CMS Extends Medicare Care Choices Test for Hospices

The U.S. Centers for Medicare and Medicaid Services (CMS) is extending the Medicare Care Choices Model by one year. The program is now expected to remain in effect until Dec. 31, 2021, meaning that providers can enroll eligible beneficiaries through June 30, 2021 and provide supportive services through the program’s scheduled end date.

Through the test of its Medicare Care Choices Model, which the agency launched in 2016, CMS has explored the idea of allowing hospice patients to receive concurrent care. The model allows participating hospices to provide services that are currently available under the Medicare hospice benefit, but cannot be separately billed under Medicare Parts A, B, and D, while enrollees are also pursuing curative treatments.

Stakeholders in the hospice space applauded the decision, including industry groups such as the National Hospice & Palliative Care Association (NHPCO) and the National Association for Home Care & Hospice (NAHC).

“NHPCO encourages flexibility and innovation in the delivery of hospice care, and we welcome the one-year extension of the Medicare Care Choices Model. We urge CMS to build upon this successful demonstration in future years by offering even greater choice to patients suffering from serious illness, many of whom are in need of interdisciplinary, person-centered care prior to qualifying for the hospice benefit,” said NHPCO President and CEO Edo Banach. “We look forward to our continued collaboration with CMMI and Congress in implementing policies that have been proven to work.” 

CMS pays participants a fee ranging from $200 to $400 per patient, per month while they are delivering services under the model, including care coordination, case management, symptom management, and other support for beneficiaries and families.

CMS is assessing whether concurrent care can improve the quality of life and care of hospice patients covered by Medicare, boost patient satisfaction, and cut the agency’s costs. Federal law allows the Center for Medicare and Medicaid Innovation (CMMI) to test innovative payment and service delivery models that have the potential to reduce Medicare, Medicaid or Children’s Health Insurance Program (CHIP) expenditures, while maintaining or improving the quality of care for Medicare beneficiaries.

The program was initially set to include 30 providers, but CMS expanded the program to allow for 140 participants due to widespread interest. According to the agency, 82 hospices are participating in the demonstration as of June 2020.

“While the [Medicare Care Choices] model has some shortcomings — including issues surrounding the level of payment and some of its eligibility requirements — patients and providers that have participated in it have generally reported high satisfaction rates, and the model does appear to show some promise, including that it appears to be drawing a younger cohort of patients into hospice care and those that enter hospice are on service longer than the usual median length of stay (which is 18 days),” said Theresa Forster, NAHC’s vice president of hospice policy. “So the model does show some promise and could serve, at least in part, as the foundation for a set of services that could help prepare seriously ill patients in advance of their entering hospice care.”