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BREADCRUMB
1. Innovation Center Home
2. Innovation Models
3. Medicare Advantage Value-Based Insurance Design Model
MEDICARE ADVANTAGE VALUE-BASED INSURANCE DESIGN MODEL
FOR INFORMATION ON THE HOSPICE BENEFIT COMPONENT, PLEASE CLICK HERE
FOR INFORMATION ON THE 2023 VBID MODEL, PLEASE CLICK HERE
Through the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model,
CMS is testing a broad array of complementary MA health plan innovations
designed to reduce Medicare program expenditures, enhance the quality of care
for Medicare beneficiaries, including those with low incomes such as
dual-eligibles, and improve the coordination and efficiency of health care
service delivery. Overall, the VBID Model contributes to the modernization of MA
and tests whether these model components improve health outcomes and lower costs
for MA enrollees.
For plan year 2023, the VBID Model has 52 participating Medicare Advantage
Organizations (MAOs) with a total of 9.3 million enrollees projected to be
enrolled in participating plan benefit packages (PBPs). Over 6.0 million of
these enrollees are projected to receive additional Model benefits and/or
rewards and incentives as part of the Model test in 2023.
Read moreFor plan year 2023, the VBID Model has 52 participating Medicare
Advantage Organizations (MAOs) with a total of 9.3 million enrollees projected
to be enrolled in participating plan benefit packages (PBPs). Over 6.0 million
of these enrollees are projected to receive additional Model benefits and/or
rewards and incentives as part of the Model test in 2023.
* Alignment Healthcare USA, LLC
* AllCare Health, Inc.
* AlohaCare
* Athena Healthcare Holdings, LLC
* Banner Health
* Blue Cross & Blue Shield of Rhode Island
* Blue Cross and Blue Shield of North Carolina
* Blue Cross Blue Shield of Arizona
* BlueCross BlueShield of Tennessee
* Bright Health Group, Inc.
* Cambia Health Solutions, Inc.*
* Capital District Physicians' Health Plan, Inc.
* CareOregon, Inc.
* Catholic Health Care System*
* Centene Corporation
* Chinese Hospital Association
* CIGNA
* Commonwealth Care Alliance, Inc.
* Community Health Group
* Community Health Plan of Washington
* CVS Health Corporation*
* Devoted Health, Inc.
* DOCTORS HEALTHCARE PLANS, INC.
* Elevance Health, Inc.*
* EmblemHealth, Inc.
* Geisinger Health
* Guidewell Mutual Holding Corporation*
* Hawaii Medical Service Association*
* Healthfirst, Inc.
* HealthPartners, Inc.
* Henry Ford Health System
* Highmark Health*
* Humana Inc.*
* INLAND EMPIRE HEALTH PLAN
* Kaiser Foundation Health Plan, Inc.*
* Louisiana Health Service & Indemnity Company*
* Marquis Companies I, Inc.*
* MHH Healthcare, L.P.
* New York City Health and Hospitals Corporation
* Presbyterian Healthcare Services*
* SANTA CLARA COUNTY HEALTH AUTHORITY
* SCAN Group*
* Sentara Health Care (SHC)
* The Health Plan of West Virginia, Inc.
* Thomas Jefferson University
* Triton Health Systems, L.L.C.
* Troy Holdings, Inc.
* Ultimate Healthcare Holdings, LLC
* UnitedHealth Group, Inc.*
* Universal Health Services, Inc.
* UPMC Health System
* Visiting Nurse Service of New York*
*Indicates participation in the Hospice Benefit Component of the VBID Model for
Calendar Year 2023
BACKGROUND
MA plans offer Medicare beneficiaries an alternative to Original Medicare, also
referred to as “Fee-for-Service.” In addition to covering all Medicare services,
some MA plans also offer Medicare beneficiaries extra coverage through
supplemental benefits, such as vision, hearing, and dental services.
Additionally, some MA Plans also offer prescription drug coverage (Part D) as
part of their plan.
MA plans can charge different out-of-pocket costs for certain services within
guidelines defined by Medicare. VBID generally refers to health insurers’
efforts to structure cost-sharing and other health plan design elements to
encourage enrollees to use the services that can benefit them the most.
