CMS has updated the design of the Medicare Advantage Value-Based Insurance model in its second year on the market.
CMS' MA-VBID model is a way for Medicare Advantage plans to offer clinically focused benefit packages to help improve care quality while reducing costs, largely by encouraging enrollees to use "high-value clinical services" that are most likely to positively affect their health.
CMS has issued a number of changes to the program for its second year meant to expand its coverage and membership. The new model is effective Jan. 1, 2018.
Here are four plan changes.
1. CMS will open the model to applicants in three new states — Alabama, Michigan and Texas.
2. The plan extends coverage to patients with rheumatoid arthritis and dementia.
3. CMS will lower the minimum membership requirement. In 2017, CMS will restrict the model MA plans in test states with a minimum enrollment of 2,000. In 2018, CMS will open the program to MA organizations with at least 2,000 enrollees in one health plan and a minimum of 500 enrollees in a MA-VBID model.
4. CMS added four new approaches for targeted interventions for certain clinical outcomes, including video consultations with audio and video technologies for diabetics.