Adios VBID

[somarco]

CMS will sunset the Medicare Advantage Value-Based Insurance Design Model at the end of 2026, citing "unprecedented" costs to the Medicare trust fund.

The VBID model was introduced as a pilot program in 2017. The program allowed MA plans to develop targeted supplemental benefits aimed at addressing chronic conditions and offer $0 cost-sharing for prescription drugs.

Here are five things to know:

CMS ends value-based Medicare Advantage model: 5 things to know

"CMS announces sunset of Medicare Advantage VBID Model in 2026 due to unprecedented costs. MA plans may still offer similar benefits.

www.beckerspayer.com

When the government steps in, someone's ox will inevitably be gored . . . and it is almost always the end user that gets the worst end of the deal.

 

[straightnochaser]

Here are five things to know:

• In a Dec. 16 blog post, CMS said the program cost $2.3 billion in 2021 and $2.2 billion in 2022, an unprecedented cost trend for CMS innovation models. The increases were driven by increased enrollee risk scores and Part D expenditures.

• Medicare Advantage plans will be able to offer many of the same supplemental benefits to those available under the VBID model, CMS said. In 2019, legislation allowing MA plans to offer non-primarily health-related benefits aimed at addressing social determinants of health went into effect.

• The end of the model could increase Part D cost-sharing for some enrollees. CMS will introduce the Two Dollar Drug List model in 2027 which could offset some of these changes, the agency said in the blog post.

• In its evaluation of the program, CMS found "no evidence to conclude that the increased costs of the model were associated with the offering of interventions that address health-related social needs," the agency wrote.

• In a Dec. 18 news release, the Better Medicare Alliance, a pro-MA group backed by major insurers, urged the agency to reconsider terminating the model.

Not so much adios, more like a small change. You MSO agents can put your dick back in your pants now.

 

[EckoRomeo]

Here are five things to know:

• In a Dec. 16 blog post, CMS said the program cost $2.3 billion in 2021 and $2.2 billion in 2022, an unprecedented cost trend for CMS innovation models. The increases were driven by increased enrollee risk scores and Part D expenditures.

• Medicare Advantage plans will be able to offer many of the same supplemental benefits to those available under the VBID model, CMS said. In 2019, legislation allowing MA plans to offer non-primarily health-related benefits aimed at addressing social determinants of health went into effect.

• The end of the model could increase Part D cost-sharing for some enrollees. CMS will introduce the Two Dollar Drug List model in 2027 which could offset some of these changes, the agency said in the blog post.

• In its evaluation of the program, CMS found "no evidence to conclude that the increased costs of the model were associated with the offering of interventions that address health-related social needs," the agency wrote.

• In a Dec. 18 news release, the Better Medicare Alliance, a pro-MA group backed by major insurers, urged the agency to reconsider terminating the model.

Not so much adios, more like a small change. You MSO agents can put your dick back in your pants now.

You didn't expect the copy and paste king to actually read what he posted, did you?

 

[straightnochaser]

You didn't expect the copy and paste king to actually read what he posted, did you?

Very true

 

[Duaine]

The VBID allowed MA plans to offer supplemental benefits, often targeting members with chronic conditions. The CMS does not expect the model's termination to impact MA plans, because its interventions are more widely available than when the program launched in 2017.

"This model was the mechanism by which DSNP plans offered $0 Rx copays (amongst many other non-Part D benefits)," said Brooks Conway, principal for Oliver Wyman, in a LinkedIn post. "In the absence of the model, it is very likely that we will see Rx cost sharing added back to most DSNPs in 2026."