The Centers for Medicare and Medicaid Services announced Thursday it will extend its Medicare Advantage Value-Based Insurance Design (VBID) demonstration model for calendar years 2025 through 2030. CMS also said it will introduce changes to the model that will more fully address the health-related social needs of patients, advance health equity and improve care coordination for patients with serious illnesses.
The VBID model is designed to help participating MA organizations innovate their plans to better meet the needs of some patients, including the chronically ill, and reduce overall healthcare expenditures. For example, plans can tailor supplemental benefits to patients that lower prescription drug costs; provide groceries to ensure patients are eating nutritious meals; and support to help them manage chronic health conditions.
CMS also extended the hospice benefit component of VBID, which helps patients in need of end-of-life care seamlessly transition to hospice. Under VBID, MA plans can be financially responsible for all services, including hospice.
Fifty-two MAOs with approximately 9.3 million enrollees are participating in the VBID model for 2023. CMS estimated that more than 6 million of those enrollees will receive additional benefits under the model.
In an annual report to Congress in December, CMS stated that the model was associated with increased use of many high-value services, such as primary care visits and 30-day drug refills. Care coordination had also improved under the program, however, CMS could not yet point to any detected changes in patient outcomes or quality measures. Although VBID was not yet generating savings, CMS said it wasn’t costing Medicare additional money either.
The jury is still out with the hospice community on the VBID model. Early evaluation data find that members are finding it hard to get paid on time or at all, they are facing a significant administrative burden, and some are not being contracted with to deliver an upstream palliative care component, David Baird, director of government affairs for hospice at the National Association for Home Care & Hospice, has said.