CMS to test value-based insurance model on Medicare Advantage plans

CMS announced the Medicare Advantage Value-Based Insurance Design Model on Tuesday, which aims to reduce the utilization of avoidable high-cost care while improving Medicare beneficiaries' health.

Value-based insurance approaches are increasingly being used in the commercial market, and CMS said some of the elements of the design may be an effective tool to improve the quality of care and reduce the cost of care for Medicare Advantage enrollees with chronic diseases.

The new model will specifically focus on Medicare Advantage enrollees with the following chronic conditions: diabetes, congestive heart failure, chronic obstructive pulmonary disease, past stroke, hypertension, coronary artery disease and mood disorders.

The model will begin Jan. 1, 2017, and run for five years in Arizona, Indiana, Iowa, Massachusetts, Oregon, Pennsylvania and Tennessee.

The Medicare Advantage Value-Based Insurance Design Model was developed by the CMS Innovation Center, which was created by the Affordable Care Act to test innovative healthcare payment and service delivery models that have the potential to reduce Medicare, Medicaid and Children's Health Insurance Program expenditures while preserving or enhancing the quality of beneficiaries' care.

More information about the model can be found here.

More articles on Medicare Advantage:

CMS finalizes 2016 Medicare Advantage payment rates: 10 things to know
Study: Medicare Advantage upcoding cost $2B in 2014
3 common pitfalls health systems encounter when offering their own Medicare Advantage plans

Copyright © 2022 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Webinars

Featured Whitepapers

Featured Podcast

Top 40 articles from the past 6 months