The Hospice Medicare Advantage Carve-In Moves Forward

CMS has released a fact sheet about VBID which, among many changes, includes the Medicare Advantage Carve-In Demonstration for hospice. From CMS:

CY 2021 VBID Request for Applications

CMS is releasing the CY 2021 Model RFAs in two parts. First, CMS is releasing an RFA specific for the hospice benefit component. Second, CMS will release an updated RFA that outlines how eligible MA plans may include: (i) Value-Based Insurance Design by Condition, Socioeconomic Status, or both; (ii) MA and Part D Rewards and Incentives; and (iii) Wellness and Health Care Planning. To the extent CMS includes any additional components in the VBID Model for CY 2021, those will be outlined as well. CMS is releasing the first RFA – the Medicare hospice benefit component – today and intends to release the second CY 2021 RFA in January 2020. CMS has streamlined the application process, including the required supporting financial analysis, and MA organizations will have until March 2020 to apply for participation in the Model and indicate the one or more Model components it requests to include in its plan benefit design for CY 2021, including Wellness and Health Care Planning. Working with CMS, MA organizations will have until the MA bid submission deadline (June 1, 2020) to finalize their plan benefit designs for the VBID Model.

VBID Model – Hospice Benefit Component Request for Applications

The Centers for Medicare & Medicaid Services announced in January 2019 that beginning in CY 2021, through the VBID Model, participating MA organizations could include the Medicare hospice benefit in their Part A benefits package. CMS chose to announce this component of the VBID Model almost two years in advance of it beginning to allow CMS to work with MA organizations, palliative and hospice care providers, beneficiary advocate groups, and other stakeholders on how to ensure quality and safety for those beneficiaries enrolled in a VBID-participating MA plan who elect the Medicare hospice benefit. CMS received broad engagement and perspectives from MA organizations, palliative and hospice care providers, and others over the past year on improving access to high-quality palliative and hospice care.

For more information, see the fact sheet from CMS.

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