House Passes Medicare Advantage Bill

On June 17th, the House of Representatives passed The Strengthening Medicare Advantage through Innovation and Transparency for Seniors Act of 2015 (H.R. 2570, available via The bipartisan legislation would establish a demonstration project allowing Medicare Advantage plans to use a principle called Value-Based Insurance Design (V-BID). The concept comes from University of Michigan research that aligns patients’ out-of-pocket costs, such as copayments, with the value of health care services.

If the bill becomes law, it would allow Medicare Advantage plans to lower copayments and coinsurance for beneficiaries, encouraging the use of high-value, evidence-based medical services to better manage chronic conditions. It prevents plans from increasing beneficiary cost sharing on any service. The legislation was originally introduced by U.S. Reps. Diane Black (R-TN), Earl Blumenauer (D-OR) and Cathy McMorris Rodgers (R-WA).

The bipartisan companion bill, the Value-Based Insurance Design Seniors Copayment Reduction Act of 2015 (S.1396), was introduced to the Senate on May 20th by U.S. Senators Debbie Stabenow (D-MI) and John Thune (R-SD). In addition to the Capitol Hill activity, V-BID was included in a recent Centers for Medicare and Medicaid Services (CMS) Request for Information to Innovate Medicare. To date, V-BID programs have been implemented by numerous private and public payers, employers, unions, and business coalitions nationwide. The accumulating evidence validates a central V-BID premise that reducing out-of-pocket costs for selected high-value medical services for certain patients can improve health outcomes, reduce disparities and potentially slow the growth of health care costs.

SeeChange Recognized for Innovation

Fast Company magazine named SeeChange health as one of the most innovative companies of 2013. The following is an excerpt from the magazine about SeeChange,

The simplest way to lower health care costs is also the hardest: encourage healthy behavior. That’s the premise behind the insurance policies of SeeChange Health, which serves small employers and offers customers many discounts–depending on how healthy any one person works to be. “We know that can save a lot of money,” says CEO Martin Watson. Before selling its own policies in 2010, it managed plans for larger insurers (which it still does). In one case, it incentivized 45% of diabetics to drop an average of 9 pounds, which led to a 19% drop in costs over two years. The company is now adding 2,200 members per month. In 2012, it says revenue increased sevenfold, to $54.2 million. That’s healthy growth.

Last Updated 06/23/2021

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