The Medicare Advantage Value-Based Insurance Design (VBID) Model team at the Center for Medicare and Medicaid Innovation (CMMI) and national leaders participated in a discussion around pathways for addressing food and nutritional insecurity at webinar event of our Health Equity Incubation Program on Thursday, March 31, 2022, from 3:00-4:30 PM ET.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
As part of a broader partnership, CMMI, the Office of the Assistant Secretary for Health (OASH) and the Administration for Community Living (ACL) are jointly sponsoring a webinar titled, Unleashing the Capabilities of MAOs to Deliver Health Innovation for Older Adults in Underserved Settings on October 7 from 2:30-4:00 PM ET to highlight the emerging, numerous opportunities for MAOs to support beneficiaries in more fully meeting their care needs and goals through novel approaches and services enabled by technology.
The webinar will provide an overview of the data supporting these opportunities and will include a panel of three speakers from payer organizations, each of whom will provide an overview of their experience and results in innovating in the use of technology to address unmet enrollee health needs. Panelists include Mona Siddiqui MD, MPH, Senior Vice President for Enterprise Clinical Strategy and Quality at Humana, who will discuss Humana’s approach to the use of data and predictive modeling to proactively engage and provide care for the highest risk and most vulnerable populations; John Wiecha, Medical Director, Senior Products Division at Point32Health, representing the newly combined organizations of Harvard Pilgrim Health Care and Tufts Health Plan will provide an overview of a recent pilot project to improve dementia care through a digital caregiver support program; and Caesar A. DeLeo, MD, MHSA Vice President & Executive Medical Director Strategic Initiatives, Highmark Health Enterprise Clinical Organization, Highmark BCBS who will discuss Highmark’s experience with telemedicine to approach substance use disorders during the pandemic and results from a five-year data driven program addressing appropriate opiate prescribing through profiling and academic detailing.
The webinar offers attendees the opportunity to gain a better understanding of the evidence and potential of several technology-enabled services in improving access, quality and outcomes of care, including, importantly, for underserved populations and will provide MAOs with insights more broadly on the challenges and solutions in design, implementation and evaluation of innovative and technology-enabled service. MAOs that are considering such innovations who may wish to target the use of technology-enabled and/or other services based on chronic illness and/or Low-Income Subsidy (LIS) status through the VBID Model are encouraged to attend.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
Health Equity Investments: Opportunities and Challenges in 2023Health Catalyst
Trudy Sullivan and Dr. Melissa Welch will discuss how to establish mechanisms using data you already have for ongoing health equity evaluation and how to drive data-informed decisions. Trudy Sullivan and Dr. Melissa Welch will discuss how to establish mechanisms using data you already have for ongoing health equity evaluation and how to drive data-informed decisions.
Has your organization prioritized addressing health inequities? How can a Center for Medicare and Medicaid Innovation (CMMI) Model factor into your organization’s health equity strategy? How can you structure your plan’s benefits to have the greatest impact on underserved communities? What partnership opportunities are available with CMMI?
These are important questions CMMI plans to answer in a new webinar series focused on health equity! CMMI is sponsoring a series of webinars for current and potential Medicare Advantage Organization (MAO) participants in the Value-Based Insurance Design (VBID) Model.
The first webinar in the series provided an overview of the Model’s Health Equity Incubation Sessions effort, articulated a business case for MAOs to leverage VBID Model Components to address health inequities in their member populations, and provided specific guidance and clarification on the full extent of health equity focused flexibilities that fall under the Model’s waiver authority.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
CMMI, in partnership with Million Hearts® at the Centers for Disease Control and Prevention (CDC), will sponsor a webinar entitled Value-Based Insurance Design, Opportunities to Improve Medication Adherence for Cardiovascular Disease Prevention on October 21, 2021 from 3:00-4:00 PM ET. The webinar will present evidence-based high impact strategies for MAOs to improve care and outcomes for beneficiaries with cardiovascular disease (CVD), including underserved populations.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
As part of a broader partnership, CMMI, the Office of the Assistant Secretary for Health (OASH) and the Administration for Community Living (ACL) are jointly sponsoring a webinar titled, Unleashing the Capabilities of MAOs to Deliver Health Innovation for Older Adults in Underserved Settings on October 7 from 2:30-4:00 PM ET to highlight the emerging, numerous opportunities for MAOs to support beneficiaries in more fully meeting their care needs and goals through novel approaches and services enabled by technology.
The webinar will provide an overview of the data supporting these opportunities and will include a panel of three speakers from payer organizations, each of whom will provide an overview of their experience and results in innovating in the use of technology to address unmet enrollee health needs. Panelists include Mona Siddiqui MD, MPH, Senior Vice President for Enterprise Clinical Strategy and Quality at Humana, who will discuss Humana’s approach to the use of data and predictive modeling to proactively engage and provide care for the highest risk and most vulnerable populations; John Wiecha, Medical Director, Senior Products Division at Point32Health, representing the newly combined organizations of Harvard Pilgrim Health Care and Tufts Health Plan will provide an overview of a recent pilot project to improve dementia care through a digital caregiver support program; and Caesar A. DeLeo, MD, MHSA Vice President & Executive Medical Director Strategic Initiatives, Highmark Health Enterprise Clinical Organization, Highmark BCBS who will discuss Highmark’s experience with telemedicine to approach substance use disorders during the pandemic and results from a five-year data driven program addressing appropriate opiate prescribing through profiling and academic detailing.
The webinar offers attendees the opportunity to gain a better understanding of the evidence and potential of several technology-enabled services in improving access, quality and outcomes of care, including, importantly, for underserved populations and will provide MAOs with insights more broadly on the challenges and solutions in design, implementation and evaluation of innovative and technology-enabled service. MAOs that are considering such innovations who may wish to target the use of technology-enabled and/or other services based on chronic illness and/or Low-Income Subsidy (LIS) status through the VBID Model are encouraged to attend.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
Health Equity Investments: Opportunities and Challenges in 2023Health Catalyst
Trudy Sullivan and Dr. Melissa Welch will discuss how to establish mechanisms using data you already have for ongoing health equity evaluation and how to drive data-informed decisions. Trudy Sullivan and Dr. Melissa Welch will discuss how to establish mechanisms using data you already have for ongoing health equity evaluation and how to drive data-informed decisions.
Has your organization prioritized addressing health inequities? How can a Center for Medicare and Medicaid Innovation (CMMI) Model factor into your organization’s health equity strategy? How can you structure your plan’s benefits to have the greatest impact on underserved communities? What partnership opportunities are available with CMMI?
These are important questions CMMI plans to answer in a new webinar series focused on health equity! CMMI is sponsoring a series of webinars for current and potential Medicare Advantage Organization (MAO) participants in the Value-Based Insurance Design (VBID) Model.
