Eli's Hospice Insider

Published on Wed Dec 18, 2013 PDF

Hospice patients’ exclusion from Medicare Advantage plans is under scrutiny by the influential Medicare Payment Advisory Commission. “The rationale for the hospice carve-out from Medicare Advantage in not fully known,” MedPAC staffer Kim Neuman said in the body’s Nov. 8 meeting. The exclusion may have been due to limited hospice utilization and data.

“Does it make sense for MA plans to have full financial responsibility for end-of-life care for some of their members but not all of them?” Neuman asked, explaining that members who do not elect hospice are still under the MA plan. “The hospice carve-out results in a complex and fragmented set of coverage rules.”

“Given how the hospice carve-out leads to fragmentation at several levels, a policy option that could be explored is including hospice within Medicare Advantage,” Neuman suggested.

See more discussion of the topic in the meeting transcript at www.medpac.gov/transcripts/11_13_transcript.pdf — discussion begins on p. 11.