The VBID model was introduced as a pilot program in 2017. The program allowed MA plans to develop targeted supplemental benefits aimed at addressing chronic conditions and offer $0 cost-sharing for prescription drugs.
Here are five things to know:
- In a Dec. 16 blog post, CMS said the program cost $2.3 billion in 2021 and $2.2 billion in 2022, an unprecedented cost trend for CMS innovation models. The increases were driven by increased enrollee risk scores and Part D expenditures.
- Medicare Advantage plans will be able to offer many of the same supplemental benefits to those available under the VBID model, CMS said. In 2019, legislation allowing MA plans to offer non-primarily health-related benefits aimed at addressing social determinants of health went into effect.
- The end of the model could increase Part D cost-sharing for some enrollees. CMS will introduce the Two Dollar Drug List model in 2027 which could offset some of these changes, the agency said in the blog post.
- In its evaluation of the program, CMS found “no evidence to conclude that the increased costs of the model were associated with the offering of interventions that address health-related social needs,” the agency wrote.
- In a Dec. 18 news release, the Better Medicare Alliance, a pro-MA group backed by major insurers, urged the agency to reconsider terminating the model.
“Terminating the VBID model will disrupt progress made in achieving more equitable and affordable care for beneficiaries,” the Better Medicare Alliance said. “It will also limit Medicare Advantage’s ability to test and scale strategies that reduce costs while improving health outcomes, potentially leaving vulnerable seniors without critical benefits they desperately need.”