The first webinar in the series provided an overview of the Model’s Health Equity Incubation Sessions effort, articulated a business case for MAOs to leverage VBID Model Components to address health inequities in their member populations, and provided specific guidance and clarification on the full extent of health equity focused flexibilities that fall under the Model’s waiver authority.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
CMMI, in partnership with Million Hearts® at the Centers for Disease Control and Prevention (CDC), will sponsor a webinar entitled Value-Based Insurance Design, Opportunities to Improve Medication Adherence for Cardiovascular Disease Prevention on October 21, 2021 from 3:00-4:00 PM ET. The webinar will present evidence-based high impact strategies for MAOs to improve care and outcomes for beneficiaries with cardiovascular disease (CVD), including underserved populations.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Future of Personalizing Care Management & the Patient ExperienceRaphael Louis Vitón
Actionable segmentation model findings - by Raphael Louis Vitón & Dream team of industry experts, physicians and leaders from Blue Cross, GEHealthCare, RingLeaderVentures, Maddock Douglas, Dr.Daniel Friedland, etc working on improving health outcomes by Personalizing the Care Management business model for Better Outcomes & Better Economics (through patient empowerment)
SOCW 6351 Wk 9 Discussion 1. Need Responses.Respond in one of t.docxrosemariebrayshaw
SOCW 6351 Wk 9 Discussion 1. Need Responses.
Respond in one of the following ways:
· Describe two factors that might make minority groups especially vulnerable in the Medicaid policy your colleague cited. Explain why these groups may not have a voice in the policy-making process.
· Offer examples of organized self-help and citizens’ groups as both support mechanisms and potentially powerful lobbies. Describe how these lobbying bodies can help in amending the policy your colleague described.
Support your response with specific references to the resources. Be sure to provide full APA citations for your references.
NA:
Top of Form
Medicaid is a medical assistance program developed specifically for low income individuals of any age, unlike Medicare, which is designed for those over 65 and have no income requirements (“Difference between Medicare and Medicaid”, n.d.). When health care policies are change, they affect programs such as Medicaid and Medicare. For example, when the ACA (Affordable Care Act) was implemented, it led to an increase of enrollment as it made the process easier and reached more individuals and it expanded Medicaid eligibility to low-income adults (Wachino, Artiga & Rudowitz, 2014).
In the state of Pennsylvania, a Medicaid policy that I would amend would be the Healthy PA policy, which was a Medicaid expansion that included drug and alcohol services (IRETA, 2015). The issue is the length of time it takes for someone to be admitted into a program. Whether it’s getting into an inpatient or outpatient program, the process needs to be expedited and more streamlined. Many who are suffering from substance abuse disorders struggle with finally getting themselves into a program and delaying the process could result in someone hesitating and deciding not to move forward with treatment that is crucial (IRETA, 2015).
In Pennsylvania, stakeholders include a steering committee, which is made up of hospitals, health care providers, consumers, foundations and academic institutions (“HIP”, 2019). This committee comes up with ways to improve population health and control health cost including Medicaid and Medicare. They developed a plan for heathcare delivery that will improve the quality of life for everyone, without limitations on income or background (“HIP”, 2019). This committee has 5 work groups that develop implementation plans for the goals that were developed by the committee and focus on specific aspects such as payment, price and quality transparency, population health, healthcare transformation and health information technology (“HIP”, 2019).
References:
HIP stakeholders. (2019). Retrieved from https://www.health.pa.gov/topics/Health-Innovation/Pages/Stakeholders.aspx
IRETA. (2015). Pennsylvania’s Medicaid expansion smooths the road to addiction treatment, but barriers remain. Retrieved from https://ireta.org/resources/pennsylvanias-medicaid-expansion-smooths-the-road-to-addiction-treatment-but-barriers-remain/
Wachino, V., A.
Reviews The Legitimate Equity Disparities In HealthcareHealth 2Conf
This presentation highlights innovative solutions to tackle legitimate equity disparities in healthcare. Learn how to improve access to quality care for all people, regardless of race, ethnicity, socioeconomic status, or other factors. Access experts’ insights through the Health 2.0 Conference on new research, best practices, and tools that can help patients fight for health equity.
Addressing health equity & the risk in providing careEvan Osborne
What Is Health Equity & Why Should It Be Addressed?
How Does Health Equity Impact Providers & Payors?
How Can Providers & Payors Be Rewarded For Addressing Health Equity?
How Can Health Equity Be Addressed Through Technology?
Partnering with Patients, Families and Communities for Health: A Global Imper...EngagingPatients
Engagement is an essential tool to improving global health. This report introduces a new framework for engagement to help countries assess current programs and think strategically about future engagement opportunities. It spotlights barriers to engagement and offers concrete examples of effective engagement from around the globe.
Driving Health Equity into Action: The Potential of Health Equity Impact Asse...Wellesley Institute
This presentation provides a critical analysis of the potential of a health equity impact assessment.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
The CMS Innovation Center will host a webinar on Thursday, March 10, 2022 from 3:00-4:00 PM ET. During this webinar, presenters will provide a brief review of the recently released Calendar Year (CY) 2023 Requests for Applications (RFAs) for the VBID Model and the Hospice Benefit Component as well as the payment design related to the Hospice Benefit Component of the VBID Model. This session will also offer attendees an opportunity to ask follow-up questions.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
discussion on Health Economics and Health Care in our country and abroad, and what resources are given by the private sectors and with the very scarce help from the DOH, national and local government, and from the support given by WHO.
Provides an overview of wellness program trends, including a look at the role of prepaid wellness cards as a central component of employer wellness programs. We will also look at meaningful incentive thresholds and identify obstacles to program adoption.
Running head THE DETERMINATION OF ELIGIBILITY FOR MEDICAID .docxtoltonkendal
Running head: THE DETERMINATION OF ELIGIBILITY FOR MEDICAID 1
THE DETERMINATION OF ELIGIBILITY FOR MEDICAID 6
The Determination of Eligibility for Medicaid
Tiffany Williams
The Determination of Eligibility for Medicaid
Introduction
The social health care program, Medicaid is aimed at providing health care services to the needy and those with disabilities in the United States. The Act should provide the state with the way forward or criteria to be followed in selecting the people who are to benefit from the social health program. However, over time, it has not been clear to every American citizen as to which criteria should be used in determining the needy in the society. In particular, it has been challenging on selecting the eligible citizens for the program with a focus on the level of income and the level of expenditure. For instance, the issue of “spend down” periods has posed a lot of difficulties in determining the eligibility for Medicaid. A way great issue regarding the funding, expansion, and determination of eligibility for Medicaid includes the requirement by the Supreme Court in the United States for regions such as Massachusetts to contribute the six months’ excess income towards medical expenditure before the Medicaid coverage program begins in such regions. This paper seeks to explain the issue of Medicaid coverage and the eligibility of the different level of community members. It also explores the level of government affected by the issue as well as the analysis of the eligibility of Medicaid.
