About the Event

For 2021 we are focusing on prospective financial issues of hospices while still addressing retrospective reporting issues. We recognize the importance of preparing for the integration of hospices into Medicare Advantage Plans (“MA”) based on our experience with other providers’ dealings with MA as well as the financial results of not being part of a Medicare Advantage Organization (“MAO”). For this reason, we have two outside presenters addressing both the structure of the hospice benefit as part of an MAO as well as detailed financial and patient information monitoring processes to assist hospices in assessing activities and becoming a provider of choice.

Speaker: Melinda A. Gaboury, CEO
Tuesday, September 14 | 1:00 PM – 2:40 PM | Understanding the Medicare Advantage Carve In: How Does The Model Work?

The time has come for Medicare Advantage (“MA”) to offer coverage to hospice patients under the MA benefit, previously exclusive to home health patients. There are numerous Medicare Advantage Organizations (“MAO”) that will participate and offer coverage in multiple states. In addition to hospice care, an expansion of palliative care services will be offered to patients through the MAO. CMS is testing how the Hospice Benefit Component can improve beneficiary care through greater care coordination, reduced fragmentation, and transparency in line with recommendations by the Office of Inspector General (OIG), the Medicare Payment Advisory Commission (MedPAC), and others. CMS will require MAOs to provide beneficiaries with broad access to the complete original Medicare hospice benefit.

This session will address the Value-Based Insurance Design (VBID) Model – Hospice Benefit Component, and the VBID demonstration which began on January 1, 2021, including all aspects of the demonstration to assist hospices for the reality of Medicare Advantage.