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The Centers for Medicare & Medicaid Services (CMS) Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model will be extended for calendar years 2025 through 2030 with five major changes. Three changes are related to the provision of targeted supplemental benefits to address members’ health-related social needs. Two more changes affect the Hospice Benefit Component that allows the MA plans to cover hospice services.

Three new policies affect the provision of targeted supplemental benefits to address beneficiary need for health-related social needs, as follows:

Medicare Advantage organizations (MAOs) will be required to offer supplemental benefits to address health . . .

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Social Services

The social service market is defined as supports and services related to the social determinants of health such as poverty, food insecurity, lack of education, racism, discrimination, environment, and community conditions. Addressing social determinants of health has become a common strategic conversation in a market focused on whole person care and the value equation. Payers and health plans are taking a more structured approach to addressing social support needs and this opens new possibilities for managers of organizations that provide social support programs that have typically been excluded from health care financing arrangements.

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