Medicare Advantage advocacy group urges CMS to reconsider decision to end VBID model

Better Medicare Alliance, a research and advocacy organization that supports Medicare Advantage, said on Wednesday it was “deeply disappointed” that the Centers for Medicare & Medicaid Services has decided to end the Medicare Advantage Value-Based Insurance Design (VBID) at the end of 2025.

"Terminating the only model serving Medicare Advantage Organizations (MAOs) will have negative consequences on nearly nine million seniors and people with disabilities, and particularly on minorities and those in low-income communities who rely on essential benefits like in-home support services, groceries, and transportation,” said Mary Beth Donahue, president and CEO of Better Medicare Alliance, in a statement published Wednesday on the organization’s web site. 

CMS announced on Monday it would discontinue the model at the end of 2025 because of escalating and unsustainable costs. The model cost $2.3 billion in calendar year 2021 and $2.2 billion in calendar year 2022, an amount that is unprecedented in CMS Innovation Center models. The program, which currently includes 62 participating Medicare Advantage organizations, tests interventions intended to lower health care costs and improve health outcomes. 

RELATED: Breaking news: CMS will terminate MA Value-Based Insurance Design model at end of 2025

Donahue said the Better Medicare Alliance was deeply disappointed by the decision, which was made despite CMS’ previous recognition of the model’s potential to achieve the goals of lower costs and better outcomes for Medicare beneficiaries.

The model, which was extended through 2030 last year, has proven valuable in advancing the goals of person-centered, value-based care by allowing plans to tailor benefits to address beneficiaries’ unique needs, according to the Better Medicare Alliance. The organization said the VBID model has facilitated innovative approaches to care delivery, such as targeted interventions for individuals with chronic conditions, improved access to supplemental benefits, and programs addressing social determinants of health.

“Terminating the VBID model will disrupt progress made in achieving more equitable and affordable care for beneficiaries. It will also limit Medicare Advantage’s ability to test and scale strategies that reduce costs while improving health outcomes, potentially leaving vulnerable seniors without critical benefits they desperately need,” the organization said.

The advocacy group ended the statement with a call for CMS to reconsider the decision and work collaboratively with stakeholders to build on the model’s successes and ensure continued innovation and value for Medicare beneficiaries.