Three main factors drove the U.S. Centers for Medicare & Medicaid Services’ (CMS) decision to extend the value-based insurance design (VBID) model through 2030: patients’ social needs, health equity and improved care coordination. Originally set to run between 2021 and 2024, CMS indicated yesterday that it would invest five additional years in the demonstration. This […]
The U.S. Centers for Medicare & Medicaid Services (CMS) is extending the value-based insurance design demonstration for calendar years 2025 to 2030, including the hospice component. The hospice component of VBID, also called the MA carve-in, launched in 2021 and was originally slated to complete after four years. Each year, elements of the program have […]
As the health care ecosystem changes, hospices will have to evolve. Going forward, this will likely include more engagement with managed care organizations. Though hospices operate within the dedicated Medicare benefit, market forces in the system at large wield considerable influence on how they operate — including the meteoric rise of managed care. This is […]
As the Center for Medicare & Medicaid Innovation (CMMI) advances new payment models and care delivery systems, it should place more emphasis on Medicare Advantage, according to SCAN Group CEO Dr. Sachin Jain. The sheer number of beneficiaries enrolled in MA warrants a ramped-up approach to innovation within the program, Jain said. More than 28 […]
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 […]
When stakeholders consider ways to improve Medicare Advantage, they should take care not to romanticize fee-for-service Medicare in the process, SCAN Health Plan CEO Dr. Sachin Jain cautions. Medicare Advantage (MA) is a growing force in health care. More MA plans emerge each year and the size of their beneficiary populations continues to grow. While […]
The U.S. Department of Health & Human Services has set its sights on the long-term expansion of value-based reimbursement, as well as advancing health equity. Going forward, this could mean greater collaboration with private-sector payers and providers. Also on the table is the question of how to meet the needs of Medicare beneficiaries who increasingly […]
New York-based Calvary Hospital has founded a high-needs population Accountable Care Organization branded as NavigatorACO. Calvary is the only acute-care hospital in the United States that focuses almost exclusively on hospice and palliative care. NavigatorACO is designed to participate in the forthcoming Realizing Equity, Access and Community Health (ACO REACH) program. Effective Jan. 1, 2023, […]
The Accountable Care Organization Realizing Equity, Access and Community Health (ACO REACH) payment model will launch on Jan. 1, 2023, and hospices that collaborate with participating ACOs could realize some unique benefits. The Center for Medicare & Medicaid Innovation announced the program in February to replace the Global and Professional Direct Contracting (GPDC) models. The […]
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 […]
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