Hospice advocates are calling for a delay to the Centers for Medicare and Medicaid Services’ (CMS) Medicare Advantage (MA) carve-in demonstration set to begin in Jan. 2021.
Earlier this year, the agency announced it would start testing hospice care coverage through MA plans in 2021 with the intention of increasing care coordination and access to services. However, critics expressed concerns about reduced payments, changes to coverage and most of all, the time frame.
The National Hospice and Palliative Care Association (NHPCO) sent a request to CMS to delay the start of the Value-Based Insurance Design (VBID) model by at least one year out of concern hospices and plans will not have enough time to evaluate if the model will increase access to quality care.
For Arizona, hospice is a big market, with 66.4 percent of Medicare beneficiaries in 2019 age 65 and older enrolled in hospice during the last six months of life.
Hospice advocates have doubts about hospices operationalizing the model in time, emphasizing that building provider networks and working out contracts is time consuming, and more so for smaller providers administering care in underserved and rural areas.
The NHPCO letter read, in part:
While we support innovation that enhances access to care for the seriously ill and their families, we are concerned about the effect this model will have on beneficiary access to high-quality hospice care because of CMS’ delay in providing policy and operational details that are necessary for successful implementation.
Other organizations have also voiced concerns.
The National Association for Home Care & Hospice stated its opposition to the model earlier in the year, telling Hospice News that it’s possibly a solution searching for a problem. William Dombi, president of the organization, said:
We think the Medicare hospice benefit has proven itself to be an incredibly well-run, well-designed program that will not benefit from being integrated into Medicare Advantage.
On the insurance side, Humana Chief Medical Officer William Shrank, M.D., expressed his support for the agency’s approach, telling Home Health Care News “if you can carve in hospice, you can have more seamless transitions.”
According to Hospice News, CMS indicated it would release a request for application for MA plans to offer the Medicare Hospice Benefit to their enrollees in the near future, but the agency did not provide a time frame.
For more on Arizona’s hospice care statistics, check out America’s Health Rankings.
Take a look at Hospice News for more on what hospice advocated have to say.
And also refer to Inside Health Policy.
Check out this Hertel Report post for background.