Eli's Hospice Insider

Published on Thu Nov 12, 2020 PDF

Medicare Care Choices Model continues to rack up savings.

For the third year, Medicare’s concurrent care demonstration has shown providing hospice services to beneficiaries who don’t want to elect the hospice benefit can help both patients and the Medicare program.

Reminder: The Medicare Care Choices Model “offers eligible Medicare beneficiaries the option to receive supportive services from participating hospices while continuing to receive treatment for their terminal condition through fee-for-service Medicare,” the Centers for Medicare & Medicaid Services summarizes in a new annual report on the program. “Participating hospices receive $400 per beneficiary per month.” Among the requirements to participate is a six-month prognosis and a diagnosis of cancer, congestive heart failure, chronic obstructive pulmonary disorder, or HIV/AIDS.

Medicare expenditures for MCCM were nearly $10,000 less for MCCM enrollees who later transitioned to the hospice benefit, found the report that analyzed the program through Sept. 30. The reduction was much less for those MCCM enrollees who did not transition to hospice benefit in the last 30 days of life at $345, but was still a savings with enhanced services for the beneficiary.

Another finding: MCCM enrollees were 20 percent more likely to enroll in the Medicare hospice benefit and elected hospice one week earlier, on average, than the comparison group, CMS notes in a report summary. Benes who enrolled in MCCM more than a year prior to death elected hospice two weeks earlier, on average.

Caregivers were generally happy with the program, with 95 percent indicating they “would definitely or probably recommend the model to friends and family members,” CMS adds.

Bottom line: “Total Medicare expenditures decreased by 25 percent, generating $26 million in gross savings and $21.5 million in net savings, largely by reducing inpatient care” from 2016 to 2019, CMS says. The program has saved nearly $6,000 per decedent in its three years. It will run through the end of 2021.

Note: Links to the summary and full report are at https://innovation.cms.gov/innovation-models/medicare-care-choices — scroll down to the “Evaluations” section.