CMS to End Hospice Carve-in for VBID Demonstration

The Centers for Medicare and Medicaid Services (CMS) will end the Hospice Benefit Component of the Value-based Insurance Design (VBID) Model at the end of the year.

The hospice carve-in was designed to test coverage of hospice, palliative and transitional care coverage through the Medicare Advantage program. According to Hospice News, 13 Medicare Advantage Organizations (MAOs) are participating through 78 health plans in 19 states, representing a drop in interest from 15 MAOs with 119 plans in 23 states the year prior.

CMS did not provide any explanation for why the program would sunset early, although the rest of the VBID demonstration will continue until 2030. The agency promised to issue additional guidance to ensure that any impacted organization would be addressed in order for hospice beneficiaries to “maintain a coordinated, seamless care experience.”

A recent study by the Population Aging Research Center at the University of Pennsylvania looked at the impact MA plans were having on hospice care. It found that MA enrollees were 11% less likely to die at hospitals and increased hospice use overall at time of death by 6.2% and 7.7% in the last 30 days of life. But use of intensive care rose, and there was no difference in hospitalization rates for traditional Medicare and MA enrollees during the last 30 days of life.