CMMI to Test New Medicare Advantage Health Plan Innovations
The CMS Center for Medicare and Medicaid Innovation (CMMI) will be testing Medicare Advantage (MA) health plan innovations during the Value-Based Insurance Design (VBID) model for CY 2020. The purpose of the VBID model is to test the impact of allowing MA plans to offer reduced cost sharing or additional supplemental benefits to enrollees with chronic conditions. The innovations being tested during CY 2020 are available to MA health plans in all 50 states and territories as well as Regional Preferred Provider Organizations (RPPO) and chronic condition, dual eligible, and institutional Special Needs Plans (SNP). CMS has extended the performance period of the VBID through 2024 to allow for sufficient time to evaluate the impact on cost and quality of these approaches.
The CY 2020 VBID application period is open through March 1, 2019 and eligible MA organizations may apply for any combination of the following:
- Value-Based Insurance Design by Condition, Socioeconomic Status, or Both
- Medicare Advantage and Part D Rewards and Incentives Programs
- Telehealth Networks
- Wellness and Health Care Planning (required for all VBID participating MA plans)
Among plans that apply for the telehealth networks innovation, CMS plans to observe how different service delivery innovations in telehealth may be used alongside an MA plan’s current network and providers and how telehealth may allow plans to expand their services to underserved areas. Plans testing this innovation may propose using telehealth in place of in-person services for the purpose of meeting network adequacy requirements. Those plans would be required to maintain an enrollee’s choice if that enrollee prefers to opt-out of a telehealth visit.
For further information about the CY 2020 Value-Based Insurance Design model, visit the CMS newsroom.