Including Hospice Care In The Medicare Advantage Benefits Package: Considering The Implications And Opportunities

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Perennial growth in Medicare Advantage (MA) enrollment and appreciable increases in use of hospice services and expenditures have been two unerring trends in US health care since the turn of the 21st century. Yet, bucking the parallel push to expand the scope of MA plans, hospice care remains excluded from the MA benefits package. The growth in MA enrollment, combined with efforts to synchronize Medicare policy across payment models, establish strategic priorities at the Centers for Medicare and Medicaid Services (CMS) to promote coordination of care, and the emerging bipartisan consensus on the importance of Medicare Advantage make this exclusion untenable. A policy change to include hospice care in the MA benefits package (colloquially referred to as a carve-in), however, is fraught with complexity, disquieting to many hospice providers and health plans, and susceptible to misunderstanding. Consequently, any policy to carve hospice into Medicare Advantage requires a deliberative approach and must be designed in a way that is unequivocally seen as a “win” for Medicare beneficiaries.