Economic Issue
The social health program (Medicaid) requires adequate funding in order to cover effectively a large and needy population. While it would be more beneficial to expand the program to the other categories of people in the society such as those with disabilities, there should be constant and enough supply of funds both from the government and the good wishers such as donors to help reach out every needy member of the society. Inadequate funding is an issue since there is a large percentage of people who need medical assistance and cannot afford it unless they get subsidized medical health care or fully assisted by programs such as the Medicaid (Ford, Spicer, & Institute of Medicine (U.S.), 2012).
Coupled with the low income of most of the society members, it is clear and evident enough that the majority of the people in the United States value social programs such as Medicaid. However, failure to adequately fund the program has only led to development and implementation of strict procedures and regulations in determining those who are eligible for the program. In particular, the six-month spend down period has resulted in more complex procedures, some of which are neither clear nor understandable to society members. The methodology used has never been friendly to the low-income people; the approach involving spend down for ...
The CMS Innovation Center hosted an office hours session on Tuesday, April 5, 2022 from 3:00-4:00 PM ET to discuss the Medicare Advantage Value-Based Insurance Design (VBID) Model and its Hospice Benefit Component. Attendees received an overview of the Model and the CY 2023 application process, and had an opportunity for questions and answers with the Model team.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The ACO REACH Model Team will hosted a health equity webinar on Tuesday, April 5, 2022 from 4:00 - 5:00 p.m. EDT. The ACO REACH Model team highlighted Health Equity provisions added to the ACO REACH Model.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
More Related Content
Similar to VBID-HEIP-Food-Nutrition-Webinar-Slides.pdf
The Future of Personalizing Care Management & the Patient ExperienceRaphael Louis Vitón
Actionable segmentation model findings - by Raphael Louis Vitón & Dream team of industry experts, physicians and leaders from Blue Cross, GEHealthCare, RingLeaderVentures, Maddock Douglas, Dr.Daniel Friedland, etc working on improving health outcomes by Personalizing the Care Management business model for Better Outcomes & Better Economics (through patient empowerment)
SOCW 6351 Wk 9 Discussion 1. Need Responses.Respond in one of t.docxrosemariebrayshaw
SOCW 6351 Wk 9 Discussion 1. Need Responses.
Respond in one of the following ways:
· Describe two factors that might make minority groups especially vulnerable in the Medicaid policy your colleague cited. Explain why these groups may not have a voice in the policy-making process.
· Offer examples of organized self-help and citizens’ groups as both support mechanisms and potentially powerful lobbies. Describe how these lobbying bodies can help in amending the policy your colleague described.
Support your response with specific references to the resources. Be sure to provide full APA citations for your references.
NA:
Top of Form
Medicaid is a medical assistance program developed specifically for low income individuals of any age, unlike Medicare, which is designed for those over 65 and have no income requirements (“Difference between Medicare and Medicaid”, n.d.). When health care policies are change, they affect programs such as Medicaid and Medicare. For example, when the ACA (Affordable Care Act) was implemented, it led to an increase of enrollment as it made the process easier and reached more individuals and it expanded Medicaid eligibility to low-income adults (Wachino, Artiga & Rudowitz, 2014).
In the state of Pennsylvania, a Medicaid policy that I would amend would be the Healthy PA policy, which was a Medicaid expansion that included drug and alcohol services (IRETA, 2015). The issue is the length of time it takes for someone to be admitted into a program. Whether it’s getting into an inpatient or outpatient program, the process needs to be expedited and more streamlined. Many who are suffering from substance abuse disorders struggle with finally getting themselves into a program and delaying the process could result in someone hesitating and deciding not to move forward with treatment that is crucial (IRETA, 2015).
In Pennsylvania, stakeholders include a steering committee, which is made up of hospitals, health care providers, consumers, foundations and academic institutions (“HIP”, 2019). This committee comes up with ways to improve population health and control health cost including Medicaid and Medicare. They developed a plan for heathcare delivery that will improve the quality of life for everyone, without limitations on income or background (“HIP”, 2019). This committee has 5 work groups that develop implementation plans for the goals that were developed by the committee and focus on specific aspects such as payment, price and quality transparency, population health, healthcare transformation and health information technology (“HIP”, 2019).
References:
HIP stakeholders. (2019). Retrieved from https://www.health.pa.gov/topics/Health-Innovation/Pages/Stakeholders.aspx
IRETA. (2015). Pennsylvania’s Medicaid expansion smooths the road to addiction treatment, but barriers remain. Retrieved from https://ireta.org/resources/pennsylvanias-medicaid-expansion-smooths-the-road-to-addiction-treatment-but-barriers-remain/
Wachino, V., A.
Reviews The Legitimate Equity Disparities In HealthcareHealth 2Conf
This presentation highlights innovative solutions to tackle legitimate equity disparities in healthcare. Learn how to improve access to quality care for all people, regardless of race, ethnicity, socioeconomic status, or other factors. Access experts’ insights through the Health 2.0 Conference on new research, best practices, and tools that can help patients fight for health equity.
Addressing health equity & the risk in providing careEvan Osborne
What Is Health Equity & Why Should It Be Addressed?
How Does Health Equity Impact Providers & Payors?
How Can Providers & Payors Be Rewarded For Addressing Health Equity?
How Can Health Equity Be Addressed Through Technology?
Partnering with Patients, Families and Communities for Health: A Global Imper...EngagingPatients
Engagement is an essential tool to improving global health. This report introduces a new framework for engagement to help countries assess current programs and think strategically about future engagement opportunities. It spotlights barriers to engagement and offers concrete examples of effective engagement from around the globe.
Driving Health Equity into Action: The Potential of Health Equity Impact Asse...Wellesley Institute
This presentation provides a critical analysis of the potential of a health equity impact assessment.
Bob Gardner, Director of Policy
www.wellesleyinstitute.com
Follow us on twitter @wellesleyWI
The CMS Innovation Center will host a webinar on Thursday, March 10, 2022 from 3:00-4:00 PM ET. During this webinar, presenters will provide a brief review of the recently released Calendar Year (CY) 2023 Requests for Applications (RFAs) for the VBID Model and the Hospice Benefit Component as well as the payment design related to the Hospice Benefit Component of the VBID Model. This session will also offer attendees an opportunity to ask follow-up questions.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
discussion on Health Economics and Health Care in our country and abroad, and what resources are given by the private sectors and with the very scarce help from the DOH, national and local government, and from the support given by WHO.
Provides an overview of wellness program trends, including a look at the role of prepaid wellness cards as a central component of employer wellness programs. We will also look at meaningful incentive thresholds and identify obstacles to program adoption.
