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Dr. Mark Fendrick

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More sculpting of Medicare Advantage value-based program


Modern Healthcare reported:

“The federal government will expand a new Medicare Advantage program to three states in 2018, as part of an effort to change behaviors and cost-sharing for seniors who have chronic diseases.

“In addition, plans that want to join the Medicare Advantage Value-Based Insurance Design model can offer expanded benefits to two new types of chronically ill members {dementia and rheumatoid arthritis}.

“The concept behind VBID is to eliminate the financial barriers sick patients face when they are trying to get certain exams, prescriptions drugs and procedures. If patients with chronic conditions are able to obtain high-quality care that is recommended by doctors for free or at a reduced cost, in theory, they are more likely to get that care and avoid potentially more expensive care down the road. Cost-sharing likewise would increase for services that offer little to no value for patients.”

“Dr. Mark Fendrick, a physician at the University of Michigan and one of the original supporters of VBID, has championed a bill in Congress that would allow all private plans to provide first-dollar coverage for chronically ill people …in a high-deductible policy.

“Starting this January, interested Medicare Advantage insurers will be able to offer enhanced benefits in seven states: Arizona, Indiana, Iowa, Massachusetts, Oregon, Pennsylvania and Tennessee. In 2018, the project will expand to Alabama, Michigan and Texas.”

To read the whole article, please hit this link.

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