Dr Michael Chernew's Expectations for the Medicare Advantage VBID Model

Although there are still some unknowns surrounding the new Medicare Advantage Value-Based Insurance Design (VBID) Model, beneficiaries are likely to appreciate the reduction in copays for high-value care, said Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and director of the Healthcare Markets and Regulation Lab in the Department of Health Care Policy at Harvard Medical School.

Transcript (slightly modified)

As we get closer to the launch of the Medicare Advantage Value-Based Insurance Design Model on January 1, 2017, what do you expect to see in the first year of the initiative?

So it’s the beginning of the program and we’re not sure. We have not yet seen the number of plans that have bid to enter the program, we know there have been a number that have. We haven’t seen the selected set of diseases that they’ve chosen for the VBID programs that they want to put in place. I think the plans are working through their business model for VBID. I think they’re going to have to work through their communication strategies with their members.

I expect that we will see a number of plans start with these types of benefit designs. I think that we will have to monitor over time what that means for the risk profile of individuals on different plans, what it means for the use of the high-value services that are incentivized by these VBID programs. What it means for the mix of enrollment, what it means for the ultimate outcomes.

There’s a lot of challenges to do seemingly simple things, just adjudicate claims for example, so I think in the first year it’ll be a victory if they can just get these up and running and if people understand what’s going on. Our experience in the private sector outside of Medicare Advantage is that people with important chronic conditions have really appreciated the copay relief for the high-value services that they need to manage their diseases, and I expect in Medicare where there’s a lot of fiscal pressure on the beneficiaries as well, there will be an equal appreciation for the copay relief for the services that they’re told to use.