Patients Praise Medicare Advantage as Hospice Carve-In Takes Effect

Beneficiaries participating in Medicare Advantage give high ratings to the coverage and services they receive, with as many as 98% reporting satisfaction, according to a recent Better Medicare Alliance poll. This feedback comes shortly after the Jan. 1 inception of the value-based insurance design demonstration, often called the Medicare Advantage hospice carve-in.

Payers and hospice providers now have the option to participate in the demonstration, which according to the U.S. Centers for Medicare & Medicaid Services (CMS) is intended to increase access to hospice services and facilitate better coordination between patients’ hospice providers and their other clinicians.

“In a global health care emergency that has laid bare deep, persisting challenges in health care, we saw beneficiaries’ satisfaction with Medicare Advantage reach new heights,” said Allyson Y. Schwartz, president and CEO of the Better Medicare Alliance. “The results of this poll depict a rapidly growing beneficiary population that is highly pleased with their health coverage and ready to take action to ensure it is protected.”

The poll found that 98% of respondents are satisfied with their Medicare Advantage coverage, up from increase from 94% in the fall of 2019; 97% of beneficiaries indicated that they are satisfied with their network of doctors, hospitals, and specialists, and 98% said they were satisfied with their health plan’s response to COVID-19.

Through Medicare Advantage, CMS contracts with private insurance companies to provide coverage for Medicare beneficiaries. CMS in early 2019 year announced that it would test coverage of hospice care through Medicare Advantage plans beginning in 2021.

Through the demonstration CMS will evaluate the inclusion of hospice in VBID using several metrics, including rates of patient length of stay that are less than seven days as well as those that exceed 180 days. The agency will also measure documentation of patients’ goals of care, performance on pain control, family satisfaction and the number of days that patients were in their homes during their final six months of life.

The carve-in will be a small program in its first year. The 53 participating Medicare Advantage plans cover 8% of the market and a limited geographic footprint, according to CMS. Support for the program is not universal. The National Hospice & Palliative Care Organization has called on CMS to delay the program’s implementation to give providers more time to prepare in light of the COVID-19 pandemic, and the National Home Care & Hospice Association has opposed the carve-in altogether.

A high majority of the respondents to the alliance’s survey 95% of survey respondents indicated that they agreed that seniors should have coverage options aside from traditional Medicare, and 93% reported that a candidate’s support for Medicare Advantage is important to their vote.

“The results of this poll depict a rapidly growing beneficiary population that is highly pleased with their health coverage and ready to take action to ensure it is protected.” Schwartz said. “With these numbers in hand, Better Medicare Alliance and our grassroots beneficiary advocates will work to ensure lawmakers know that standing up for Medicare Advantage is good politics and good policy.”