Blumenauer, Black Introduce the VBID for Better Care Act of 2014

Press Release

Today, Reps. Diane Black (R-TN-06) and Earl Blumenauer (D-OR-03), both members of the House Ways and Means Committee, introduced H.R. 5183 -- the Value-Based Insurance Design (VBID) for Better Care Act of 2014 -- a bipartisan measure that would establish a regional demonstration program for high-quality Medicare Advantage (MA) plans to utilize V-BID to reduce the copayments or coinsurance for beneficiaries with specific chronic conditions. In doing so, beneficiaries are provided with increased access to the care they need to ensure better health outcomes. V-BID allows plans with the flexibility needed to offer the best possible care coordination for disease management, and provides the right incentives for beneficiaries.

"As a nurse for over 40 years, improving our nation's health care system by implementing policies that help promote patient-centered care and provider accountability is a top priority of mine in Congress," said Congressman Black. "Specifically, this legislation would allow Medicare Advantage plans the flexibility to improve how care is delivered by allowing them to use VBID practices that give beneficiaries access to lower costs for certain medications or services that are clinically proven to have good health outcomes. Such flexibility has the potential to not only improve beneficiary outcomes, but also to promote cost transparency and encourage greater efficiencies within the health plans. Essentially, this creates an incentive for providers to have better outcomes -- and at lower costs."

"There is a growing body of evidence showing individuals forgo necessary care as their out-of-pocket costs increase," said Congressman Blumenauer. "This demonstration project will allow high-quality plans to lower out-of-pocket costs for the care that beneficiaries need most--building upon private market initiatives already taking place in Oregon and around the country. By reducing or eliminating such costs for medically necessary drugs or services, it will be easier for seniors in MA to get evidence-based care, manage chronic conditions, and follow their treatments."

Specifically, this legislation:

Directs the Secretary of Health and Human Services to establish a demonstration program to test V-BID methodologies in MAplans for beneficiaries with chronic clinical conditions (i.e. increased access to insulin for people with diabetes or beta blockers for people with heart disease);

Allows MA plans the option to use V-BID benefits to lower copayments and coinsurance to encourage the use of specific, evidence-based medications or clinical services and/or specific high-performing providers;

Explicitly prohibits plans from increasing copayments or coinsurance to discourage use of services;

Requires an independent review, assessment, and report on the impact of the demonstration program; and

Expands the demonstration program to allow all MA plans to pursue V-BID should the report conclude the demonstration has lowered costs and increased quality for beneficiaries.

Click here for bill text.

Value-Based Insurance Design (V-BID) was conceptualized and developed by a multidisciplinary team of faculty at the University of Michigan's Center for Value-Based Insurance Design. To learn more about the V-BID Center and ongoing research, please visit www.vbidcenter.org.

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