8 July - 2023IN MY OPINIONThe organization I work for--VNS Health--has been part of a demonstration project being conducted by the Centers for Medicare & Medicaid (CMS), in which participating Medicare Advantage (MA) plans directly manage the Medicare Part A hospice benefit for their members. Let me note right at the start that this is a big change. The way Medicare is currently set up, MA plans cannot offer hospice services as part of their coverage. Instead, Medicare recipients who meet clinical criteria and want to elect hospice care must do so through Original Medicare (fee-for-service) ­ not through an MA plan they may be enrolled in ­ and stop receiving any curative or life-prolonging treatments. For family of someone who is at the end of life, this is a huge hoop to have to jump through. Instead of working through their loved one's MA plan that they all know and like, they have to navigate both the MA plan for supplemental benefits and care unrelated to the terminal illness and Original Medicare for hospice services. The result is a fragmented, disjointed experience for the plan member and their family, at a time when they need their health care to be as simple and straightforward as possible. It's such a hurdle, in fact, that many families never bother getting hospice care for their dying loved one, even though Medicare covers hospice services in full. When families do A New Medicare Advantage Model Could Transform How Care is Delivered at End-of-LifeBy Josie Aquino, Director, Product Management, VNS Health Demonstration Project Aims to Reduce Fragmentation of Services and Encourage MA Plan Members' Use of Palliative and Hospice Care
< Page 7 | Page 9 >