Running head THE DETERMINATION OF ELIGIBILITY FOR MEDICAID .docxtoltonkendal
Running head: THE DETERMINATION OF ELIGIBILITY FOR MEDICAID 1
THE DETERMINATION OF ELIGIBILITY FOR MEDICAID 6
The Determination of Eligibility for Medicaid
Tiffany Williams
The Determination of Eligibility for Medicaid
Introduction
The social health care program, Medicaid is aimed at providing health care services to the needy and those with disabilities in the United States. The Act should provide the state with the way forward or criteria to be followed in selecting the people who are to benefit from the social health program. However, over time, it has not been clear to every American citizen as to which criteria should be used in determining the needy in the society. In particular, it has been challenging on selecting the eligible citizens for the program with a focus on the level of income and the level of expenditure. For instance, the issue of “spend down” periods has posed a lot of difficulties in determining the eligibility for Medicaid. A way great issue regarding the funding, expansion, and determination of eligibility for Medicaid includes the requirement by the Supreme Court in the United States for regions such as Massachusetts to contribute the six months’ excess income towards medical expenditure before the Medicaid coverage program begins in such regions. This paper seeks to explain the issue of Medicaid coverage and the eligibility of the different level of community members. It also explores the level of government affected by the issue as well as the analysis of the eligibility of Medicaid.
Economic Issue
The social health program (Medicaid) requires adequate funding in order to cover effectively a large and needy population. While it would be more beneficial to expand the program to the other categories of people in the society such as those with disabilities, there should be constant and enough supply of funds both from the government and the good wishers such as donors to help reach out every needy member of the society. Inadequate funding is an issue since there is a large percentage of people who need medical assistance and cannot afford it unless they get subsidized medical health care or fully assisted by programs such as the Medicaid (Ford, Spicer, & Institute of Medicine (U.S.), 2012).
Coupled with the low income of most of the society members, it is clear and evident enough that the majority of the people in the United States value social programs such as Medicaid. However, failure to adequately fund the program has only led to development and implementation of strict procedures and regulations in determining those who are eligible for the program. In particular, the six-month spend down period has resulted in more complex procedures, some of which are neither clear nor understandable to society members. The methodology used has never been friendly to the low-income people; the approach involving spend down for ...
Similar to VBID-HEIP-Food-Nutrition-Webinar-Slides.pdf (20)
The CMS Innovation Center hosted an office hours session on Tuesday, April 5, 2022 from 3:00-4:00 PM ET to discuss the Medicare Advantage Value-Based Insurance Design (VBID) Model and its Hospice Benefit Component. Attendees received an overview of the Model and the CY 2023 application process, and had an opportunity for questions and answers with the Model team.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The ACO REACH Model Team will hosted a health equity webinar on Tuesday, April 5, 2022 from 4:00 - 5:00 p.m. EDT. The ACO REACH Model team highlighted Health Equity provisions added to the ACO REACH Model.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
This webinar focuses on the new financial policies featured in the ACO REACH webinar. For more information on the financial methodology for the ACO REACH Model that will be transitioned from the Global and Professional Direct Contracting (GPDC) Model, please refer to prior released financial webinars available on the GPDC Model webpage.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
During this webinar, a high-level overview of the ACO REACH Model was provided including information on the participation and eligibility requirements, Accountable Care Organization (ACO) types, payment mechanisms, and beneficiary alignment methodology.
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CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
This webinar provided an overview of the Model and the Part D Sponsor application process, as well as included a Q&A session for interested Part D sponsors.
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CMS Innovation Center:
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy:
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The CMS Innovation Center hosted a webinar on Wednesday, March 2, 2022 at 3pm – 4pm ET, during which presenters shared updates on the Comprehensive End Stage Renal Disease (ESRD) Care (CEC) Model, the Kidney Care Choices (KCC) Model, and the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model. This event was available to the first 1,000 registrants. Presentation materials will be available on the respective model webpages following the session.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Medicare Advantage Value-Based Insurance Design (VBID) Model Team hosted an office hours session on Thursday February 3rd, 2022 on the Hospice Benefit Component to provide technical and operational support to interested stakeholders. During this office hours session, presenters answered questions submitted in advance to the VBID Mailbox and offered attendees an opportunity to ask additional questions.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The ET3 Model and Medicaid: Opportunities for Alignment webinar provided background on the ET3 Model, discussed the benefits for states of aligning coverage and payment policies with ET3, and explored considerations for states seeking to implement new Medicaid services that align with the ET3 Model. This webinar was intended for state Medicaid agencies, ET3 Model Participants, and other stakeholders interested in learning more about optional Medicaid alignment with the ET3 Model.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
CMS announced an Office Hour event for potential applicants to ask questions ahead of the PCF application deadline.
The PCF Model Team was available to answer questions on key topics including eligibility, payment design and attribution, and more.
You may also refer to the materials from the two PCF webinars held in March: Introduction to PCF and Ready, Set, Apply.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
In order to help ETC Model Participants prepare for the ETC Model, CMS conducted an introductory webinar on Wednesday, December 9, 2020 from 1 p.m. to 2 p.m. The webinar provided an overview of the ETC Model, including:
Participant selection
The Home Dialysis Payment Adjustment
The Performance Payment Adjustment
The ETC Model timeline, including the timing of payment adjustments
Information about how to communicate with CMS about the ETC Model
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Value-Based Insurance Design (VBID) Model team hosted a webinar on January 28, 2021 from 4:00-5:00 PM EST. During this webinar, presenters provided a brief review of the recently released Calendar Year (CY) 2022 Requests for Applications (RFAs) for the VBID Model and the Hospice Benefit Component. This session also offered attendees an opportunity to ask follow-up questions.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Medicare Advantage Value-Based Insurance Design (VBID) Model team hosted a webinar on Wednesday, March 17, 2021 from 4:00 - 5:00 PM EDT. During this webinar, presenters provided a preview of the Calendar Year 2022 payment design related to the Hospice Benefit Component of the VBID Model. The session also offered attendees an opportunity to ask follow-up questions.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Part D Senior Savings Model and Part D Payment Modernization Model teams hosted a webinar on Tuesday, March 23, 2021 from 1:00 to 2:00 PM EDT. During this webinar, presenters provided an overview of the two Models and the Calendar Year (CY) 2022 application process. The session also offered attendees an opportunity to ask follow-up questions.
- - -
CMS Innovation Center
http://innovation.cms.gov
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CMS hosted a virtual office hour session on April 13, 2021 from 4:00-5:00 PM EDT. During this office hour, presenters provided a review of the Calendar Year 2022 payment design and payment rates related to the Hospice Benefit Component of the Value-Based Insurance Design (VBID) Model. This session also offered attendees an opportunity to ask follow-up questions.
