Humana CMO: Lack of Medicare Advantage Coverage a Barrier to Hospice

Patients covered by Medicare Advantage plans who are faced with the decision of whether to elect hospice may be discouraged by the need to transition off their health plan for most of their care. This practice that has the potential to change through the forthcoming value-based insurance design model demonstration, often called the Medicare Advantage […]

Hospices Leverage Palliative Services in VBID Arena

Hospice providers are increasingly expanding palliative services as a bridge to end-of-life care and engage patients further upstream. With the forthcoming value-based insurance design (VBID) demonstration, hospices that have robust palliative care business lines will have a leg up on competitors in demonstrating their value to participating insurance plans. Many hospice providers see palliative care […]

Humana the Most Prominent Payer in the Medicare Advantage Hospice Carve-In

Among the nine insurance companies that will participate in the Medicare Advantage carve-in during the program’s first year in 2021, Humana, Inc. (NYSE: HUM) operates the most plans that will offer hospice.  The carve-in, formally known as the hospice component of the value-based insurance design (VBID) model, is designed to assess payer and provider performance […]

Medicare Advantage Hospice Carve-In Starting Small in 2021 

The demonstration project to test inclusion of hospice in the value-based insurance design model — often called the Medicare Advantage hospice carve-in — will be a small program in its first year. The 53 participating Medicare Advantage plans cover 8% the market and a limited geographic footprint, according to data from the U.S. Centers for […]

Humana to Build Up In-Home Services, Focus on Social Determinants

Expanding health care services in the home setting will be a key priority during 2020 for Louisville, Ky.-based Humana (NYSE: HUM), as will an intensified focus on social determinants of health. A Humana spokesperson told Hospice News that hospice services would be a part of this effort. “The next phase beginning in 2020 is to […]

Humana Agrees to Purchase Hospice Pharmacy Provider Enclara

Insurance giant Humana (NYSE: HUM) has entered into a definitive agreement to acquire Philadelphia-based hospice pharmaceutical provider and benefit manager Enclara Healthcare, for an undisclosed amount. The transaction includes the privately held pharmacy company’s subsidiaries Enclara Pharmacia, GuidantRx and Avanti Health Care Services and is expected to close during the first six months of the […]

Hospices Gain from Value-Based Advanced Care Plan Initiatives

As more of the U.S. health care system migrates towards value-based care, efforts on the part of payers and other stakeholders to promote advance care planning could lead to increased hospice utilization as well as earlier admission of prospective patients. Advance care planning is designed to identify patients’ wishes, goals, and desires for their care […]

Humana CMO: Medicare Advantage Hospice Carve-In to Foster Seamless Care Transitions

A forthcoming hospice carve-in for Medicare Advantage plans will help provide seamless transitions to hospice from other care settings such as home health care or hospitals, according to Humana’s (NYSE: HUM) recently appointed Chief Medical Officer William Shrank, M.D. The U.S. Centers for Medicare & Medicaid Services (CMS) will begin testing the hospice carve-in in […]

Hospice Providers Move Towards Addressing Social Determinants of Health

Marshaling community resources to address social determinants of health among patients and their families is the next step in the evolution of hospice care, Bill Frist, M.D., co-founder of Frist-Cressey Ventures, told Hospice News at Feb. 19 assembly of health care investors in Chicago. Social determinants of health include patient and family demographics, access to […]