CMS to test value-based model for MA, prescription drug plans

Sep 09, 2015 - 03:28 PM

The Centers for Medicare & Medicaid Services last week announced the Medicare Advantage Valued-Based Insurance Design Model, which will test whether encouraging plan enrollees with certain conditions to consume high-value clinical services through reduced cost sharing and other approaches improves quality and reduces costs. Interventions will target enrollees with diabetes, chronic obstructive pulmonary disease, congestive heart failure, past stroke, coronary artery disease and mood disorders. Eligible MA and prescription drug plans in Arizona, Indiana, Iowa, Massachusetts, Oregon, Pennsylvania and Tennessee may submit proposals to participate in the model, which CMS expects to begin Jan. 1, 2017 and run for five years. The agency expects to post the Request for Applications soon at innovation.cms.gov/initiatives/VBID. For more information, see the CMS factsheet.

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