POSTED ON MONDAY, APRIL 20, 2020 12:53 PM
CMS has published its final payment capitation rates that reveal the amounts the agency will provide to Medicare Advantage plans to offer hospice coverage through the value-based insurance design demonstration project, commonly called the “carve-in”, which will begin on January 1,2020. They did not indicate what percentage of would go to hospice providers, the presumption is that will be decided between health plans and hospices.
“It’s important to note that these rates are what CMS will pay to plans that participate in the model, and these rates incorporate a number of factors that can vary widely across hospices in any specific area, including aggregate cap status and variability in levels of care,” Theresa Forster, vice president for hospice policy for the National Association of Home Care & Hospice, said. “Ultimately it will be the contractual agreement between the [Medicare Advantage] plan and the individual hospice that will govern what a hospice is paid.”
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