Hospice Medicare Advantage Carve-In: The Time Has Come

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[3505] Hospice Medicare Advantage Carve-In: The Time Has Come
Details of the Value-Based Insurance Design (VBID) Model – Hospice Benefit Component.


Presentation Info:

  • TAHC&H Virtual Event | Winter Conference | Recorded for On-Demand Access
  • Presentation Date | February 9, 2021

Program Description: This presentation covers the details of the Value-Based Insurance Design (VBID) Model – Hospice Benefit Component. Medicare Advantage (MA) has long had coverage for home health patients, but there has never been coverage for Hospice under the MA benefit. VBID is a demonstration that will begin January 1, 2021. There are 9 Medicare Advantage Organizations (MAO) that will be participating and have coverage in multiple states. In addition to Hospice care there is an expansion of Palliative Care services that will be offered to patients through the MAO. CMS is testing how the hospice benefit component can improve beneficiary care through greater care coordination, reduced fragmentation, and transparency in line with recommendations by the Office of Inspector General (OIG), the Medicare Payment Advisory Commission (MedPAC) and others. CMS will require that MAOs provide beneficiaries with broad access to the complete original Medicare hospice benefit. This presentation covers all known aspects of the demonstration and prepares hospices for the reality that Medicare Advantage is now in the Hospice world.

HCSSA Topic(s) Addressed:

  • §558.259[d][4]agency responsibilities
  • §558.260[a][3]basic principles of management in a licensed health-related setting
  • §558.260[a][7]financial management

Education-Training Credits:

  • TX HCSSA Administrator/Alternate Continuing Education
    • 1.25 Clock Hr(s)
  • Continuing Education for Nurses
    • 1.25 Contact Hr(s)
    • This program awards CNE until 02.09.2023

Texas HCSSA CE Approval Statement
This program meets continuing education requirements for Administrators and Alternates under Texas HCSSA licensing regulations.

Nurse CE Approval Statement
Texas Association for Home Care & Hospice is an approved provider of continuing nursing education by Louisiana State Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. LSNA Provider No. 4002151


Requirements for Successful Completion
To receive continuing education credits for this online presentation participant must view the entire online presentation, complete an evaluation, and post-test attestation.

Reporting of Perceived Bias
Bias, as defined by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC COA/LSNA) is the “tendency or inclination to cause partiality, favoritism, or influence.” Commercial bias may occur when a CNE activity promotes one or more product(s) (drugs, devices, services, software, hardware, etc.). This definition is not all inclusive and participants may use their own interpretation in deciding if a presentation is biased. The ANCC COA is interested in the opinions and perceptions of participants at approved CNE activities, especially in the presence of actual or perceived bias in continuing education. Therefore, ANCC invites participants to access their “ANCC Accreditation Feedback Line” to report any noted bias or conflict of interest in the education activity. The toll free number is 1(866) 262-9730.

TAHC&H Faculty/Presenter(s): Melinda Gaboury, COS-C, Chief Executive Officer, Healthcare Provider Solutions, Inc.

About the Presenter(s):
Melinda Gaboury
, with more than 28 years in home care, has over 18 years of executive speaking and educating experience, including extensive day to day interaction with home care and hospice professionals. She routinely conducts Home Care and Hospice Reimbursement Workshops and speaks at state association meetings throughout the country. Melinda has profound experience in Medicare PDGM training, billing, collections, case-mix calculations, chart reviews and due diligence. UPIC, RA, ADR & TPE appeals with all Medicare MACs have become the forefront of Melinda’s current impact on the industry. She is currently serving on the NAHC/HHFMA Advisory Board and Work Group and is Associate Director on the Home Care Association of Florida Board of Directors. Melinda is also the author of the Home Health OASIS Guide to OASIS-D1.


[3505] Hospice Medicare Advantage Carve-In: The Time Has Come

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