- - -
CMS Innovation Center
http://innovation.cms.gov
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http://newmedia.hhs.gov/standards/comment_policy.html
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The Emergency Triage, Treat, and Transport (ET3) Model Medical Triage Line Notice of Funding Opportunity (NOFO) webinar provided an overview of the application process and NOFO requirements for implementing 911 medical triage lines. This webinar was intended for those interested in learning more about the ET3 Model’s Notice of Funding Opportunity, which was released March 12.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Primary Care First Model (PCF) Options team provided an overview of the PCF payer partnership. Participants were able to learn about current PCF Model participants, benefits to payer partnership, the framework against which payer proposal alignment will be evaluated, and the payer solicitation process and timeline.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Primary Care First Model Options team provided an overview of the Model, including goals, eligibility to participate in the second cohort, payment design and attribution, and data sharing. Model staff answered your questions about these topics.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
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CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Community Health Access and Rural Transformation (CHART) Model team hosted an overview webinar on Tuesday, August 18, 2020 from 1:00 - 2:30 PM EDT. Attendees had the opportunity to hear an overview of the CHART Model, including its objectives, eligible participants and their roles, payment options, and timeline.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
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http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Direct Contracting Model Options team hosted a webinar on June 29, 2020 from 1:00 to 2:00 PM EDT. During this webinar, presenters provided a demonstration of the application portal and the Provider List Submission Tool (PLST). Following this session, attendees had an opportunity to ask follow-up questions.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Centers for Medicare & Medicaid Services hosted a webinar on Thursday, April 2, 2020 to discuss the Value Based Insurance Design (VBID), Part D Payment Modernization, and Part D Senior Savings models. Attendees received an overview of the models and the CY 2021 application process, and had an opportunity for questions and answers with the Model teams.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
More from Centers for Medicare & Medicaid Services (CMS) (20)
Jennifer Schaus and Associates hosts a complimentary webinar series on The FAR in 2024. Join the webinars on Wednesdays and Fridays at noon, eastern.
Recordings are on YouTube and the company website.
https://www.youtube.com/@jenniferschaus/videos
Up the Ratios Bylaws - a Comprehensive Process of Our Organizationuptheratios
Up the Ratios is a non-profit organization dedicated to bridging the gap in STEM education for underprivileged students by providing free, high-quality learning opportunities in robotics and other STEM fields. Our mission is to empower the next generation of innovators, thinkers, and problem-solvers by offering a range of educational programs that foster curiosity, creativity, and critical thinking.
At Up the Ratios, we believe that every student, regardless of their socio-economic background, should have access to the tools and knowledge needed to succeed in today's technology-driven world. To achieve this, we host a variety of free classes, workshops, summer camps, and live lectures tailored to students from underserved communities. Our programs are designed to be engaging and hands-on, allowing students to explore the exciting world of robotics and STEM through practical, real-world applications.
Our free classes cover fundamental concepts in robotics, coding, and engineering, providing students with a strong foundation in these critical areas. Through our interactive workshops, students can dive deeper into specific topics, working on projects that challenge them to apply what they've learned and think creatively. Our summer camps offer an immersive experience where students can collaborate on larger projects, develop their teamwork skills, and gain confidence in their abilities.
In addition to our local programs, Up the Ratios is committed to making a global impact. We take donations of new and gently used robotics parts, which we then distribute to students and educational institutions in other countries. These donations help ensure that young learners worldwide have the resources they need to explore and excel in STEM fields. By supporting education in this way, we aim to nurture a global community of future leaders and innovators.
Our live lectures feature guest speakers from various STEM disciplines, including engineers, scientists, and industry professionals who share their knowledge and experiences with our students. These lectures provide valuable insights into potential career paths and inspire students to pursue their passions in STEM.
Up the Ratios relies on the generosity of donors and volunteers to continue our work. Contributions of time, expertise, and financial support are crucial to sustaining our programs and expanding our reach. Whether you're an individual passionate about education, a professional in the STEM field, or a company looking to give back to the community, there are many ways to get involved and make a difference.
We are proud of the positive impact we've had on the lives of countless students, many of whom have gone on to pursue higher education and careers in STEM. By providing these young minds with the tools and opportunities they need to succeed, we are not only changing their futures but also contributing to the advancement of technology and innovation on a broader scale.
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This session provides a comprehensive overview of the latest updates to the Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (commonly known as the Uniform Guidance) outlined in the 2 CFR 200.
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- Understand the rationale behind the 2024 updates to the Uniform Guidance outlined in 2 CFR 200, and their implications for federal grant recipients.
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1. Value-Based Insurance Design (VBID)
Model’s Health Equity Incubation Program
Advancing Food and Nutritional Security
March 31, 2022
Center for Medicare & Medicaid Innovation
Centers for Medicare & Medicaid Services
People using assistive technology may not be able to fully access information in this file. For
assistance, please contact digital@hhs.gov
2. Disclaimer
2
This presentation is offered only for general informational and educational purposes.
As always, the agency’s positions on matters may be subject to change.HHS’s
comments are not offered as and do not constitute legal advice or legal opinions,and
no statement made during this presentation will preclude the agency and/or its law
enforcement partners from enforcing any and all applicable laws, rules,and regulations.
MedicareAdvantage Organizations (MAOs) and Prescription Drug Plan (PDP)
Sponsors are responsible for ensuring that their actions fully comply with applicable
laws, rules,and regulations,and we encourage you to consult with your own legal
counsel to ensure such compliance.
3. Table of Contents
3
ONE / WELCOME
TWO / FOOD & NUTRITION SECURITY: STRATEGIES FOR HEALTH SETTINGS
THREE / BENEFIT DESIGN OPPORTUNITIES, INCLUDING THROUGH THE VBID MODEL
FOUR / IMPLEMENTATION CHALLENGES AND SUCCESSES
FIVE / FIRESIDE CHAT ON DATA AND EVALUATION STRATEGIES
SIX / QUESTION & ANSWER AND NEXT STEPS
4. PART ONE
3:00 – 3:10 PM ET
4
WELCOME
SPEAKERS
Laura McWright,JD, MSW
Deputy Director, Seamless Care Models Group,
Center for Medicare and Medicaid Innovation,CMS
Sibel Ozcelik, ML, MS
Acting Deputy Director, Division of Delivery System Demonstrations,
Center for Medicare and Medicaid Innovation,CMS
5. 5
“
Health equity means the attainment of the highest level of health
for all people, where everyone has a fair and just opportunity to
attain their optimal health regardless of race, ethnicity, disability,
sexual orientation, gender identity, socioeconomic status,
geography, preferred language, or other factors that affect
access to care and health outcomes. CMS is working to advance
health equity by designing, implementing, and operationalizing
policies and programs that support health for all the people
served by our programs, eliminating avoidable differences in
health outcomes experienced by people who are disadvantaged
or underserved, and providing the care and support that our
enrollees need to thrive.
”
6. Addition of theVoluntaryVBID Health Equity Incubation Program
6
Health Equity Incubation
Program Overview
The Health Equity Incubation Program will
serve as the central pillar of planned learning
activities with the goal of:
• Encouraging innovation in most promising
focus areas;
• Optimizing design and implementation best
practices; and
• Building evidence base for quality
improvement and medical cost savings
related to social needs interventions.
