More Tweaks Coming for Value-Based Medicare Advantage Project

“The federal government will expand a new Medicare Advantage program to three states in 2018, as part of an effort to change behaviors and cost-sharing for seniors who have chronic diseases. In addition, plans that want to join the Medicare Advantage Value-Based Insurance Design model can offer expanded benefits to two new types of chronically ill members, the CMS said Wednesday.

“Last year, the CMS Innovation Center, created and funded by the Affordable Care Act, unveiled the five-year experiment, building on the request of doctors and consumer advocates who wanted to see more so-called value-based insurance design. The concept behind VBID is to eliminate the financial barriers sick patients face when they are trying to get certain exams, prescriptions drugs and procedures. If patients with chronic conditions are able to obtain high-quality care that is recommended by doctors for free or at a reduced cost, in theory, they are more likely to get that care and avoid potentially more expensive care down the road. Cost-sharing likewise would increase for services that offer little to no value for patients.”

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