Dr Mark Fendrick Outlines His Preferred Outcomes For Medicare's VBID Demonstration

During the 5-year value-based insurance design (VBID) demonstration in Medicare Advantage, the hope is that the models will show that lower cost-sharing for high-value services and providers meets the triple aim, explained A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design at the University of Michigan.

Transcript (slightly modified)

What are the outcomes you would like to see from the Medicare Advantage Value-Based Insurance Design demonstration to be able to say it worked?

The Center for Medicare and Medicaid Innovation (CMMI) test of value-based insurance design in Medicare Advantage is a very exciting turn for us. Obviously the 5-year model will look, at the end, to see if lowering cost-sharing for high-value services and providers will meet the triple aim of better quality of care, better patient experience, and lower healthcare costs.

We are not only looking at the end game, but also understanding that very important information may allow us to understand what happens within a VBID model test to allow its feasbility to move forward within the 7 states and hopefully see it expand to the other 43 and the District of Columbia. There are concerns about who might enroll, there concerns about if the communication will go well, there are concerns about even if we lower cost-sharing people might not know about it and now take advantage of these things. So we will be looking at, hopefully, a lot of these processes such as: is there adverse selection going on? Is there not? Are there people in earlier stages of a disease, as opposed to at later one moving forward?

We are very fortunate to have an onging dialogue with CMMI, and that CMMI has been very forthright about wanting to work with various stakeholders to make sure they get the model right.