Pennsylvania is one of seven states that will participate in a new value-based purchasing demonstration program for Medicare Advantage plans.
According to a fact sheet published by the Centers for Medicare & Medicaid Services (CMS),

Value-Based Insurance Design (VBID) generally refers to health insurers’ efforts to structure enrollee cost sharing and other health plan design elements to encourage enrollees to use high-value clinical services – those that have the greatest potential to positively impact enrollee health. VBID approaches are increasingly used in the commercial market, and evidence suggests that the inclusion of clinically-nuanced VBID elements in health insurance benefit design may be an effective tool to improve the quality of care while reducing its cost for Medicare Advantage enrollees with chronic diseases. As part of the “better care, smarter spending, healthier people” approach to improving health care delivery, CMS will test VBID in Medicare Advantage and measure whether structuring patient cost sharing and other health plan design elements does encourage enrollees to use  health care services in a way that reduces costs.

According to CMS,

The MA-VBID model supports high-value clinical services, improved health outcomes, and health care cost savings or cost neutrality through the use of structured patient cost sharing and other health plan design elements that encourage enrollees to use high-value clinical services. The MA-VBID model will provide flexibility for Medicare Advantage plans accepted into the model to develop clinically-nuanced benefit designs for enrollee populations that fall within certain clinical categories.

The clinical conditions on which the program will focus are diabetes, chronic obstructive pulmonary disease, congestive heart failure, patients who have suffered strokes, hypertension, coronary artery disease, and mood disorders.
The program, to be launched in January of 2017, will run for five years in seven states: in addition to Pennsylvania, Medicare Advantage plans in Arizona, Indiana, Iowa, Massachusetts, Oregon, and Tennessee will be invited to participate.
To learn more about Medicare’s new Value-Based Insurance Design programs, see this CMS news release and fact sheet.