CMS expands value-based Medicare Advantage program to 25 states

The Centers for Medicare and Medicaid Services (CMS) updated its Medicare Advantage Value-based Insurance Design model for 2019 to include 15 additional states, bringing the total to 25.

The five-year demonstration model was launched in 2015 for the 2017 plan year, with seven states participating. It gives Medicare Advantage plans the flexibility to offer additional benefits or lower cost sharing for beneficiaries with certain chronic health conditions, with the idea that encouraging these patients to use “high-value” clinical services will lead to improved health outcomes and lower overall costs. Last year CMS expanded the model to include three more states for the 2018 plan year.

The recent updates will also allow Chronic Conditions Special Needs Plans to participate and will allow participants to propose their own models for beneficiaries with chronic conditions other than those included when the model was launched.