Author: Harper Dion
Posted Date: May 9, 2023
The post-acute industry continues to experience significant changes with continuous developments from CMS. One of the most innovative developments in recent years is Value-Based Insurance Design (VBID). VBID is a unique approach to healthcare insurance that seeks to align patients' out-of-pocket expenses with the value of medical services.
Value-Based Insurance Design (VBID), often mentioned in relation to Medicare Advantage, is a healthcare insurance model that seeks to incentivize patients to utilize high-value healthcare services by decreasing their out-of-pocket costs for those services.1 In other words, VBID encourages patients to choose healthcare services that are proven to be effective and efficient. The increased focus on quality and high-value care includes things like increased length of stay and improved access.1 Agencies that work directly with Medicare Advantage plan partners will be prepared to develop the correct solutions to fully optimize VBID. Agencies that follow suit are fully prepared to provide patients with the best quality care while reducing overall healthcare costs.
Things to consider as a VBID provider
While VBID offers numerous benefits, there are several factors that providers need to consider before implementing this approach. First and foremost, VBID requires comprehensive data analysis to ensure that the approach is working as intended. Providers need to invest in high-quality data analytics tools to determine which services offer the most value to their patients.
Furthermore, providers must ensure that they have an effective communication strategy in place to explain VBID to their patients. Patients need to be educated about the approach and how it can benefit them. Finally, VBID requires significant collaboration between providers, payors, and other stakeholders in the healthcare industry.
Extension into 2030
The VBID model was originally intended to run its trail phase until 2025. Recently, however, CMS extended the VBID model into 2030. As the model expands it will introduce more changes to address advanced needs of patients while improving care-coordination for serious cases.2 As the model becomes more prominent, more healthcare providers and payers will adopt VBID. The model’s integration and synergy with Medicare Advantage will increase in importance as CMS influences the industry to continue to innovate and improve patient outcomes.
This extension will prove challenging, but with proper preparation it is incredibly beneficial for the post-acute industry. VBID provides much-needed stability and allows providers and payors to continue to invest, while improving customized care outcomes overall for patients. As more providers and payers adopt VBID, patients will have access to a wider range of affordable care, including hospice services covered by Medicare Advantage.2 This extension also means that the industry will continue to prioritize value-based care, which is crucial in improving patient outcomes and reducing healthcare costs.
What do agencies need to do to prepare?
As VBID becomes an even more integral part of the healthcare industry, agencies need to start preparing for the future. This begins with investments in data analysis tools to develop effective communication strategies. From there, agencies should prioritize collaboration with other stakeholders in the industry. Agencies that get creative now will be ahead of the curve. Preparing a communications plan and collaborating with relevant Medicare Advantage providers gives your agency a competitive edge, contributing to lower cost of care while satisfying payers.1
The MHA Difference
The extension of VBID means there is an increased need for planning as hospice and Medicare Advantage begins integration. Proper adoption of VBID is a heavy lift, paving the way for higher care quality and patient satisfaction at lower operational costs. Our team of industry veterans at MHA is here to help your agency embrace this legislation. Starting with a deep dive into data, we analyze your payor sources, compiling data to reallocate areas of good and bad debt. From there we offer Monthly Business Insights, giving continued insight to ensure your processes remain on track. Our team then mobilizes this data to provide a tailored solution, implementing a fully optimized VBID strategy. We offer comprehensive data analytics tools, effective communication strategies, and unparalleled support from start to finish, allowing your agency to reach unseen heights amid new developments.
1. Parker J. (2023, March 28). "Hospices Get Creative to Succeed in VBID." Hospice News, https://hospicenews.com/2023/03/28/hospices-get-creative-to-succeed-in-vbid/.
2. Parker J. (2023, March 23). “CMS Extends Hospice VBID through 2023.” Hospice News, https://hospicenews.com/2023/03/23/cms-extends-hospice-vbid-through-2023/?itm_source=parsely-api.