#TBT: Value-Based Insurance Design & New Medicare Advantage Model

The Center for Medicare and Medicaid Innovation (CMMI) recently announced the start of a new demonstration program, Medicare Advantage Value-Based Insurance Design (V-BID) Model. The program will test the utility of structuring patient cost-sharing and other health plan design elements to encourage patients to utilize high-value clinical services, with the goal of improving quality and reducing costs.

As part of our Throwback Thursday blog series, we’re taking a look at a topic that’s currently in the news and tagging it with previous research, videos or commentaries in a relevant way. As the saying goes, “what’s old is new again” – and we hope you enjoy our wonky twist on #TBT.

The Center for Medicare and Medicaid Innovation (CMMI) recently announced the start of a new demonstration program, Medicare Advantage Value-Based Insurance Design (V-BID) Model. The program will test the utility of structuring patient cost-sharing and other health plan design elements to encourage patients to utilize high-value clinical services, with the goal of improving quality and reducing costs.

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While CMMI’s model is new, the concept of V-BID, which is built on the principle of lowering or removing financial barriers to essential clinical services, is not. In fact, the University of Michigan’s V-BID Center celebrated “A Decade of Transforming the Health Care Cost Discussion from ‘How Much’ to ‘How Well’” yesterday during its 2015 Summit.

The National Pharmaceutical Council (NPC) partnered with the V-BID Center and its director, Mark Fendrick, MD, in 2009 on the “Value-Based Insurance Design Landscape Digest,” a research publication that defines the concept of V-BID; outlines the key objectives, design features and potential barriers to its implementation; and describes evaluation tools for measuring the outcomes of V-BID programs. The publication (and our #TBT pick of the day) also highlights how companies have adopted V-BID programs and reviews the clinical and economic implications of V-BID.

Following on the research, NPC again partnered with Dr. Fendrick in 2011 on “Synergies at Work: Realizing the Full Value of Health Investment,” a research publication about the benefits of employee health, including the value of reduced absence and improved workplace productivity. It notes that employers who recognize the full range of benefits can maximize the value of their investment in making employees healthier.

For more information on the role of V-BID in Medicare Advantage, explore the V-BID Center’s infographic and additional resources