Hospice VBID Model to Expand in 2023
WASHINGTON, D.C. (October 4, 2022)—On Sept. 29, 2022, the Centers for Medicare & Medicaid Services (CMS) released the list of Medicare Advantage (MA) plans that will participate in the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model during Calendar Year (CY) 2023, including those that will participate in the MA VBID Hospice Benefit Component (an offshoot of the larger VBID model which began operation in January 2021).
For CY 2023, 15 plans are participating in the Hospice Benefit Component (two more than in 2022). These 15 organizations will test the inclusion of the Part A hospice benefit in MA benefits through 119 plan benefit packages (PBPs). The estimated number of hospice enrollees who will be part of the model starting in 2023 is not yet known; during CY 2022 CMS estimated that approximately 20,000 hospice enrollees would be part of the model.
While the VBID Hospice Benefit Component will be offered in 25 states and territories during CY2023 (up from 22 states and territories in CY 2022), no single plan will offer hospice state-wide. Two plans that participated in 2022 will no longer be participating in 2023—AvMed (which operated in Florida) and Intermountain Health Care (which operated in select counties of Idaho and Utah). The VBID Hospice Component will be offered by two plans in areas of six states and territories (California, New York, Ohio, Oregon, Pennsylvania and Puerto Rico).
If you are a hospice provider and the VBID Hospice Benefit Component is offered in your state and you are interested in determining whether it will be offered in your service area, CMS has posted a link on the VBID Page titled, “CY 2023 Hospice Benefit Component Model Participant Service Area and Contact Information”. This Excel spreadsheet contains information related to the states, zip codes and counties where the various PBPs will be operating.
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