CMS to test new value-based Medicare Advantage model

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Medicare Advantage will unveil a new model where plans are tailored to meet individual clinical needs. Tests of the model will begin in 2017.

The new model, dubbed the Medicare Advantage Value-Based Insurance Design, offers varied plans based on eight categories of clinical needs, including diabetes, congestive heart failure, past stroke, hypertension and combinations of the categories. The categories were determined by conditions that are prevalent within the Medicare Advantage population, Centers for Medicare & Medicaid Services said in a memo sent Tuesday.

By varying coverage by conditions, CMS hopes the new model will allow for improved quality of care and reduced costs for beneficiaries with those conditions. CMS is considering adding categories for other chronic conditions that might benefit from the value-based  model in coming years.

Tests of the MA-VBID model will begin on January 1, 2017, and run for five years in Arizona, Indiana, Iowa, Massachusetts, Oregon, Pennsylvania and Tennessee.