The Value-Based Insurance Design Model (VBID) was originally established at the University of Michigan in 2005. Now, CMS will begin implementing the model on January 1, 2017.
VBID is a payment model that offers benefits or reduced costs on high-value services to Medicare Advantage enrollees with chronic conditions. The program was designed to improve patients’ likelihood to make use of higher-value care services.
These services are often unaffordable for many patients, even with insurance. VBID will lower the cost of certain high-value services while raising the cost of other, nonessential services to balance cost-sharing and encourage patients to get the care they need.
The plan increased patient cost-sharing by $100 to $500 for sleep studies, endoscopies, advanced imaging services and spine surgeries — all deemed low-value services by the plan. When compared with a similar group of large employers, use of those services fell 12% on average.
CMS will test the model in seven states in 2017, adding three more in 2018.