Introduction to the CY 2021 Hospice Component
Introduction to the CY 2021 Hospice Component
VBID Model Information Session
Centers for Medicare & Medicaid Services (CMS) Innovation Center
Presenters
Gary Bacher Chief Strategy Officer CMS Innovation Center
? Mark Atalla,VBID Model Lead ? Sibel Ozcelik,VBID Model - Hospice Lead ? Julia Driessen, HHS/ASPE Affiliate
2
Agenda
? Introducing the CY 2021 Hospice Component in the VBID Model ? Perspectives ? Policy Goals,Vision and Guiding Principles
? Current State ? Medicare Advantage (MA) ? The Medicare Hospice Benefit ? How MA Enrollees Access Hospice Today
? Next Steps & Q&A
3
Perspectives
"The carve-out of hospice from MA fragments financial responsibility and accountability for care for MA enrollees who elect hospice. Including hospice in the MA benefits package...would promote integrated, coordinated care, consistent with the goals of the MA program."
- MedPAC 2014 Report to Congress (reiterated in 2017)
"...By giving plans greater flexibility in their targeting and delivery of services, eliminating the MA hospice carve-out could reduce the difficult and arbitrary distinctions that Medicare hospice eligibility criteria force clinicians, patients, and families to make about having an expected prognosis of 6 months or less and about forgoing potentially life-prolonging therapies."
- D. Stevenson & H. Huskamp, JAMA 2014
"A policy change to include hospice care in the MA benefits package (colloquially referred to as a carve-in), however, is fraught with complexity, disquieting to many hospice providers and health plans, and susceptible to misunderstanding. Consequently, any policy to carve hospice into Medicare Advantage requires a deliberative approach and must be designed in a way that is unequivocally seen as a "win" for Medicare beneficiaries."
- J. Driessen and T.West, Health Affairs, 2018
4
How MA Enrollees Access Hospice Today
Coverage for MA-PD enrollees who elect hospice
Before hospice enrollment MA-PD enrollee elects hospice
MA?PD enrollee disenrolls from hospice
FFS Medicare covers
? Hospice ? Part A and Part B services
unrelated to terminal condition ? Until the end of the month, all Part A and Part B services
Source: MedPAC Report to Congress 2014
MA-PD covers
? All Part A, Part B, and Part D services, and any supplemental benefits
? Part D drugs unrelated to terminal condition ? Any supplemental benefits (e.g., reduced cost
sharing)
? All Part D drugs ? Any supplemental benefits (e.g., reduced cost
sharing) ? Beginning the next month after disenrollment, Part A
and Part B services
5
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- medicare benefit policy manual cms
- medicare hospice benefits
- hospice requirements cms emergency preparedness final rule
- cms fy 2011 top ten hospice survey deficiencies compliance
- introduction to the cy 2021 hospice component
- hospice medicare billing codes sheet
- hospice and end of life care and cms compliance group
- mln9895410 creating an effective hospice plan of care cms
- hospice regulations conditions of participation cops
Related searches
- introduction to financial management pdf
- introduction to finance
- introduction to philosophy textbook
- introduction to philosophy pdf download
- introduction to philosophy ebook
- introduction to marketing student notes
- introduction to marketing notes
- what to say in a hospice card
- how to cite introduction to sociology 2e
- cy 2021 final rule
- completing the 2020 2021 fafsa
- introduction to the stock market