The National Hospice and Palliative Care Organization (NHPCO) is pleased to announce its partnership with Better Medicare Alliance (BMA), to engage in a mutual collaboration addressing the challenges and opportunities associated with possible policy changes that would “carve-in” hospice under the Medicare Advantage (MA) program. The organizations look forward to identifying research gaps, policy questions and areas of agreement.
“NHPCO is excited about its partnership with BMA. Hospice and Palliative Care play an important role in helping families, individuals and payers manage serious illness. Whether Hospice continues to be ‘carved out’ of Medicare Advantage or is thoughtfully and responsibly ‘carved-in,’ our paramount concern is for patients and families receiving hospice care. This dialogue is an important step in assuring that we protect these patients and families,” said Edo Banach, NHPCO president and CEO.
Under current policy, MA enrollees who elect hospice remain in their MA plan, but fee-for-service (FFS) Medicare becomes responsible for most services while the MA plan retains responsibility for other services. This fragmented payment arrangement goes against the goal of more care integration. In a March 2014 report, and reiterated in 2016, the Medicare Payment Advisory Commission (MedPAC) explored the issue and recommended that MA plans assume both the clinical management of and financial responsibility for the hospice benefit.
Medicare Advantage is a fully integrated care model that promotes coordination of services and incentivizes high quality and patient satisfaction. MA has the potential to use flexibilities not available under Traditional Medicare to innovate around advanced illness and end-of-life care, but there are numerous challenges and issues that must first be explored through this collaboration.
Through ongoing dialog and a series of convening meetings, NHPCO and BMA will gather input from hospice and palliative care leadership and providers, health plan leaders, policy experts, sponsors and other stakeholders to ultimately chart a course for policy development that will meet the needs of patients, families, providers and payers.
BMA is nonprofit advocacy coalition of more than 100 ally organizations including providers, professional associations, aging services organizations, health plans and more than 400,000 senior advocates focused on strengthening Medicare Advantage.
Both organizations look forward to identifying research gaps, areas of agreement, and policy questions that will require further deliberation and releasing findings as they become available. Information about the first convening will be released later this summer.
“The success of Medicare Advantage in achieving better health outcomes for American seniors and people with disabilities highlights the importance of an integrated system. At BMA, we are keenly interested in examining options and opportunities to enhance integration across the continuum of care for those who are terminally ill, including palliative care, hospice and end-of-life care. We look forward to these discussions to improve care transitions and ensure continuity for terminally ill beneficiaries in Medicare Advantage,” said Allyson Y. Schwartz, BMA President and CEO.
With BMA’s expertise of Medicare Advantage and NHPCO’s combined strategic efforts, we can help create a policy that would result in a more robust care continuum that extends palliative care to patients with serious illness, while ensuring timely hospice access for patients with serious and advanced illnesses.