The ISNP Opportunity for Hospice Providers

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 […]

MA Enrollment to Outstrip Traditional Medicare in 2025

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 […]

Hospice’s Post-VBID Value-Based Outlook

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 […]

Empath Health, American Health Plans Launch ISNP Joint Venture

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 […]

Understanding the ACO Opportunity For Hospices

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 […]

How ACO Flex Could Make Hospice ‘Top of Mind’ with Primary Care Providers

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 […]

Hospice’s Outlook in Value-Based Care

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 […]

New ACO Primary Flex Model Could Increase Hospice, Palliative Care Access

The Centers for Medicare & Medicaid Innovation (CMMI) has unveiled a new primary care-oriented Accountable Care Organization (ACO) payment model that holds opportunities for hospices.  This demonstration reflects a push by the U.S. Centers for Medicare & Medicaid Services (CMS) to reduce fragmentation in the health care system by strengthening primary care as a hub […]

Hospices Welcome VBID’s Demise, But Questions Remain

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 […]

CMS to Sunset Hospice VBID in 2024

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 […]