Dementia care added to Medicare Advantage insurance model

A value-based, clinically-focused insurance model will add benefits tailored for people with dementia in its second year, the Centers for Medicare & Medicaid Services announced on Thursday.

The Medicare Advantage Value-Based Insurance Design, set to kick off tests in 2017, offers “clinically-nuanced benefit designs” for enrollees that have certain clinical conditions such as diabetes, congestive heart failure or past strokes.

The model will add dementia, as well as rheumatoid arthritis, to its covered conditions beginning in 2018, CMS said.

The MA-VBID update also includes plans to expand testing of the model in 2018 from the originally announced states — Arizona, Indiana, Iowa, Massachusetts, Oregon, Pennsylvania and Tennessee — to Alabama, Michigan and Texas as well. Tests will run for five years.

“As part of the ‘better care, smarter spending, healthier people' approach to improving healthcare delivery, CMS will test VBID in Medicare Advantage and measure whether structuring patient cost sharing and other health plan design elements encourages enrollees to use healthcare services in a way that improved their health and reduces costs,” the agency said in a fact sheet.