Additionally, currently, Medicare Beneficiaries may enroll into MA and have
access to all original Medicare benefits plus additional supplemental benefits
beyond what original Medicare covers. Historically, when an MA enrollee elects
hospice, Fee-For-Service (FFS) Medicare becomes responsible for most services
while the MA organization retains responsibility for certain services (e.g.,
supplemental benefits). This hospice “carve-out” from MA results in a convoluted
set of coverage rules for MA enrollees who elect hospice and fragments
accountability for care and financial responsibility across the care continuum.
INITIATIVE DETAILS
The VBID Model tests a broad array of MA service delivery and/or payment
approaches and contributes to the modernization of MA through increasing choice,
lowering cost, and improving the quality of care for Medicare beneficiaries.
The VBID Model allows MAOs to further target benefit design to enrollees based
on chronic condition and/or socioeconomic characteristics (as defined as being
eligible for the Low Income Subsidy (LIS) or, in US territories, being dually
eligible) and/or incentivize the use of Part D prescription drug benefits
through rewards and incentives. MAOs may also offer the Medicare hospice benefit
to its enrollees (as described below) as part of the VBID Model. Additionally,
the VBID model requires that all participating plans engage their enrollees
through structured and timely wellness and health care planning, including
advanced care planning.
In Calendar Year (CY) 2023, the VBID Model will test the following Model
Components. All participating MAOs must participate in the mandatory Wellness
and Health Care Planning component of the VBID Model in 2023. Participating MAOs
may also test one or more of the other interventions in CY 2023.
1. Wellness and Health Care Planning (WHP)
2. VBID Flexibilities, for Model PBPs’ select enrollees targeted by condition,
socioeconomic status or a combination of both, for offering:
1. Primarily and non-primarily health related supplemental benefits, which
may include new and existing technologies or FDA-approved medical devices
as a mandatory supplemental benefit
2. Use of high-value providers and/or participation in care management
program(s)/ disease state management program(s)
3. Reductions in cost-sharing for Part C items and services and covered Part
D drugs
3. Part C and Part D Rewards and Incentives (RI) Programs
4. Hospice Benefit Component
For more details on these Model Components please see the links to the VBID and
VBID Hospice Benefit Components Requests for Applications (RFA) below.
HOSPICE BENEFIT COMPONENT
The Centers for Medicare & Medicaid Services announced in January 2019 that
beginning in CY 2021, through the VBID Model, participating MAOs could include
the Medicare hospice benefit in their Part A benefits package.
Under the Model in CY 2023, fifeen MA organizations, through 119 PBPs, will
participate in the Hospice Benefit Component of the VBID Model. These PBPs will
test the Hospice Benefit Component in service areas that cover 806 counties.
A downloadable list of PBPs with service area and contact information can be
found here: VBID CY2023 Hospice Benefit Contact Information (XLS)
By including the Medicare hospice benefit in the MA benefits package, CMS will
test the impact on service delivery and quality of MA plans providing all
original Parts A and B Medicare items and services required by statute.
Additionally, CMS is testing how the hospice benefit component can improve
beneficiary care through greater care coordination, reduced fragmentation, and
transparency in line with recommendations by the Office of Inspector General
(OIG), the Medicare Payment Advisory Commission (MedPAC) and others. CMS will
require that MAOs provide beneficiaries with broad access to the complete
original Medicare hospice benefit. MAOs participating in the hospice benefit
component will be required to outline how they will provide palliative care to
eligible enrollees, irrespective of the election of hospice, and may make
transitional, concurrent care services as well as hospice-specific supplemental
benefits available to enrollees who elect hospice through network hospice
providers.
For technical and operational guidance, please reference the Hospice Benefit
Component Technical and Operational Guidance. Visit the Hospice Benefit
Component overview page for further information.
