Posted April 12, 2023
As CMS extends the Medicare Advantage hospice carve-in through 2023, providers are worried about keeping patient choice and the nature of concurrent care. CMS recently extended the hospice component of the value-based insurance design model (VBID) which was scheduled to be completed in 2024. The agency announced that patients will be able to receive curative treatments in tandem with hospice care and that it would permit health plans to further restrict the utilization of out-of-network providers.
The possibility of plans closing their networks raises questions about patients’ ability to choose who provides their hospice care, according to Mike Smith, CEO of Hospice of Iredell County. “As it currently stands a patient can choose whichever hospice they want when they elect hospice care. Narrowing that choice by creating a network could potentially reduce the pool of high-quality options for the patient depending on what criteria are used for inclusion,” Smith told Hospice News. “Another issue is the monopolistic concept of ‘pay-viders’, where the payer is also the provider. The concern is that the only providers in the network will be those owned by payers. This, by default, reduces patient choice.”
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