Key considerations for VBID participation

In January, the Centers for Medicare and Medicaid Services (CMS) announced an opportunity for Medicare Advantage organizations (MAOs) to enter the Value-Based Insurance Design (VBID) model for 2020. MAOs will need to act fast to take advantage of the opportunities afforded by the Medicare VBID model.

The first step in this process is understanding the types of interventions allowed under the model that will benefit an MAO’s covered population, if any. MAOs must then quantify savings and incorporate these interventions into the MAO’s previously submitted 2019 bid in order to apply by CMS’s March 15 deadline. The application must also include additional narrative and quantitative support as described in the calendar year 2020 VBID model actuarial guidance.

In this article, Milliman’s Catherine Murphy-Barron, Pamela Pelizzari, and Brian Regan describe the model and explore key issues for eligible MAOs considering participation in the model.