Volume 23.19
CMS has posted those plans that will be participating in the Medicare Advantage Value-Based Insurance Design Model in 2024, including those participating in the Hospice Benefit Component.
There will be less Hospice Benefit Component participation in 2024 than 2023. Four plans will drop participation:
- Catholic Health Care System (CHCS), New York,
- Elevance Health, Inc. (MMM Healthcare, LLC), Puerto Rico,
- Presbyterian Healthcare Services, New Mexico, and
- UnitedHealth Group, Alabama, Illinois, Oklahoma, and Texas.
Two new participants are:
- First Sacramento, Texas and
- Sentara, Florida.
In 2023, 15 plans provided 119 benefit packages covering 806 counties in 24 states and territories. In 2024, coverage now consists of 13 plans providing 78 benefit packages covering 609 counties in 20 states and territories. Substantial information relating to those plans participating and service areas is available here. The MA VBID model has been extended through 2030.
MEDICARE ADMINISTRATIVE CONTRACTORS HAVE NOT YET POSTED HOSPICE RATES FOR FY 2024
We get many questions regarding hospice payment rates effective October 1, 2023, based on the final hospice rule. These rates are determined by the location of the patient. Accordingly, the labor component of the payments must be adjusted by the currently applicable wage index. Palmetto GBA, CGS, and NGS (Medicare Administrative Contractors) have not yet updated their websites to provide hospice payment rates effective October 1, 2023. The 2024 hospice wage index is available here.
The labor component of the FY 2024 hospice payment rates is:
Routine home care 66.0%
Continuous home care 75.2%
General inpatient care 63.5%
Inpatient respite care 61.0%
National rates have been set at:
Routine home care (days 1-60) $ 218.33
Routine home care (days 61+) $ 172.35
Continuous home care (per hour) $ 65.23
Inpatient respite care $ 507.71
General inpatient care $ 1,145.31
The following illustrates the calculation of the payment rate for routine home care (days 1-60) in a geographical area with a wage index of .80.
Routine home care rate (days 1-60) $ 218.33
Labor component (66.0%) $ 144.10
Non-labor component $ 74.23
Labor component (adjusted for wage index) $ 115.28
Non-labor component $ 74.23
Payment rate (days 1-60) $ 189.51
FEW SPOTS REMAIN FOR THE HOSPICE FINANCIAL MANAGEMENT AND ADMINISTRATION CONFERENCE
The Health Group, LLC’s 2023 Hospice Financial Management and Administration Conference is rapidly filling up (attendance limited). The program will be held at the beautiful Lago Mar Beach Resort, Fort Lauderdale, Florida on November 9-10, 2023. Program information, including registration information, is available here. The program provides for a special session on the financial implications of the many hospice integrity initiatives, both implemented and proposed.
Special rates have been secured with the Lago Mar Beach Resort & Club; however, to secure these rates, call (855) 829-2923 and inform the hotel that you are attending “The Health Group, LLC Hospice Financial Administration Conference” or online at www.lagomar.com.
When making reservations online, go to reservations, click on group code, and enter 2311THEHEA. Select the dates you will be staying, even if the dates are indicated as not available, select them and your room type. All attendees are being offered Executive One Bedroom Suites at $235/night. Resort fees have been waived for our attendees. If you have a problem, please call the hotel. The hotel is making the $235/night available for two (2) days prior and two (2) days after the program dates.