decisionhealth Newsletters, Part B News - 2019 Issue 2 (February)
Value-based round-up: Medicare Advantage plans offer differences in design
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Article Overview
This article summarizes early results from CMS on the Medicare Advantage Value-Based Insurance Design model. It focuses on how participating plans differed in benefit design, cost-sharing, care-management requirements, and provider network concepts, and it is relevant to providers, coders, and healthcare administrators following Medicare Advantage innovation and value-based payment policy.
Why This Topic Matters
It helps readers understand how CMS is evaluating plan design variation in a Medicare Advantage demonstration that may affect patient access, cost-sharing, and provider participation.
Article Sections
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Overview of the MA-VBID model and first-year CMS findings
Introduces the Medicare Advantage Value-Based Insurance Design model, its rollout, and the general purpose of the CMS evaluation. It also frames the article’s focus on how participating plans differed in design.
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2017 VBID Approach Components
Presents a summary of the plan-design components used by participating organizations in the first year of the model. The section centers on broad categories of benefit structure and participation features.
What You Will Learn
- How the Medicare Advantage Value-Based Insurance Design model is described in CMS reporting
- What broad categories of plan design variation were highlighted in the first-year evaluation
- How CMS’ evolving participation rules may affect plan structure and provider participation
- Why the article is relevant to Medicare Advantage stakeholders and value-based care observers
Who Should Read This
- Primary care practices
- Specialty practices
- Medicare Advantage stakeholders
- Healthcare administrators
- Medical coders and revenue cycle professionals
- Payers and plan designers
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