CMS to expand value-based model for MA, prescription drug plans in 2019

Nov 22, 2017 - 08:01 AM

The Centers for Medicare & Medicaid Services today announced refinements to the Medicare Advantage Valued-Based Insurance Design Model for calendar year 2019, the third year of the demonstration program. The model is designed to 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. It began this year in Arizona, Indiana, Iowa, Massachusetts, Oregon, Pennsylvania and Tennessee. MA plans in Alabama, Michigan and Texas will join the model in January 2018, and plans in 15 more states can apply to participate in January 2019: California, Colorado, Florida, Georgia, Hawaii, Maine, Minnesota, Montana, New Jersey, New Mexico, North Carolina, North Dakota, South Dakota, Virginia and West Virginia. For 2019, CMS will allow chronic condition special needs plans to participate, and allow participants to propose their own systems or methods for identifying eligible enrollees. Plans must apply or reapply by Jan. 26, 2018 to participate in the model in 2019. For more information, visit http://innovation.cms.gov/initiatives/VBID. 

Related News Articles

Headline
Analysis finds average monthly premiums for Part D stand-alone drug plans to increase 50% in 2027 
The estimated average monthly premium for Medicare Part D stand-alone prescription drug plans is $51 for 2027, a 50% increase from $34 in 2026, for enrollees…
Headline
Blog: Four Reasons the HHS Provider Tax Study Misses the Mark
A new AHA blog examines a Department of Health and Human Services issue brief that claims Medicaid hospital provider taxes increase employer-sponsored…
Blog
HHS Analysis Does Not Establish a Causal Link Between Medicaid Provider Taxes and Commercial Premiums
Public
A recent issue brief from the Department of Health and Human Services asserts that Medicaid hospital provider taxes raise employer-sponsored insurance premiums…
Headline
Court strikes ‘medically frail’ definition in Medicaid community engagement requirements 
The U.S. District Court for the District of Massachusetts yesterday ruled in favor of 25 states and the District of Columbia to vacate the Centers for Medicare…
Headline
Study: Extending Medicaid coverage 12 months increased use of postpartum care for mothers with pregnancy complications 
Extending Medicaid coverage by 12 months following childbirth increased use of postpartum care among mothers with pregnancy complications such as diabetes and…
Headline
Department of Labor finalizes rule on transparency of PBM fee disclosures 
The Department of Labor Oct. 29 finalized a rule designed to improve transparency of fees collected by pharmacy benefit managers. The rule requires PBMs to…