CMMI to Test Part D Payment Model & Update to MA VBID Model

On January 18, the Centers for Medicare & Medicaid Services (CMS) announced that its Center for Medicare and Medicaid Innovation (CMMI) will test a new model for Part D plans and an update to the Medicare Advantage Value-Based Insurance Design (VBID) model that the agency launched in 2017. 

The Part D model, titled the Part D Payment Modernization model, is voluntary as is the MA VBID update model, meaning that certain Medicare Advantage and Part D plans can choose to participate, and patients can choose to enroll in participating plans. 

The Part D Payment Modernization model will begin in January 2020. The model is intended to test the impact of a revised Part D program design and incentive alignment on overall Part D prescription drug spending and beneficiary out-of-pocket costs.

The voluntary, five-year Part D Modernization model will be open to eligible standalone Prescription Drug Plans (PDPs) and Medicare Advantage-Prescription Drug Plans (MA-PDs) that are approved to participate. 

The CMS fact sheet on the Part D Modernization model states:
"Through this model, CMS is testing the impact of a modernized Part D payment structure that increases and better aligns Part D plan sponsor liability with the costs paid for by CMS and Medicare beneficiaries. Ultimately, this model will allow CMS to address the high list price of drugs covered by Medicare Part D and evaluate the impact on cost and quality for Medicare beneficiaries."

Read CMS fact sheet on Part D Modernization Model here.

More information is available on the CMMI website here.

The CMS press release is available here. 

Posted 1/18/19