Medicare Pilot Program Looks at Chronic Issues

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​​​​​​​iStock_000011047279XSmall-300x199 (1).jpgThe Center for Medicare and Medicaid Services (CMS) has announced that it will be launching a new test program which might be of interest to aging parents and other seniors with chronic conditions living in one of seven states.


Called the Medicare Advantage Value-Based Insurance Program (or VBIP for short), the program is based on the premise that lowering or eliminating a person's out-of-pocket costs for treatments that can be effective for people with chronic health conditions will lower their long-term health costs.

In other words, sometimes a person with a chronic condition may not always get the best treatment due to the uncovered costs associated with the service or medication. Without that treatment, the person's health is negatively affected, and over time that can result in greater costs associated with treatment of the worsening condition, complications due to the condition, and emergency room visits or hospital stays because of declining health.

The project will offer several different approaches for participants to consider as they design their VBIP plan.

Test run

The plan will be made available to Medicare Advantage participants in seven trial states: Arizona, Indiana, Iowa, Massachusetts, Oregon, Pennsylvania and Tennessee. It will begin in 2017 and run for five years. The results will be studied to see if this program should then be expanded to participants in other states.

Many aging parents and other seniors may find this approach appealing. Among the chronic conditions which could be affected by participation in this plan are diabetes, chronic obstructive pulmonary disease (COPD), hypertension, mood disorder, and coronary artery disease.

As many aging parents know, proper and consistent treatment of chronic illness is crucial in order to achieve optimal outcomes. Any programs that can help increase access to proper treatment would be a valuable addition to patient care.


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