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
CMS releases proposed rules on two drug pricing models
The Centers for Medicare & Medicaid Services Dec. 19 issued two proposed rules for implementing alternative drug pricing models. The first proposed…
Headline
AHA comments on proposed ‘public charge’ rule
The AHA Dec. 19 submitted comments on the Department of Homeland Security’s proposed rule regarding the Public Charge Ground of Inadmissibility, urging the…
Headline
Administration reaches deals with 9 drug companies to lower drug costs
The White House announced Dec. 19 that it reached most-favored-nation deals with nine pharmaceutical companies, aligning their drug prices with the lowest paid…
Headline
House passes narrow health care package; sets up a vote on EPTCs in January
The House Dec. 17 passed the Lower Health Care Premiums for All Americans Act (H.R. 6703), legislation to expand association health plans, increase…
Headline
AHA urges Elevance Health to rescind Anthem’s ‘Nonparticipating Provider Policy,’ citing harm to patient care access
The AHA Dec. 17 urged Elevance Health, which is the parent company of the Anthem brand of health plans, to rescind Anthem’s nonparticipating provider…
Headline
CMS announces pilot on MA service level data collection for initial determinations, appeals
The Centers for Medicare & Medicaid Services released a memo Dec. 16 announcing the agency’s intent to conduct a voluntary pilot in 2026, called the…