Senators Praise CMMI’s Value-Based Insurance Design Testing
By - The Center for Medicare & Medicaid Innovation’s (CMMI) efforts to minimize healthcare costs and maximize healthcare outcomes through healthcare reform testing demonstrations are generating praise from senators this week, according to a joint press release. CMMI’s objective of such is to advance health outcomes and decrease health spending.
CMMI’s establishment of a Medicare Advantage (MA) demonstration program to assess the connection between value-based insurance design (V-BID) and lower healthcare costs is supported by Senators John Thune (R-S.D.) and Debbie Stabenow (D-Mich.), who both introduced legislation last May pushing for reintroduced bipartisan legislation to lessen enrollees’ copayments and coinsurance for a number of beneficiaries with distinctive chronic conditions for certain high-value medications. CMMI – a subdivision of the Centers for Medicare and Medicaid Services (CMS), an Agency of the Department of Health and Human Services (HHS) – was established to test innovative healthcare delivery and payment models.
“We recognize that it’s a challenge to find policy solutions that achieve cost savings while at the same time improving patients’ health outcomes,” states Senator Thune within the press release. “With V-BID, a promising health insurance concept, both patients and taxpayers win, proving that if money can be spent in a more targeted, effective way, it’s also possible to improve the value of care delivered,” he adds.
Adds Senator Stabenow, “[This legislation] tests a new innovative model that lowers costs to Medicare patients for prescription drugs and services that provide the best overall value. At the same time, it lowers insurance costs for everyone.”
The cost of healthcare increases when patients relinquish costly medications or healthcare services, confirms the joint release. Resultantly, the likelihood of such patients enduring preventable healthcare issues makes healthcare more costly. As EHRIntelligence.com reported, a V-BID approach may be considered as a much better approach than the high deductible. The V-BID model contains low co-pays for high value services and medications that are higher when health fails to improve.
According to CMS, these types of testing efforts are one facet of CMMI’s tri-fold focus:
- Testing new payment and service delivery models
- Evaluating results and advancing best practices
- Engaging a broad range of stakeholders to develop additional models for testing
“Congress created the Innovation Center for the purpose of testing ‘innovative payment and service delivery models to reduce program expenditures …while preserving or enhancing the quality of care” for individuals receiving Medicare, Medicaid, or Children’s Health Insurance Program (CHIP) benefits, says CMS.
The V-BID model will begin in 2017 and run for five years, says CMS, which will test the model across seven states – Arizona, Indiana, Iowa, Massachusetts, Oregon, Pennsylvania, and Tennessee. Among these states, considered to be a representation of the general national MA market, eligible MA plans can offer varied plan benefit design with CMS’s approval.
