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. 

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