Medicare Advantage Carve-In for Hospice

Planning and Paying | January 29, 2019 | by

On January 18, 2019, the Centers for Medicare and Medicare Services (CMS) announced an array of Medicare Advantage (MA) health plan innovations that will be tested in the Value-Based Insurance Design (VBID) model for calendar year (CY) 2020. Of particular interest, this includes a hospice carve-in set to take effect in CY 2021. Hospice care is currently not allowed as a benefit covered in MA plans.

In 2020, eligible MA health plans in all 50 states and territories may apply for the health plan innovations being tested under the VBID model, which is an expansion from the existing 25 states as required under The Bipartisan Budget Act of 2018. Beginning in CY 2021, the VBID model will also test including the Medicare hospice benefit in MA. CMS will release additional information and guidance on this intervention for interested stakeholders in the coming months through the VBID model website, and through open-door forum type events.

LeadingAge believes there is opportunity for good partnerships under the proposal. We are pleased to see the carve-in will be evaluated for the impact on cost and quality of the approach before making it mandatory in all MA plans. LeadingAge is closely following this issue for our hospice members and will share more information as available.