New care model allows more end-of-life care choice for Medicare beneficiaries
The Centers for Medicare & Medicaid Services (CMS) has introduced a new model that offers Medicare beneficiaries greater flexibility in end-of-life care choices.
The Medicare Care Choices Model provides Medicare beneficiaries who qualify for coverage under the Medicare hospice benefit and dually eligible beneficiaries who qualify for the Medicaid hospice benefit the option to elect to receive supportive care services typically provided by hospice, while continuing to receive curative services.
Hospice care is covered by both the Medicare and Medicaid programs. When hospice care is chosen, a beneficiary is no longer eligible to receive curative care. According to March 2015 Medicare Payment Policy Report to the Congress, only 47.3 percent of Medicare and 42 percent of dually eligible beneficiaries used hospice care and most only for a short period of time. This data reflects the struggle in having to choose between palliative and curative care during these difficult times.
CMS originally anticipated selecting at least 30 Medicare-certified hospices to participate in the model and enrolling up to 30,000 beneficiaries throughout a three-year period. But, due to robust interest, CMS has invited over 140 Medicare-certified hospices to participate in the model and expanded the duration of the model to five years. This will enable up to 150,000 eligible Medicare and dually eligible beneficiaries to participate.
Delivery of services under the model will be phased-in over two years. Approximately half of the participating hospices will begin providing services under the model on January 1, 2016. The remaining participant hospices will provide services under the model starting January 1, 2018. This model is slated to end on December 31, 2020. Hospices participating in the model will be randomly assigned to Phase 1 or Phase 2.