Medicare Advantage Value-Based Care Expands to 25 States

The Centers for Medicare & Medicaid Services (CMS) is expanding the value-based care program for Medicare Advantage insurers to 25 states in 2019. In 2018, the program will be offered in 10 states.

The program, Medicare Advantage Value-based Insurance Design (VBID) Model, encourages customized benefit designs and flexibilities for the health needs of beneficiaries, according to CMS.

Roughly one-third of Medicare beneficiaries are currently in a Medicare Advantage (MA) plan, according to CMS. MA plans are provided by private insurers that contract with CMS to provide health care to beneficiaries. These plans often involve coordinated care, and more home health care companies are eager to get into the mix.


“This administration is committed to making sure that our seniors have more choices and lower premiums in their Medicare Advantage plans,” CMS Administrator Seema Verma said in a statement. “CMS expects that this demonstration will provide insights into future innovations for the Medicare Advantage program.”

Starting in 2019, Medicare Advantage insurers in 15 additional states will be allowed to apply to the model.

“This change will afford participants with the opportunity to include Medicare beneficiaries with different chronic conditions than those previously established by CMS—such as lower back pain, chronic kidney disease, obesity/pre-diabetes, asthma and tobacco use,” CMS stated in the announcement.


Written by Amy Baxter

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