The Centers for Medicare & Medicaid Services (CMS) has finally released the list of participants in the Medicare Advantage VBID Model for CY2022, including those that will cover the hospice benefit. The number of plans that will cover hospice has increased from 9 to 13 but the number of plan benefit packages increases from 53 to 115. The number of counties covered by these plans will increase from 206 to 461. The information below is excerpted from the CMS press release. Please note that the plans marked with an asterisk are plans that will cover hospice during CY2022. The states where these plans will cover hospice in select counties are listed beside the name of the plan for your convenience. It appears that one plan — Commonwealth Care Alliance in Massachusetts — is dropping out of the program after CY2021.
Additional information (including access to a list of covered counties) is available here.
For CY 2022, VBID Model participation continued to build on the substantial growth seen in CY 2021 and CY 2020. For CY 2022, the VBID Model has 34 participating MA organizations (MAOs), up from 14 in 2020 and 19 in 2021. These 34 participating MAOs are testing the Model in 49 states, DC, and Puerto Rico through 1,014 plan benefit packages (PBPs), up from 30 states and Puerto Rico with 157 participating PBPs in 2020, and 45 states, DC, and Puerto Rico with 451 participating PBPs in 2021. A total of 7.8 million beneficiaries are projected to be enrolled in participating PBPs in 2022, an increase from approximately 1.2 million beneficiaries in 2020 and 4.6 million in 2021. Over 3.7 million beneficiaries are projected to receive additional supplemental benefits as part of the Model test in 2022, up from 280,000 in 2020 and 1.6 million in 2021.
Of the 34 MAOs participating in 2022, 13 are participating in the Hospice Benefit Component, four more than in 2021, the initial year of the Hospice Benefit Component. These 13 organizations will test the inclusion of the Part A hospice benefit in MA benefits through 115 PBPs (up from 53 PBPs in 2021) and in 461 counties (up from 206 counties in 2021). In participating in this voluntary Model component, MAOs are incorporating the Medicare hospice benefit into MA covered benefits while offering comprehensive palliative care services outside the hospice benefit for enrollees with serious illness. Each participating MAO included as part of their palliative care strategy the following: palliative care consults, comprehensive care assessments and services provided by an interdisciplinary care team, care planning and goals of care discussions, advance care planning, 24/7 access and support, psychosocial and spiritual support, pain and symptom management, medication reconciliation, caregiver support and a focus on ensuring access to social services and community resources. In addition, participating MAOs are able to provide individualized, clinically appropriate transitional concurrent care through in-network providers and offer hospice-specific supplemental benefits.
The following MAOs are participant partners in the CY 2022 VBID Model:
*Indicates participation in the Hospice Benefit Component of the VBID Model for CY 2022.
The full CMS press release is available here.
(Source: NAHC)