Health Plan Innovation Initiatives

The Centers for Medicare & Medicaid Services (CMS) is developing initiatives to test innovations in health plan design, including value-based insurance design (VBID); care delivery; beneficiary and provider incentives and engagement; and/or network design in Medicare health plans, Part D plans and Medigap and Retiree Supplemental health plans.

Background

Health plans increasingly have responded to market developments and fiscal pressures with innovations in care delivery, plan design, beneficiary and provider incentives, and network design. Though evidence suggests that these innovations may reduce cost, improve quality, and enhance beneficiary satisfaction, adoption of some of these innovations has been limited in stand-alone Medicare Prescription Drug Plans (PDP), Medicare Advantage (MA) and Medicare Advantage Prescription Drug plans (MA-PD), Medicaid managed care plans (Medicaid plans), Medigap plans, and Retiree Supplemental health plans.

Testing models of these types of innovations will require collaboration with health plans, states, and other stakeholders. These models will complement the Innovation Center’s existing portfolio of models that use innovative methods of payment to improve health care quality and reduce costs. In support of its efforts to develop these models, the Innovation Center published a Request for Information in October, 2014. The Request for Information period has now closed.

Initiative Details

The CMS Innovation Center's announced Health Plan Innovation Initiative models include:

 

For questions regarding Health Plan Innovation efforts, please contact HealthPlanInnovation@cms.hhs.gov.

For questions specifically regarding the Medicare Advantage Value-Based Insurance Design model, please contact MAVBID@cms.hhs.gov.

For questions specifically regarding the Part D Enhanced Medication Therapy Management model, please content EnhancedMTM@cms.hhs.gov.

Additional Information