• Inform new directions in MA program
Upcoming Sessions andTechnicalAssistance
Initial VBID
Business Case
Session
September 2021 –
December 2021
Engage MAOs in “Health Equity Incubation
Sessions” in the form of webinar and follow-up
one-on-ones that focus on VBID health equity
business case
Technical
Assistance
January 2022 –
December 2022
During Health Equity Incubation Sessions, the
VBID Team will engage MAOs in health equity
focused technical assistance (TA) and leverage use
cases and case studies tailored to the most
promising focus areas (e.g., food and nutrition).
Learning and
Performance
Feedback
2023 and onwards
In the long-term, theVBID Team plans to create a
learning network, where plans can tackle common
challenges around health equity.An essential part of
this learning network will be tailored feedback based
on plan data.
7. 7
1
2
*
3
4
5
6
7
VBID Health Equity Business Case
INCREASE MEMBER
ENGAGEMENT &
RETENTION
Plans that offer supplemental
benefits like meals have been
shown to receive a higher
net promoter score and
higher member retention.1
XM Institute NPS and Customer Ratings Benchmarks, Qualtrics 2020, Qualtrics.com
IMPROVE QUALITY &
MEMBER SATISFACTION
Focusing on social needs is
correlated with positive
quality of life and member
satisfaction7
Refer to the HMA MA Supplemental Benefits Report
.
According to a 2020 McKinsey
study, MA plans with an
average customer
experience measure rating
of 4 or more Stars added
2.1 times more net
members in 2019 than their
less customer-friendly
competitors.2
Refer to the McKinsey study
OFFER BENEFITS ONLY
AVAILABLE TO MODEL
PARTICIPANTS
VBID Model participants can
offer unique features only
available to participating
plans, such MA and Part D RI
Programs, and importantly,
targeted non-primarily health-
related supplemental benefits.*
Some marketing restrictions apply
VBID tests greater
customization of benefits to
underserved populations.
LOWER MEDICAL
SPENDING &
UTILIZATION OF LOW-
VALUE SERVICES
Addressing health-related
social needs in member
populations has been shown
in other contexts to:
• Significantly lower healthcare
utilization3
Berkowitz, et al., 2018; Martin et al., 2018
• Significantly lower
Emergency Department (ED)
visits4
Ibid
• Significantly lower medical
spending5
Gurvey, et al., 2013
• Better chronic disease
management 6
Refer to the Project Angel Heart study
MINIMIZE COSTS BY
BETTER FOCUSING
INTERVENTIONS
Additional targeting flexibilities
available toVBID Model
participants, such as targeting by
socio-economic status, test the
benefits of allowing plans to
focus interventions on
populations where the
largest health
improvements can be
realized.
In addition to improving member health and promoting health equity, there is a strong business case for MAOs to participate
inVBID and leverage the Model’s waiver authority to address health disparities.
8. PARTTWO
3:10 – 3:30 PM ET
8
Food & Nutrition Security: Strategies for Health Settings
SPEAKER
Dr. Hilary Seligman, MD MAS
Professor of Medicine and of Epidemiology and Biostatistics,
University of California San Francisco
9. Food & Nutrition Security:
Strategies for Health Settings
Hilary Seligman MD MAS
University of California San Francisco
March 31, 2022
9
11. 11
Figure 3
Trends in the prevalence of food insecurity and very low food security in U.S. households, 2001-20
Source: USDA, Economic Research Service using data from U.S. Department of Commerce, Bureau of the Census, 2020 Current
Population Survey Food Security Supplement.
12. Disparities in Food Insecurity Rates
by Race, 2020
Source: USDA, Economic Research Service, using data from the December 2020 Current Population Survey Food Security
Supplement, U.S. Census Bureau
12
13. Food Insecurity Prevalence ~9% Among
Medicare Beneficiaries
Prevalence of Food Insecurity Among Medicare Beneficiaries Ages
65+ by Race/Ethnicity, 2017
13
Source: AARP Public Policy Institute analysis of the 2017 Medicare Current Beneficiary
Survey (MCBS)
14. Food Insecurity Prevalence Even Higher
Among Medicaid Enrollees
14
Table 1: Demographics
No data Total
% (n) or Mean (SE)
Food Secure
% (n) or Mean (SD)
Food Insecure
% (n) or Mean (SD)
P-Value
Insurance No data No data No data No data
Private 63.0 (7,920) 67.6 (7,226) 34.1 (692) <.0001
Medicare 7.7 (1,108) 7.7 (880) 8.1 (228) No data
Other public 14.1 (3,725) 11.6 (2,592) 29.5 (1,131) No data
Uninsured 15.3 (3,317) 13.2 (2,404) 28.3 (911) No data
Note: Nationally representative, NHIS (2011) linked to MEPS (2012-13)
Reference: Food Insecurity and Health Care Expenditures in the United States, 2011-2013.
Health Serv Res. 2018 06; 53(3):1600-1620. Berkowitz SA, Basu S, Meigs JB, Seligman HK.
15. Nutrition Security
15
WHAT IS NUTRITIONSECURITY?
Consistent access to nutritious foods that promote optimal health and
Well-being for all Americans, throughout all stages of life.
Nutrition
Security
Food
Security
Diet Quality Equity
HOW DOES NUTRITION SECURITY
BUILD ON FOOD SECURITY?
Food security is having enough calories.
Nutrition security is having the right calories.
https://www.fns.usda.gov/resource
/usda-actions-nutrition-security
16. Bidirectional relationship between
food insecurity and poor health
16
Food
insecurity
Poor health
(Development/worsening
chronic conditions)
↑Healthcare
expenditures
↓ Household income/
competing demands
(e.g. choosing between medical
care and food)
Johnson, Palakshappa, Basu, Seligman, and Berkowitz. Health Services Research, 2021.
17. “Screen and Intervene”
Identification
of food
insecurity by
positive
clinical screen
Referral to
someone who
can make a
connection to
a program
Enrollment in
on-site,
community, or
federal food
program
Improved diet
quality, food
security, and
clinical
satisfaction
Improvement
of health and
utilization
outcomes
17
18. Standardized Clinical Measurement:
Hunger Vital Sign
1. Within the past 12 months we worried whether our food would run
out before we got money to buy more.
2. Within the past 12 months the food we bought just didn’t last and
we didn’t have money to get more.
