CMS Releases Long-Awaited RFA on MA Hospice Model

Medicare Advantage organizations interested in testing the inclusion of a hospice benefit through their plans in 2021 will be tasked with ensuring timely and appropriate access to high-quality hospice care while also making sure that eligible beneficiaries receive palliative care. CMS unveiled the opportunity in January 2019, and in a request for applications (RFA) posted Dec. 19, it provided long-awaited details for how it expects MAOs and hospice providers to create a seamless care continuum for MA beneficiaries who elect hospice — a plan that one leading hospice organization found lacking.

The demonstration is part of the MA Value-Based Insurance Design (VBID) model that began in 2017 and now caters to roughly 1.2 million beneficiaries enrolled in plan benefit packages offered by 14 participating MAOs, CMS said in a press release accompanying the RFA. By reducing fragmentation and creating more financial responsibility for MAOs, the hospice component of the model will allow MAOs to better coordinate palliative and hospice care for beneficiaries, CMS said.

© 2021 MMIT

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues, including drug benefits and specialty pharmacy, for more than a decade. She served as editor of Drug Benefit News (the predecessor to Radar on Drug Benefits) from 2004 to 2005 and again from 2011 to 2016, and now manages Radar on Medicare Advantage. Lauren graduated from Vassar College with a B.A. in English.

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