Medicare Ends Hospice VBID Pilot: What’s Next?

Medicare has announced the early termination of its Hospice Value-Based Insurance Design (VBID) Pilot Program by the end of 2024, two years ahead of its planned conclusion in 2026. The pilot program was an initiative to explore the feasibility of covering hospice care under Medicare Advantage plans instead of the traditional Medicare Part A coverage.

Reasons for Early Termination

The unexpected decision to end the pilot early has sparked conversations about the underlying reasons and future implications. A significant factor influencing this decision appears to be the withdrawal of a major payer participant from the program. This withdrawal has left insufficient plan participation to effectively evaluate the program’s success and potential benefits. Without enough data to provide a reliable assessment, Medicare decided to conclude the pilot prematurely.

Implications for Hospice Coverage

Despite the abrupt end, this decision should not be seen as the final verdict on the future of hospice coverage under Medicare Advantage plans. According to Medicare, the termination of the pilot is more of a pause rather than a complete halt. There is an expectation that additional information will emerge, which may lead to a re-evaluation or a potential restart of the pilot program in the future.

Future Prospects for Hospice Care Under Medicare

This development raises important questions about the best approach to hospice care coverage under Medicare. The traditional Medicare Part A benefit has been the primary method, but exploring the inclusion of hospice under Medicare Advantage plans aimed to identify if there could be improvements in service delivery and patient outcomes.

Staying Informed and Prepared

For now, stakeholders in the hospice care community, including providers and patients, will need to stay informed about future announcements from Medicare. The evolving landscape of hospice coverage will continue to be shaped by further evaluations and potentially new pilot programs designed to enhance the quality and accessibility of care.

While the early end of the Hospice VBID Pilot Program indicates challenges, it also opens the door for future innovations in how hospice care is delivered and financed under Medicare. The decision underscores the need for continued exploration and adaptation to ensure the best possible care for patients in need of hospice services.

Please reach out to us at Advanced Revenue Cycle Management if you have any questions!