JAMA Network November 29, 2021
In 2021, the Centers for Medicare & Medicaid Services (CMS) began testing the value-based insurance design model in 9 Medicare Advantage organizations providing plans in 206 counties nationwide. Under this model, which will become more widespread in the future (anticipated to increase to 15 Medicare Advantage organizations providing plans in 461 counties in 2022),1 hospice services are paid for and overseen by Medicare Advantage, unlike the existing structure that carves out hospice services from Medicare Advantage. In the carve-out approach, when Medicare Advantage enrollees elect hospice, their hospice benefits are provided under traditional Medicare coverage and are not overseen by the Medicare Advantage plan.
Proponents of the Medicare Advantage carve-in suggest it has the potential to reduce fragmentation, produce new...
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