For decades, hospice care has operated in a perceived silo with the rest of the healthcare continuum. The Centers for Medicare and Medicaid Services (CMS) launched the Hospice Value-Based Insurance Design (VBID) Model and made a point to include palliative care. To explain the nuances of palliative care’s role in Hospice VBID programs, Axxess created a one-page reference guide to help providers easily understand how to run a program that aligns with requirements that Medicare Advantage (MA) beneficiaries have access to a palliative care provider.
Raianne Melton RN, BSN, CHPN, Senior Clinical Manager of Professional Services for Axxess, created the guide and explained how palliative care fits into Hospice VBID, what providers need to consider as they get involved, and how technology is helping organizations comply with the MA requirements.
Palliative Care in the Hospice VBID Model
Under the CMS guidelines, palliative care must be available for Medicare Advantage beneficiaries eligible for hospice care. Melton points to the fact that only 28% of patients in the hospital with a life-limiting condition have discussions with their doctor about the severity of their illness and what the progression will look like.
“I’ve always found that shocking,” said Melton. “And then they need to ponder, think about, well, I know where I’m at right now as I decline, how do I match my treatments to my goals for care?”
Melton pointed out that palliative care is more than just symptom management and noted that with its inclusion in Hospice VBID, this will encourage discussions about disease trajectory so patients are better prepared for a quality end of life.
What Providers Need to Know
The Hospice VBID Model presents opportunities for providers who want to work with MA organizations but Melton points out that there are a few key things to consider when starting a palliative program.
“The most important thing if you’re going to partner with these organizations and be successful is that you understand what they want, their expected outcomes, and you really look at a program that can focus on the expected outcomes to meet those expectations,” said Melton.
In understanding the MA organization’s needs, Melton notes that palliative providers need to be able to collect and provide the data that shows they are meeting the MA organization’s goals through care coordination.
Staffing is another consideration that Melton says providers should consider. Since hospice care is different than palliative care, not every position is a one-to-one transition and some employees may require upskilling or deeper, palliative-focused training.
Technology for Hospice VBID and Palliative Care
When it comes to care coordination, Axxess Palliative Care stands out as a solution that supports providers in Hospice VBID programs.
Axxess Palliative Care features robust reports that offer the data MA organizations look for to meet Hospice VBID requirements. And because Axxess has a complete suite of solutions for post-acute care, it’s easy to transition patients between hospice and palliative care as their condition warrants.
Melton encouraged organizations to explore the palliative care components of the Hospice VBID Model because it represents the future of how care will likely be provided.
“By 2030, up to 70% of Medicare enrollees will be in a Medicare Advantage program. So, if you want to be viable, you need to participate.”
To download Melton’s resource guide on Hospice VBID and palliative care, click here.
Axxess Palliative Care, a cloud-based palliative care software, was built for flexibility with streamlined workflows from intake to claim submission.
