CMS releases fact sheet on MA-VBID model

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The Centers for Medicare & Medicaid Services (CMS) has released a fact sheet that addresses the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model, which is being tested by the Center for Medicare & Medicaid Innovation (CMMI).

The model allows Part D and other MA plans to “offer clinically nuanced benefit packages [that are] aimed at improving quality of care while also reducing costs.” The plans can offer these benefits to patients who have certain conditions, including diabetes, chronic obstructive pulmonary disease, congestive heart failure, hypertension, coronary artery disease, and past stroke.

CMS also says that on January 1, 2018, it will 1) consider new MA-VBID applicants and 2) add Alabama, Michigan and Texas to the model and 3) permit plans to add benefits for rheumatoid arthritis and dementia and 4) adjust existing clinical categories and 5) change the minimum enrollment size for certain plan participants.

The MA-VBID model will begin on January 1, 2017 and run for five years. CMS says that it expects to release a ‘Request for Applications’ for the second year of the model in the next several months – and it will accept proposals from MA and MA-PD plans to offer VBID benefits in 2018. The MA-VBID model test is open to all qualifying MA and MA-PD plans in the test states that submit acceptable programmatic proposals to CMS.

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