CMS modifies value-based model for MA, prescription drug plans for 2018

Aug 11, 2016 - 04:07 PM

The Centers for Medicare & Medicaid Services yesterday announced refinements to the design of the second year of the Medicare Advantage Valued-Based Insurance Design Model. The model, announced last year, will test whether giving MA plans flexibility to offer supplemental benefits or reduced cost sharing to targeted groups of enrollees with certain chronic conditions improves health outcomes and reduces costs. The model will begin in January in Arizona, Indiana, Iowa, Massachusetts, Oregon, Pennsylvania and Tennessee and in 2018 in Alabama, Michigan and Texas. In the second year of the model, CMS will adjust the clinical categories for which participants may offer benefits and change the minimum enrollment size for some MA and prescription drug plan participants. CMS expects to announce the first-year participants in September and request applications for the second year of the model this fall. For more information, visit innovation.cms.gov/initiatives/VBID.

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