The U.S. Centers for Medicare & Medicaid Services (CMS) plans to increase payments to Medicare Advantage plans for 4.3% in 2026, but implementation will depend on what happens with the new presidential administration. CMS has issued an advance notice of policy changes for Medicare Advantage and Part D that would install technical updates, including to […]
Hospice providers can collaborate with institutional special needs Medicare Advantage plans (ISNP) to reach patients who reside in long-term care facilities. ISNPs restrict enrollment to MA eligible individuals who, for 90 days or longer, have had or are expected to need the level of services provided in a long-term care (LTC), skilled nursing facility, a […]
Careful management of the hospice aggregate cap is key to providers’ sustainability as regulatory scrutiny continues to heat up. The cap is designed to prevent overuse of hospice, put controls on Medicare spending and foster greater access to care among patients. For Fiscal Year 2024, the U.S. Centers for Medicare & Medicaid Services set the […]
Though the Medicare Advantage hospice carve-in is going away at the end of this year, those operators still have a role to play in value-based care. The carve-in, formally known as the hospice component of the value-based insurance design model (VBID), will expire on Dec. 31. The program was designed to test hospice coverage through […]
Calls are growing louder for Congress to build stronger reimbursement and workforce incentives aimed at improving the availability and sustainability of rural-based end-of-life care. Rural-based hospice providers face a range of challenges to improve access among their underserved patient populations. Current reimbursement structures within the federally established Medicare Hospice Benefit do not sufficiently support the […]
The Medicare Payment Advisory Commission (MedPAC) has recommended to Congress a freeze on hospice payment increases starting in 2025. In its annual report to Congress, MedPAC urged policymakers to eliminate hospice base-rate increases for 2025. “Based on the positive indicators of payment adequacy and strong margins, the Commission concludes that current payment rates are sufficient […]
In case you missed it, Hospice News has launched a new specialty publication for palliative care professionals. You can subscribe to Palliative Care News here: Subscribe today! The Medicare Advantage hospice carve-in will be carved back out by the end of this year. Many operators were glad to see it go, but the questions the […]
The U.S. Centers for Medicare & Medicaid Services will end the hospice component of the value-based insurance design model (VBID) as of Dec. 31. Often called the “hospice carve-in,” the program was designed to test coverage of hospice care through Medicare Advantage, in addition to some coverage of palliative care and transitional care. The hospice […]
Without family caregivers, most hospice and palliative care patients would be unable to receive care in the home. Now, some emerging payment models are including caregiver support as a key component. Case in point is the Guiding an Improved Dementia Experience (GUIDE) model, which the U.S. Centers for Medicare & Medicaid Services (CMS) unveiled in […]
The Medicare Payment Advisory Commission (MedPAC) has voted to recommend a freeze on hospice payment increases starting in 2025. However, the commission pulled back on prior calls for cuts to the aggregate payment cap. While MedPAC cannot implement policy or payment rate changes, it does make annual recommendations to Congress and the U.S. Centers for […]
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