The U.S. Centers for Medicare & Medicaid Services (CMS) has been working health equity components into new alternative payment models. Much movement has taken place in the payment and policy realms towards closing disparities among underserved populations, according to Hope Glassberg, senior policy advisor at the Coalition to Transform Advanced Care (C-TAC) and president of […]
Health plan participation in the hospice component of the value-based insurance design model (VBID) will fall in 2024. For calendar year 2024, 13 Medicare Advantage Organizations (MAOs) will participate in the program’s hospice component, providing coverage through 78 health plans in 19 states. In 2023, 15 MAOs participated in hospice VBID, including 119 health plans […]
For the time being, Medicare Advantage may be providers’ best bet for palliative care reimbursement. The U.S. Centers for Medicare & Medicaid Services (CMS) also allows Medicare Advantage plans to cover palliative care as a supplemental benefit. In addition, the agency has integrated palliative care components into the Value-Based Insurance Design Model (VBID), often called […]
Three principles are guiding the U.S. Centers for Medicare & Medicaid Services’ (CMS) 2024 updates to the Accountable Care Organization Realizing Equity, Access and Community Health (ACO REACH) model: care coordination, managing health equity-related risks and social determinants of health. Among a number of new requirements, the agency will also require participating organizations to develop […]
Evolving network adequacy requirements within the value-based insurance design (VBID) model demonstration have some hospices concerned that Medicare Advantage payers may have narrowed views on reimbursement and access. This year the U.S. Centers for Medicare & Medicaid Services (CMS) introduced changes to the VBID model that included modifications to network adequacy requirements for Medicare Advantage […]
Medicare Advantage plans are connecting the dots between quality scores and care delivery costs. When choosing a hospice to work with, payers in the Medicare Advantage (MA) realm zero in on providers’ quality scores and its patient population growth potential, according to Frontpoint Healthcare CEO Brent Korte. Consequently, those are key data pieces for hospices […]
The U.S. Centers for Medicare & Medicaid Services (CMS) is making significant changes in 2024 to the Accountable Care Organization Realizing Equity, Access and Community Health (ACO REACH) payment model. The updates include the introduction of a new approach to payment designed to enhance care delivery and care coordination for patients in underserved communities, according […]
The U.S. Centers for Medicare & Medicaid Services (CMS) is giving hospices a 3.1% increase to their per diem payments for 2024, according to a final rule published Friday. That will translate to a $780 million bump to hospice payments next year compared to Fiscal Year 2023, according to CMS. The finalized rule also raises […]
More cancer patients have been receiving palliative care since the Affordable Care Act expanded Medicaid. About 18.9% of eligible patients received palliative care in states that expanded Medicaid, up from 17% before the ACA provisions took effect on Jan. 1, 2014, according to American Cancer Society research recently published in Health Affairs. Among non-expansion states, […]
Patient data collection is critical in how the U.S. Centers for Medicare & Medicaid Services (CMS) is developing health equity quality measures for hospices in value-based payment. The Center for Medicare & Medicaid Innovation (CMMI) in 2022 announced a “strategy refresh” that included a renewed focus on health care equity in payment model design. Among […]
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