Hospices are seeing the potential for caregiver support improvement in the first year of the Guiding an Improved Dementia Experience (GUIDE) payment demonstration. Intended to improve care management, caregiver education and respite access for dementia patients and their families, the GUIDE model could have significant impacts, according to Dr. Marny Fetzer, chief medical officer at […]
A forthcoming alternative payment model for hospitals focuses on discharge planning and ensuring effective post-acute care, including hospice and palliative care when appropriate. The U.S. Centers for Medicare & Medicaid Services (CMS) late last year unveiled its new Transforming Episode Accountability Model (TEAM). Participation in the model will be mandatory for select hospitals. The program […]
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 […]
Growth in the number of Medicare Advantage beneficiaries will likely overtake that for traditional Medicare in 2025, according to new estimates from the U.S. Centers for Medicare & Medicaid Services (CMS). The agency projects that total MA enrollment will reach 35.7 million people following the open enrollment period slated to begin later this month, representing […]
The post-Medicare Advantage hospice carve-in landscape could include wider value-based reimbursement avenues in the hospice space, leading providers to pivot into MA payer relationships. The forthcoming end of the hospice component of the value-based insurance design (VBID) demonstrative takes effect Dec. 31. Launched in 2021, the carve-in was designed to test coverage of hospice care […]
The nonprofit senior care provider Empath Health is partnering with the Medicare Advantage organization American Health Plans (AHP), a division of American Health Partners, to serve patients who are enrolled in Institutional Special Needs Plans (ISNP). ISNPs are Medicare Advantage plans that are designed to serve beneficiaries who live in skilled nursing facilities. Through 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 […]
Collaborations with participants in the Centers for Medicare & Medicaid Innovation’s (CMMI) Accountable Care Organization (ACO) Primary Care Flex demo could allow hospices to leverage their skill sets to access more patients. Hospices and palliative care providers can come to ACOs by two main avenues. They can become members of those organizations themselves, or they […]
Data are key to understanding how value-based care has helped highlight quality benefits of hospice. The U.S. Centers for Medicare & Medicaid Services (CMS) is sunsetting the hospice component of the value-based insurance design (VBID) as of Dec. 31. Commonly called the hospice carve-in, the program in 2021 began testing the coverage of hospice through […]
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