Often or sometimes true to EITHER question suggests food insecurity (97%
sensitivity, 83% specificity)
For test characteristics among households with children: Hager, Pediatrics, 2010
For test characteristics among households without children, population-based:
Gundersen & Seligman, PHN, 2017 18
19. 19
Prescribing healthy food in Medicare/Medicaid
is cost effective, could improve health outcomes
New study finds that health insurance coverage for healthy food could
improve health, reduce healthcare costs, and be highly cost-effective after
five years
Medicare/Medicaid:
Healthy food prescriptions Fruits Nuts/
Seeds
Vegetables Whole
grains
Seafood Plant oils
Insurance covers
30% of cost of eligible
food
$100 billion
less in healthcare
utilization over
model population’s
lifetime
Cost-effective after
5 years
Less diabetes
120
thousand cases
prevented or
postponed
Less cardiovascular disease
3.28
million cases
prevented or
postponed
As or more cost-
effective than
many currently
covered medical
treatments
For more information, see “Cost-effectiveness of financial incentives for improving diet
through Medicare and Medicaid: A microsimulation study” by Lee et al. (2019).
https://doi.org/10.1371/journal.pmed.1002761
Gerald J. and Dorothy R. Friedman School of
Nutrition Science and Policy at
Tufts University
20. Food Is Medicine
• Integration of specific food and nutrition interventions
in, or in close collaboration with, the health care
system
• Medically-Tailored Meals
• Medically-Tailored Groceries
• Produce Prescriptions
• On-site interventions
• Target population: individuals with or at high risk for
serious health conditions
• Often prioritizes people with or at high risk of food
insecurity
• People with cancer and HIV were first recipients
20
21. Food Is
Medicine
Clinical Screen
for Food
Insecurity
“On-Site”
Programs
Food pantry in
clinic
Mobile food
distribution in
clinic
SNAP enrollment
assistance
Community
Programs
MTM’s/MTG’s
Food Bank/
Food Pantry
Produce
Prescriptions
Federal Nutrition
Programs
SNAP
WIC
Numerous
Others
Clinical
Referral
21
22. 22
Prevention
Treatment
Medically-tailored meals for those with
serious illness or disability who cannot
shop or cook for themselves
Medically-tailored food for those with acute or
chronic illness
Medically-tailored food for those at risk for acute or
chronic illness
Healthy food for those who are malnourished or food insecure
$
$$$$
Image from Food is Medicine Coalition
Food is Medicine
23. Federal Nutrition Programs: SNAP
• FIM intervention if enrollment occurs in, or is
facilitated by, health system
• Benefits redeemable for all foods (except some
prepared foods) at approved vendors
• Very strong evidence SNAP improves health
outcomes, reduces medication non-adherence, and
reduces health care expenditures
23
24. 24
Figure 2
Share of Medicaid Enrollees Enrolled in SNAP by Income,
Race/Ethnicity, and Health Status Prior to the Pandemic
NOTE: * Indicates statistically significant difference from the reference group (indicated with *) at the p<0.05 level.
SNAP is the Supplemental Nutrition Assistance Program. The US Census Bureau’s poverty threshold for a family with
two adults and one child was $20,212 in 2018. AIAN refers to American Indians and Alaska Natives. Persons of
Hispanic origin may be of any race but are categorized as Hispanic for this analysis; other groups are non-Hispanic.
SOURCE: KFF analysis of 2018 National Health Interview Survey Data.
25. Federal Nutrition Programs: WIC
• Already meets the definition of a FIM intervention
• Benefits are a specific package of healthy food items specific to age
• Strong evidence WIC improves dietary intake, birth outcomes,
immunization rates, child academic performance
25
26. Medically Tailored Meals
• As a FIM intervention, the referral comes from the health care setting
• Meals tailored to the medical needs of the individual patient that are
either picked up or delivered to the home, usually by a partnering
community-based organization
• Relatively strong evidence suggests these interventions can reduce
hospital admissions and readmissions, lower medical costs, and
improve medication adherence
• Suitable for populations with the highest burden of disability and
illness
26
27. Medically Tailored Meals
• Relatively high cost, but likely cost-effective for high-risk populations
• Challenge
• Easiest to demonstrate an ROI for these interventions over a short time
window
• We may not want all of our healthcare investment in FIM interventions to be
targeted toward this population
• Less opportunity for prevention (disease has already occurred)
• Over longer time periods, supporting dietary intake earlier in the course of disease (or,
even better, at the stage of prevention) will likely have the greatest ROI
27
28. Medically Tailored Groceries
• Raw ingredients that must be assembled into meals at home
• Sometimes operationalized by the same organizations as medically-
tailored meals as a way to ease off the program; more often
operationalized by food banks
• Lower cost service than medically tailored meals; targets a healthier
population that needs less support with meal preparation
• Very little health impact data
• No reason to think they function differently than other FIM interventions as
long as they reduce food insecurity and support dietary intake similarly
• Preliminary evidence suggests they do
28
29. Produce Prescriptions
• Cash value (on voucher or EBT card) redeemable for fruits and
vegetables at a farmers market or retail store
• When tightly linked to health care, these are FIM interventions
• State and local programs across the US, many funded by
USDA’s Gus Schumacher Nutrition Incentive Program (GusNIP)
• Lots of heterogeneity across programs
• Moderate evidence, but rapidly building
• Improved dietary intake
• Improved food security
• Modelling studies show substantial downstream impacts on health
outcomes and health care costs
• Suitable for populations with the lowest burden of disability
and illness
• Often targeted toward those with or at high risk of chronic disease, but
can be used for prevention in less targeted populations
29
30. On-Site Programs
• Onsite food distribution
• Food pantry permanently located at hospital or clinic, stocked and/or staffed
by Food Bank
• Mobile food distributions at hospital or clinic
• Take-home meals provided by hospital at discharge
• Eligibility workers for federal nutrition programs embedded in the
clinical setting
• Evidence for federal nutrition programs is strong
• Implementation science efforts needed to best understand how to best
deploy eligibility workers in clinical setting
30
31. Challenges Reduced Impact
• Often funded by short-term grants that someone has to keep re-
writing
• Access is often for a limited amount of time
• Referrals are still limited by fragmentation and inadequate funding of
the social safety net
• Priority populations often change
• Often implemented with the goal of demonstrating an ROI to the
health system
Barnidge EK, Stenmark SH, DeBor M, Seligman HK. The Right to Food: Building Upon
"Food Is Medicine". Am J Prev Med. 2020 Oct;59(4):611-614. 31
32. PARTTHREE
3:30 – 3:35 PM ET
32
BENEFIT DESIGN OPPORTUNITIES,
INCLUDINGTHEVBID MODEL
SPEAKER
Michael de la Guardia,
Pathways Graduate Student Intern,
Center for Medicare and Medicaid Innovation, CMS
33. MA Options
33
Category Options Available Under MA* Options Available UnderVBID
Benefit
Targeting
• Special Supplemental Benefits for the Chronically Ill (SSBCI): Allows MAOs to provide chronically ill enrollees (as
defined in § 422.102(f)(1)(i)(A) using three specific criteria) with both non-primarily and primarily health-related
supplemental benefits that have a reasonable expectation of improving or maintaining the health or overall condition of the
chronically ill enrollee.
While CMS may provide a list of chronic conditions, MA plans may consider other chronic conditions not identified
on this list if the chronic condition is life threatening or significantly limits the overall health or function of the
enrollee
Targeting by low-income subsidy (LIS) or dual status alone is NOT allowed but 422.102(f)(2)(iii) permits MA plans
to consider social determinants to help identify chronically ill enrollees whose health or overall function could
reasonably be expected to improve or maintained with the SSBCI. MA plans may not use social determinants
of health as the sole basis for determining eligibility.
