The hospice component of the value-based insurance design (VBID) model will begin its third year on Jan. 1, 2023, meaning that some of the program’s rules will change. Often called the MA hospice carve-in, the voluntary demonstration is designed to assess payer and provider performance related to hospice within Medicare Advantage (MA). The U.S. Centers […]
SCAN Health Plan is among the Medicare Advantage (MA) payers entering the hospice component of the value-based insurance design (VBID) payment demonstration in 2023. The four-year program — often called the Medicare Advantage hospice carve-in — launched Jan. 1, 2021, with 53 participating health plans. This number grew to 115 in 2022. Next year, 119 […]
Hospices and Accountable Care Organizations have the ability to customize payment contracts within the Realizing Equity, Access and Community Health (ACO REACH) program. Effective Jan. 1, 2023, the U.S. Centers for Medicare & Medicaid Services (CMS) is replacing the Global and Professional Direct Contracting (GPDC) model with ACO REACH. The agency says the new program […]
Only 10 new Medicare Advantage (MA) plans will offer home-based palliative care as a primarily health-related benefit for 2023, but payers may be offering those services through other programs. Among Medicare Advantage supplemental benefits, in-home support services and caregiver support saw the most year-over-year growth for 2023. The number of plans offering home-based palliative care […]
The Center for Medicare & Medicaid Innovation (CMMI) is developing new reimbursement pathways for palliative care. As part of that process, CMMI is applying elements of its Medicare Care Choices Model (MCCM) demonstration, which ended Dec. 31, 2021, according to a new CMMI white paper. MCCM was designed to test the impact of concurrent hospice […]
Medicare reimbursement is the lifeblood of hospice providers, and a clear understanding of policies like budget neutrality can help elucidate the payment systems that keep their businesses running. The U.S. Centers for Medicare & Medicaid Services (CMS) is required by the Affordable Care Act to ensure that reimbursement rate changes are budget neutral. An earlier […]
A U.S. court of appeals in California has upheld Medicare sequestration, ruling against hospice providers who sought an to end the practice. Delaware-headquartered Silverado Hospice and ProCare Hospice in Nevada filed the suit earlier this year against U.S. Health and Human Services Secretary Xavier Becerra, alleging that sequestration violated federal rules, including the Budget Control […]
Margin pressures from the proposed cuts to Medicare home health rates could impact palliative care and hospice. The U.S. Centers for Medicare & Medicaid Services (CMS) in June released its proposed home health reimbursement rule for 2023, which included a 4.2% reduction in aggregate payments totaling an estimated $810 million. The agency cited budget neutrality […]
More than a dozen hospice advocacy groups have called on congressional leadership to intervene in a proposed 2.7% bump in Medicare payments, which they say is insufficient in light of COVID-19 and staffing headwinds. The organizations signed a letter to party leaders in both chambers of Congress. Signatories included the National Hospice & Palliative Care […]
As hospices explore greater participation in alternative payment models, the Medicare Payment Advisory Commission (MedPAC) is urging Congress to reduce and restructure those programs. Hospice providers have been eying APMs emerging from the Center for Medicare & Medicaid Innovation (CMMI). These models represent an entry point to value-based reimbursement, as well as a means to […]
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