Over the past decade, payment reform, such as Alternative Payment Models (APMs) and value-based insurance design (VBID), have been explored as tools to improve the US health care system. APMs and VBID incentivize the quality — as opposed to volume — of care that patients receive.

In the July Issue, Sabrina Wang and coauthors examine existing research on APMs and VBID to explore whether payment reform can improve the quality and value of care diabetes patients receive.

Wang and coauthors find that "higher-risk APMs yielded greater improvements in diabetes process measures than lower-risk APMs, and that VBID models appeared to improve medication adherence."

The authors see these findings representing improvements in redesigning a payment system to better support diabetics.

The authors recommend that policymakers increase APMs and VBID for the Medicaid population, standardize diabetes quality measures across APMs, and consider integrating APMs and VBID under a single payment model.

Today in Health Affairs Forefront, Sarah Barth and Michael Monson discuss how CMS’s final rule for Contract Year 2023 Medicare Advantage and Part D programs strengthened regulatory provisions to enhance dually eligible individuals’ experiences with Dual Eligible Special Needs Plans.

However, many states will need increased capacity and support to take advantage of the new tools available to them.

This article is the latest in the Health Affairs Forefront major series, Medicare and Medicaid Integration. The series features analysis, proposals, and commentary that will inform policies on the state and federal levels to advance integrated care for those dually eligible for Medicare and Medicaid.

The series is produced with the support of Arnold Ventures. The series will run through August 30, 2022; submissions are accepted on a rolling basis.