Posted on Monday, October 26, 2020
Providers have numerous unanswered questions regarding the demonstration project to test hospice coverage of the Medicare Advantage carve-in. The most important question hospices want the answer to is how they will be paid.
“Many or some of the plans are looking, at least in this initial year, at paying some version of per diem payment. Most or all of them that we’ve heard of so far are at a fee-for-service minus rate. So it may be fee-for-servers minus 8% or 10% or 12%,” said Theresa Forster, vice president for hospice policy and programs for National Association for Home Care and Hospice (NAHC). “But that is sort of their opening gambit when they’re making an effort to contract with the hospices in-network. There may be some that are trying to do these types of contracts with a capitated rate to hospices, but in this year — because of the limited amount of time that they had to get ready, and because of the desire to have hospices be an agent involved with them — they’re taking a per diem payment approach at this time.”
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