D Rewards and Incentives Program

• Telehealth Network

• Wellness and Health Care planning

In 2021, the demonstration will also test including Medicare hospice benefit in Medicare Advantage, although significant details about this inclusion have yet to be released. Fore more information, please see the CMS fact sheet.

CY 2020 Medicare Advantage Call Letter Comments — February 2019
The Coalition submitted comments for the CY 2020 Advance Notice Call Letter for Medicare Advantage released by CMS in February, 2019.

MA V-BID Demonstration Expansion Included in the Bipartisan Budget Act of 2018—February 2018
A national expansion of the Medicare Advantage (MA) V-BID demonstration to all states was included in the Congressional budget deal (the Bipartisan Budget Act of 2018), which passed the House and Senate on February 9, 2018!  The Coalition’s press release is available here.

MA V-BID Hospice Carve In — January 2020
Starting CY 2021, MA plans may also offer the Medicare hospice benefit to its enrollees (as described below) as part of the VBID Model