Manatt Health Counsel Adam Finkelstein was quoted in a Modern Healthcare article discussing the Centers for Medicare and Medicaid Services’ (CMS) decision to remove the Value-Based Insurance Design (VBID) model for Medicare Advantage (MA) enrollees.
According to the article, VBID was previously expanded to help improve coverage, especially for low income MA enrollees. However, the initiative is now set to be terminated at the end of 2025 due to high costs resulting from increased risk scores and MA Star Rating quality bonuses. As VBID is intended to elevate quality of care, removing the initiative because of higher spending linked to the Star Ratings program is “jarring” for many, according to Finkelstein. “This is how Congress set up MA, to encourage plans to increase quality,” Finkelstein said. “Plans delivered better quality and got paid more for it. This is a feature, not a bug, of MA.”
Modern Healthcare subscribers can read the full article here.