As part of the CMS VBID program, Medicare Advantage Organizations (MAOs) had the opportunity to waive pharmacy copays for low-income (LI) beneficiaries. This whitepaper explores the impact this benefit had on part D quality measures, namely medication adherence to diabetes, hypertension, and hyperlipidemia drug routines. Our analysis found that removing copays on maintenance medications improved beneficiary adherence which is subsequently tied to improved quality of care and health outcomes. Though it has since been announced that the VBID model will be sunsetting come calendar year 2026, lessons learned from the program and impacts of the implemented benefits will inform future priority interventions. Eliminating copay barriers for LI members should remain a key focus for reasons outlined in this paper.
