Joining Payer Networks Key to Success for Hospices in Medicare Advantage

The journey toward value-based care remains uncertain, yet impactful for hospice. Providers and payers of all walks are taking a sharper look at hospice as the value-based insurance design (VBID) demonstration project approaches its second year. Hospices need a seat at the bargaining table in order to maintain control of their financial destiny, according to industry stakeholders. 

Commonly called the Medicare Advantage hospice carve-in, the demonstration project took effect Jan. 1. The intention of the program is to increase access to hospice services and facilitate better care coordination, according to the U.S. Centers for Medicare & Medicaid Services (CMS). The carve-in is designed to assess payer and provider performance related to hospice within Medicare Advantage. Participation in the demonstration is voluntary for both payers and providers.

The carve-in changes the ways participating hospices receive payment for their services. In the VBID arena, hospice providers accept greater financial risk in exchange for incentives for improving quality or reducing costs.