• Uniformity Flexibility (UF): Allows MAOs to target enrollees for healthcare services that are medically related to the
patient’s health status or disease state (e.g., reduced cost sharing of eye exams for diabetics) if the benefit is offered
uniformly to all individuals with the same qualifying condition. Supplemental benefits must be primarily health related (§
422.100(d)(2)(ii))
• NOTE: Part D reductions in cost sharing are not permitted under SSBCI or UF
Allows MAOs to provide enrollees with LIS/dual
status or chronic condition(s) (or both) with:
• Non-primarily health related supplemental benefits
(allowed under SSBCI, but not UF)
• Reductions in cost sharing for Part D drugs
• New and existing technologies or FDA-approved
medical devices as a mandatory supplemental
benefit
RI Programs • Part C RI must reflect the cost/value of the health related activity and not the expected benefit
• Part D RI only for Real Time Benefit Tool (RTBT)
• RI limit that is tied to the value of the expected
impact on enrollee behavior or the expected
benefit, within an annual limit
• Part D RI outside of RTBT
Hospice • Available to MA enrollees through Original Medicare • MA plans participating in the Hospice Benefit
Component generally cover ALL of their Medicare
benefits, including hospice care. Can also offer
transitional concurrent care and hospice
supplemental benefits
*See 85 FR 33802 and 42 CFR 422.102(f)(1)(i)(B) for other requirements.
34. CurrentVBID Model Components and Health Equity
34
Model Intervention Example
Targeted Benefits by Condition,
SES, or both
• Plan offers healthy food card or medically tailored meals targeted to enrollees with LIS and hypertension (paired
with messaging around DASH diet) – alternatively, plan could offer this benefit to all enrollees with LIS
• Plan can also propose for CMS consideration and approval provision of a benefit that is not primarily health related
for a targeted population that does not meet the definition of “chronically ill enrollee” in 422.102(f)(1)(i)(A) but is
within the scope of the VBID Model limits for targeting enrollees. For example, the plan could propose targeting
enrolleesfacing food insecurity as diagnosed by their PCP or through a standard screening tool (e.g., AHC).
MA and Part D RI Programs • Plan could provide reward to incentivize utilizationof high-value services by a certified nutrition specialist (CNS) for
enrollees with LIS with pre-diabetes.
o This could be complemented with other VBID interventionslike reduced cost-sharing for CNS visits or Metformin
Targeted Coverage of New &
Existing Technologies or FDA
Approved Medical Devices
• Plan offers targeted coverage of blood pressuremonitors and cuffs to enrollees with hypertension
• Plan offers targeted coverage of continuous glucose monitors for defined special populations
35. 35
1) 2)
3)
VBID Use Case: Rosa and
Food Insecurity
• Rosa is a 70 year old Hispanic female
from Richmond, CA
• She has pre-diabetes and was recently
put on Metformin
• She receives low income subsidies (LIS),
struggles to afford healthy food for her
whole family
• There are few grocery stores nearby
serviced by public transportation and
Rosa does not own car
As part of your plan’s health equity program you may notice
many “Rosas” and that there are significant racial and ethnic
disparities in diabetes management and food insecurity.
In your VBID application, you could use estimated medical
savings from lower utilization and fewer ED visits1
Estimates require approval in application and will vary from plan to plan
to bid
lower on the benchmark rate and use the difference to pay
for healthy food card, reduction in Part D cost sharing for
Metformin, and/or many other social needs interventions
that are targeted based on LIS status.
Diabetes and Food Insecurity
• Existing literature and pilot studies show a strong association
between diabetes and food insecurity and improved dietary patterns
and glycemic control when food insecurity is addressed2
Gucciardi, Enza, et al. “The Intersection between Food
Insecurity and Diabetes: A Review.” Current Nutrition Reports, vol. 3, no. 4, 2014, pp. 324–32. PubMed Central, doi:10.1007/s13668-014-
0104-4.
• The CDC found that the annual per capita excess cost for non-
disability Medicaid enrollees with diabetes in the state of California
was $8,5303
https://www.cdc.gov/pcd/issues/2018/18_0148.htm
(other studies show similar increases in Medicare
population)
• By using a combination of interventions, including lifestyle
interventions like healthy foods, health plans can lower the chance
Rosa develops diabetes
Understanding and Addressing Rosa’s Food and Nutrition Needs
In the past, Non-VBID plans may have tried coordinating with community
organizations to prevent costs like those highlighted above, but direct
interventions (e.g., healthy food cards) were expensive because they must be
provided to all enrollees, not just the enrollees who couldn't afford healthy
meals.
Under VBID plans can now invest directly in interventions that address HRSNs
like food insecurity by using targeting eligibility based on LIS status.
Tailoring a Suite of Benefits for Rosa through VBID
VBID allows for a more cost effective approachto tailoring a suite of benefits to
your high cost and high need enrollees (e.g., enrollees with LIS and pre-diabetes).
Reduced Cost
Sharing for
Certified
Nutrition
Specialists
(CNS)
Delivery of
Medically
Tailored Meals
for Diabetes
Healthy Food
Card
Targeted
Coverage of
Continuous
Glucose
Monitors
Coverage of
Non-Medical
Transportation
to Grocery
Store / Farmers
Market
36. PART FOUR
3:35 – 4:00 PM ET
36
IMPLEMENTATION CHALLENGESAND SUCCESSES
SPEAKERS
Dr. Shantanu Agrawal, MD, M.phil
Chief Health Officer
Anthem
Dr.Andrew Renda
VP, Population Health Strategy
Humana
Leah Brucchieri
Director, Retail Product Development
Humana
37. PART FIVE
4:00 – 4:15 PM ET
37
FIRESIDE CHAT ON DATA AND EVALUATION STRATEGIES
SPEAKER
Abigale Sanft
VBID Model Co-Lead,
Center for Medicare and Medicaid Innovation, CMS
Dr. Seth Berkowitz
Assistant Professor of Medicine at the University of North
Carolina at Chapel Hill School of Medicine in the Division of
General Medicine & Clinical Epidemiology
40. Next Steps and Future Sessions on the Horizon
40
1
Participate in upcoming health equity Incubation sessions that will provide a deeper dive into how to
best leverage the Model to address Diabetes (in June 2022)
2 Provide feedback on future health equity TA that will be valuable to your organization
3
Schedule 1-on-1 with VBID Model Team via VBID@cms.hhs.gov in the next one to two weeks and
identify cross-functional members of your team that could benefit from understanding the realm of
targeted benefits allowed under the VBID Model (e.g., clinical team)
41. 41
Thank you for joining us today!
Please email us with questions or to discuss your interests at
VBID@cms.hhs.gov