Policy & Medicine January 20, 2025
Some value-based models are more valuable than others
The United States Centers for Medicare and Medicaid Services (CMS) recently announced that it will discontinue the Medicare Advantage (MA) Value-Based Insurance Design model at the end of this year. CMS cited “increased risk score growth and Part D expenditures” that made the model too costly to continue to operate.
Under the Value-Based Insurance Design model, MA plans were able to offer supplemental benefits. Most patients who participated in the model had chronic conditions. In calendar years 2021 and 2022, the model cost the Medicare Trust Fund $2.3 billion and $2.2 billion, respectively. This was an “unprecedented” cost with a lack of “viable policy modifications” that may make the model more financially...
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