· Steve Almeroth · 3 min read
The Medicare Advantage VBID Model: A Study in Bad Design is Ending in 2025
High costs lead CMS to end Medicare Advantage Value-Based Insurance Design model.
The Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model has been an innovative program designed to improve healthcare for millions of Americans. Launched by the Centers for Medicare & Medicaid Services (CMS), the VBID Model has focused on providing better care, lowering costs, and addressing the unique needs of Medicare enrollees, particularly those with chronic health conditions or low incomes. As the program is set to end after 2025, it’s worth reflecting on its impact and what’s next for Medicare Advantage.
What Is the VBID Model?
The VBID Model was introduced to modernize Medicare Advantage plans. It aimed to make healthcare more accessible and person-centered by tailoring benefits to enrollees’ specific needs. For example, people with chronic illnesses or financial struggles could receive special benefits like reduced prescription costs, transportation to medical appointments, and even grocery assistance. These additions were designed to address obstacles that prevent individuals from seeking or receiving care.
A key innovation of the VBID Model was its flexibility. Participating Medicare Advantage plans could create customized benefits based on factors like chronic conditions, income level, or residence in underserved areas. The goal was simple: help people get the care they need in a way that fits their lives.
Highlights of the Program’s Final Year
In its final year, 2025, the VBID Model will include 62 Medicare Advantage Organizations (MAOs) offering benefits to over seven million enrollees. These plans continue to address health and social challenges, making it easier for people to access medical care and manage their health. The program has demonstrated how a person-centered approach can lead to better health outcomes and cost savings.
One notable component of the VBID Model was the inclusion of hospice care benefits. Traditionally, Medicare enrollees who chose hospice care faced fragmented coverage. The VBID Model tested integrating hospice care into Medicare Advantage plans, aiming for seamless care coordination. However, this hospice component will conclude at the end of 2024, slightly ahead of the program’s overall termination.
What’s Next?
As the VBID Model sunsets, CMS plans to apply the lessons learned to future healthcare initiatives. The program has highlighted the value of flexibility and innovation in addressing healthcare disparities. While the VBID Model is ending, its successes will shape how Medicare Advantage plans evolve to better serve their enrollees.
For current participants, CMS is committed to ensuring a smooth transition as the program winds down. Resources, FAQs, and updates are available to help enrollees understand what these changes mean for them.
Final Thoughts
The Medicare Advantage VBID Model has been a powerful example of how healthcare can adapt to meet people’s needs. By reducing barriers and offering tailored benefits, it has improved access to care for millions of Americans. Although the program is ending, its impact will continue through future efforts to modernize healthcare delivery and improve outcomes for Medicare beneficiaries.
As we say goodbye to the VBID Model, we can look forward to a future where these innovations inspire even better healthcare solutions. For more information, visit the CMS website or contact the VBID Model team.
