Key Points
- The Medicare Advantage Value-Based Insurance Design Model, which tests certain innovations in the Medicare Advantage program, operates under section 1115A of the Social Security Act (42 U.S.C. § 1315a, added by section 3021 of the Patient Protection and Affordable Care Act). This policy authorizes CMS to test innovative health care payment and service delivery models that have the potential to lower Medicare, Medicaid, and CHIP spending while maintaining or improving the quality of beneficiaries’ care.
FIM Opportunities
One of the innovative flexibilities in the Value-Based Insurance Design (VBID) Model is the ability for CMS-approved Medicare Advantage plans to offer supplemental benefits (which can be primarily health related or nonprimarily health related) to a targeted subset of enrollees who are identified by chronic health condition, socioeconomic status, or area deprivation index (ADI). Food-related supplemental benefits were the most common type of supplemental benefit offered through the VBID Model in 2024, reaching over 8 million enrollees.
For an example, see Addressing Food and Nutritional Insecurity: A Use Case in Leveraging the Value-Based Insurance Design (VBID) Model.
