Hospice Carve-In for Medicare Advantage is ‘Inevitable’

Posted on Thursday, April 26, 2018 4:39 PM

The health care industry is moving  toward more Medicare beneficiaries in managed care, yet hospice continues to stand alone. Today, Medicare Advantage plans do not have hospice as a benefit but hospice providers may not be isolated for too much longer, Julia Driessen, Assistant Professor of health policy and management at the University of Pittsburgh and others suggested at this years National Hospice and Palliative Care Organization (NHPCO) management leadership conference.

“With Medicare Advantage providers on side of the benefit wall and hospice on the other, the bifurcation isn’t helping improve one major problem with hospice care: late utilization.

Currently, about half of hospice patients are admitted within the last two weeks of life, while the benefit can provide end-of-life care services for six months. Hospice providers have aimed to improve these transition times for better care and to also reduce the overall cost of end-of-life care by preventing some patients from ping-ponging in and out of the emergency room.”

Medicare Advantage plans saw increased flexibility earlier this year when CMS added non-skilled in-home as a benefit. 

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