CY 2023 MATERIALS
* CY 2023 VBID Model and Hospice Benefit Component Model Participant
Announcement - September 2022
* CY 2023 Hospice Benefit Component Model Participant Service Area and Contact
Information (XLS) - September 2022
* Addressing Food and Nutritional Insecurity Use Case Technical Assistance
Document (PDF)
* Addressing Transportation Barriers Use Case Technical Assistance Document
(PDF)
* CY 2023 VBID Hospice Benefit Component Monitoring Guidelines (PDF) - October
3, 2022
* CY 2023 VBID Model Monitoring Guidelines (ZIP) - October 3, 2022
* Request for Applications - VBID Model (PDF)
* Request for Applications - VBID Model Hospice Benefit Component (PDF)
* CY 2023 VBID Model Fact Sheet (PDF)
* VBID Model Application
Link: https://cms.gov1.qualtrics.com/jfe/form/SV_etFZ2SQSOxVzCzY
* Additional VBID Model Application Materials (ZIP) - Please download this ZIP
file, fill and complete the applicable materials, in addition to completing
the application
* CY 2023 Final Hospice Capitation Payment Rate Actuarial Methodology (PDF)
* CY 2023 Final Hospice Capitation Payment Ratebook (XLS)
* CY 2023 Final Hospice Benefit Component Data Book for Year-1 Rates (XLS)
* CY 2023 Final Hospice Benefit Component Data Book for Mature-Year Rates (XLS)
* CY 2023 VBID Model Hospice Benefit Component Phase 2 Network Adequacy
Guidance (PDF)
* CY 2023 VBID Hospice Benefit Component Minimum Number of Provider (MNP) Data
Book (XLSX)
* CY 2023 Preliminary Hospice Capitation Payment Rate Actuarial Methodology
Paper (PDF)
* CY 2023 VBID Communications and Marketing Guidelines (PDF) - May 27, 2022
CY 2022 MATERIALS
* CY 2022 WHP Reporting Tool (PDF) - October 3, 2022
* CY 2022 Hospice Benefit Component Model Participant Service Area and Contact
Information (XLS) - February 2022
* CY 2022 VBID Model and Hospice Benefit Component Model Participant
Announcement - September 2021
* CY 2022 VBID Model Fact Sheet (PDF)
* CY 2022 VBID Hospice Benefit Component Monitoring Guidelines (PDF)
* CY 2022 Final Hospice Capitation Payment Rate Actuarial Methodology (PDF)
* CY 2022 Final Hospice Capitation Payment Ratebook (XLS)
* CY 2022 Final Hospice Benefit Component Data Book for Year-1 Rates (XLS)
* CY 2022 Final Hospice Benefit Component Data Book for Year-2 Rates (XLS)
* CY 2022 Preliminary Hospice Capitation Payment Rate Actuarial Methodology
Paper (PDF)
* CY 2022 VBID-Hospice Supplemental File for CBSA Descriptions (XLS)
* Request for Applications - VBID Model (PDF)
* Request for Applications - VBID Model Hospice Benefit Component (PDF)
* VBID Application
Link: https://cms.gov1.qualtrics.com/jfe/form/SV_9KMUFxReQX6qmih
* Additional VBID Application Materials (ZIP) - Please download this ZIP file,
fill and complete the applicable materials, in addition to completing the
application
* CY 2022 VBID Communications and Marketing Guidelines (PDF) - March 14, 2022
ADDITIONAL INFORMATION
The separate, OIG-issued, fraud and abuse waivers applicable to Medicare
Advantage Organizations in the VBID Model are available at
https://www.cms.gov/medicare/physician-self-referral/fraud-and-abuse-waivers.
CMMI has released a memorandum providing guidance on Model treatment of
reductions in Part D cost-sharing. CMMI released an additional memorandum on
December 1, 2022, providing further guidance and examples regarding the
reporting of VBID Model benefits in the Prescription Drug Event (PDE) data.
