CMS announces 2020 Part D model, changes to MA value-based model

The Center for Medicare and Medicaid Innovation today announced a new payment model for Medicare Part D and Medicare Advantage drug plans beginning January 2020, which will test new incentives for plans, patients and providers to choose drugs with lower list prices. Plans participating in the voluntary five-year model will take on greater risk for spending in the catastrophic phase of Part D and share in any resulting savings to federal reinsurance subsidy costs. The model also includes a Part D rewards and incentives program and other tools to help plans control drug costs and enrollees choose drugs with lower list prices. Also today, the Centers for Medicare & Medicaid Services announced changes to the MA Value-Based Insurance Design model for calendar year 2020, which will allow plans to provide reduced cost sharing and additional supplemental benefits to enrollees based on condition and/or socioeconomic status; bolster rewards and incentives for beneficiaries to improve their health; and increase access to telehealth services.