activevoluntarydisease-specific

VBID

Medicare Advantage Value-Based Insurance Design Model

Through the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model, CMS tested a broad array of MA health plan innovations. These innovations aimed to enhance the quality of care for Medicare enrollees, including those with low income, and reduce costs for enrollees and the overall Medicare program. The model allowed participating MAOs to further target benefit design to enrollees based on chronic health conditions, Low-Income Subsidy eligibility, or place of residence.

Active since 2017-01-01

Innovation

Allowed MA plans to target benefit design to enrollees based on chronic health conditions, LIS eligibility, or Area Deprivation Index (ADI) data, and tested the inclusion of the Medicare hospice benefit directly within the MA benefits package.

The Problem

A variety of factors including financial strain, limited access to healthy foods and transportation, and unmanaged chronic health conditions can prevent patients from seeking health care, but current rules make it hard to reach certain patients. Additionally, the historical hospice 'carve-out' from MA results in a convoluted set of coverage rules and fragments accountability for care across the care continuum.

The Solution

The VBID Model helped remove obstacles to health care by allowing participating MA plans to provide tailored supplemental benefits such as lower costs for prescription drugs, grocery assistance, transportation services, and support managing chronic conditions. It also tested including the Medicare hospice benefit in the MA benefits package to improve care coordination and reduce fragmentation.

Expected Outcomes

Improved health outcomes, lowered costs for MA enrollees, enhanced quality of care, greater care coordination, reduced fragmentation, and transparency in care delivery.

Strategy

The VBID Model contributed to the modernization of MA through increasing choice, lowering cost, and improving the quality of care for Medicare enrollees, aligning with person-centered approaches to care.

Model Goals

  • Enhance the quality of care for Medicare enrollees
  • Reduce costs for enrollees and the overall Medicare program
  • Remove obstacles to health and health care
  • Improve beneficiary care through greater care coordination and reduced fragmentation

Patient Eligibility

Medicare Advantage enrollees, specifically targeting those with chronic health conditions, Low-Income Subsidy (LIS) eligibility, dual eligibility, or based on place of residence (ADI data).

  • Enrolled in a participating Medicare Advantage plan
  • Has one or more chronic health conditions
  • Eligible for Low-Income Subsidy (LIS) or dually eligible for Medicare and Medicaid
  • Place of residence based on Area Deprivation Index (ADI) data

Provider Eligibility

Medicare Advantage Organizations (MAOs) offering MA plans.

  • Must be a Medicare Advantage Organization (MAO)

Care Categories

Chronic Disease Management

Chronic health conditions

End-of-Life Care

Hospice carePalliative care

CMS Benchmarks & Thresholds

financial

Estimated Cost to Medicare Trust Funds (CY$2,200,000,000
Additional Cost Per Member Per Month (CY24.64
Estimated Cost to Medicare Trust Funds (CY$2,300,000,000
Additional Cost Per Member Per Month (CY44.9

operational

Typical Implementation Timeline108
Model Termination Year2,025
Hospice Benefit Component Termination Year2,024
TrOOP-Eligible Effective Year for VBID Cost-Sharing Reductions2,025
Geographic Reach (States, DC, Puerto Rico) for CY50
Number of Plan Benefit Packages for CY967
Minimum Supplemental Benefits for HRSNs (CY2
Hospice Benefit Component Duration in Years2,021 – 2,024

population

Typical Beneficiary Count7,000,000
Number of Participating MAOs for CY62

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