WEBINARS
CY 2023 WEBINARS & RECORDINGS
* Webinar: VBID Model Health Equity Incubation Program - Leveraging VBID
Flexibilities to Improve Equity in Housing Stability and Quality (Thursday
December 8, 2022)
* Webinar: VBID Model Hospice Benefit Component - Provider (Thursday, December
1, 2022)
* Webinar: VBID Model Health Equity Incubation Program - Leveraging VBID to
Improve Equity in Transportation Access (Thursday, September 15, 2022)
* Slides (PDF)
* Transcript (PDF)
* Recording (MP4)
* Administration for Community Living Quick Transportation Resource Guide
(PDF)
* Webinar: VBID Health Equity Incubation Program Webinar: Advancing Health
Equity in Diabetes Care and Outcomes (Thursday, June 30, 2022)
* Slides (PDF)
* Transcript (PDF)
* View or download the Recording (MP4) | Password: UfSx3sjm
* Office Hours: 2023 Medicare Advantage Value-Based Insurance Design Model and
its Hospice Benefit Component (Tuesday, April 5, 2022)
* Slides (PDF)
* Transcript (PDF)
* Recording (MP4)
* Webinar: VBID Model - Health Equity Incubation Program - Addressing Food and
Nutritional Insecurity (Thursday, March 31, 2022)
* Slides (PDF)
* Transcript (PDF)
* Recording (MP4)
* Webinar: Medicare Advantage Value-Based Insurance Design Model - Hospice
Benefit Component Overview (Thursday, March 10, 2022)
* Slides (PDF)
* Transcript (PDF)
* Recording (MP4)
* Webinar: VBID Health Equity Business Case for MAOs (Thursday, December 2,
2021)
* Slides (PDF)
* Transcript (PDF)
* Recording (MP4)
* Webinar: Value-Based Insurance Design, Opportunities to Improve Medication
Adherence for Cardiovascular Disease Prevention (Thursday, October 21, 2021)
* Slides (PDF)
* Transcript (PDF)
* Recording (MP4)
* Webinar: Unleashing the Capabilities of MAOs to Deliver Health Innovation for
Older Adults in Underserved Settings (Thursday, October 7, 2021)
* Slides (PDF)
* Transcript (PDF)
* Recording (MP4)
* Archived Materials
EVALUATION REPORTS
LATEST EVALUATION REPORTS
* Two Pager: At-A-Glance Report (PDF) | Hospice At-A-Glance Report (PDF)
* Evaluation of Phase II of the Medicare Advantage Value-Based Insurance
Design Model Test (PDF)
* Appendices (PDF)
PRIOR EVALUATION REPORTS
* Two Pager: At-A-Glance Report (PDF)
* White Paper - Synthesis of Evaluation Results Across 21 Medicare Models
(PDF) | Slides (PDF) | Recording (MP4) | Transcript (PDF)
* Two Pager: At-A-Glance Report (PDF)
* First Three Years (2017-2019) Evaluation Report (PDF)
* Perspective Report (PDF)
* Two Pager: At-A-Glance Report (PDF)
* Year One Evaluation Report (PDF)
MODEL SUMMARY
Stage: Participants Announced, Ongoing
Number of Participants: 52 for CY 2023
Category: Initiatives to Accelerate the Development and Testing of New Payment
and Service Delivery Models
Authority: Section 3021 of the Affordable Care Act
MILESTONES & UPDATES
October 17, 2022
Announced: Evaluation of Phase II of the Medicare Advantage Value-Based
Insurance Design Model Test reports posted
September 29, 2022
Announced: CY 2023 VBID Model Participants (including MAOs participating in the
Hospice Benefit Component) released
March 1, 2022
Announced: CY 2023 Request for Applications and associated materials posted
September 29, 2021
Announced: CY 2022 VBID Model Participants (including MAOs participating in the
Hospice Benefit Component) released
April 19, 2021
Announced: Slides and associated materials from April 13 hospice benefit
component payment design office hours posted
March 8, 2021
Announced: CY 2022 hospice benefit component payment design webinar
February 1, 2021
Announced: CY 2022 Request for Applications and associated materials posted
December 9, 2020
Announced: Registration open for January 14 RFA and hospice benefit component
webinar and February 11 office hours
October 8, 2020
Announced: CY 2021 Hospice Benefit Component Technical and Operational Guidance
released
September 24, 2020
Announced: CY 2021 Model Participants
TIMELINE
JANUARY 1, 2017
Performance period begins
DECEMBER 31, 2024
Anticipated performance period end date
WHERE HEALTH CARE INNOVATION IS HAPPENING
See who's working with CMS to implement new payment and service delivery models.
Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut
Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa
Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota
Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico
New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode
Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia
Washington West Virginia Wisconsin Wyoming American Samoa Federated States of
Micronesia Guam Midway Islands Northern Mariana Islands Puerto Rico Republic of
Palau Republic of the Marshall Islands U.S. Virgin Islands Models for state
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Value in Opioid Use Disorder Treatment Demonstration Program
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Learn More about Value in Opioid Use Disorder Treatment Demonstration Program
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Last updated on:
12/01/2022
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