The Centers for Medicare & Medicaid Services announced a new payment model for Medicare Part D, and “transformative updates” to the Medicare Advantage Value-based Insurance Design, VBID.
The Part D Payment Modernization initiative is part of the Trump Administration’s blueprint to lower drug prices and reduce out-of-pocket costs. It calls for increased competition, better negotiations, and creating incentives to lower prices and reduced out-of-pocket costs for seniors.
The updates to Medicare Advantage Value-based Insurance Design will also take effect in 2020 and Medicare Advantage plans across the United States will be able to apply.
The updates include:
  • Allowing plans to provide reduced cost sharing and other benefits to enrollees in a more targeted fashion, including customization for chronic conditions, socioeconomic status, and for benefits such as dental, vision, hearing, senior day care, home care, transportation, and more.
  • Bolstering rewards and incentives that plans can offer beneficiaries to improve their health by permitting plans to offer higher-value rewards. 
  • Increasing access to telehealth services, along with in-person options, to meet network requirements.
Beginning in the 2021 plan year, the VBID model will also test allowing Medicare Advantage plans to offer Medicare’s hospice benefit. 
                  Summary of an recent Article from CMS
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Posted by Brian J Schroeder – LUTCF

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