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NHPCO Examines Hospice Implications of Extension of Medicare Advantage Value-Based Insurance Design Model

For Immediate Release
April 28, 2023

(Alexandria, VA) – Earlier this month, the Center for Medicare & Medicaid Innovation (CMMI) published details on the extension of the Medicare Advantage Value-Based Insurance Design (VBID) Model that may have significant implications for hospice care going forward. In response, the National Hospice and Palliative Care Organization (NHPCO) shared the following analysis of some key details contained in the CMS fact sheet.

Concurrent care:

      • CMS is using this model program to expand what is known as “concurrent care,” which is giving a patient who wants it access to both hospice care and curative care at the same time. NHPCO and our members have long argued that patients should not have to give up curative care in order to access hospice care. CMS tested concurrent care on a limited scale with the former Medicare Care Choices Model (MCCM) and had excellent results. We’re pleased that under the VBID extension more people will get greater access to the care they want during the end-of-life journey.
      • Unfortunately, concurrent care will be limited to select patients enrolled in Medicare Advantage (MA) Plans participating in VBID. When Congress designed the Medicare Hospice Benefit, the intent was very clearly to provide access to all Americans who want hospice care. As our country expands the type of hospice care available–in this case, concurrent hospice and curative care–those choices should be available to all. The lessons learned on concurrent care from MCCM and from the VBID extension should be rolled out as quickly as possible to all Americans. NHPCO will work with CMS and Congressional leaders to ensure that is the case.

Limiting patient choice:

      • The VBID extension gives MA Organizations the ability to limit the hospice choices available to their plan enrollees starting in 2026.
      • Care choices at the end of life are among the most personal, consequential choices a person and their loved ones will ever consider. Allowing MA plans to limit their enrollee’s hospice choice based on the MA plan’s business relationships means limiting patient access, and it runs against the spirit of the Medicare Hospice Benefit.
      • While we welcome the emphasis on a continuity of care as patients transition to hospice, we are concerned about allowing private insurance companies to limit the hospice benefit, which is guaranteed to all Americans. Again, NHPCO will work with Congress and CMS to continue speaking up for access and choice in hospice care.

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About NHPCO

The National Hospice and Palliative Care Organization (NHPCO) is the nation’s largest and oldest membership association for providers who care for people affected by serious and life-limiting illness. Our members deliver and expand access to high-quality, person-centered interdisciplinary care to millions of Americans. NHPCO provides education and resources to support that mission. Together with our advocacy partner, the Hospice Action Network (HAN), we serve as the leading voice advancing public policy to improve serious-illness and end-of-life care, while our CaringInfo program provides free resources to educate and empower patients and caregivers. nhpco.org

NHPCO Contact:
Madison Summers
571-412-3973