Evaluation of Medicare Advantage Value-Based Insurance Design (VBID) Model test (2020-2023) - Key takeaways: VBID Hospice Component, 2021–2023

Evaluation of Medicare Advantage Value-Based Insurance Design (VBID) Model test (2020-2023) - Key takeaways: VBID Hospice Component, 2021–2023
CMS press release email; 4/18/25
From 2021 through 2024, the voluntary Medicare Advantage (MA) Value-Based Insurance Design (VBID) model allowed MA insurers to offer the Medicare Hospice Benefit within their plans. Outside VBID, hospice care is not included in MA plan benefit packages and is paid through traditional Medicare. The Hospice Benefit component consolidated responsibility and accountability for the cost, quality, and outcomes of MA beneficiaries in hospice with the intent of promoting care coordination and improving quality of care while maintaining budget neutrality or reducing costs.

• Plan participation in the Hospice Benefit component grew between 2021 and 2023, but uptake of palliative care, transitional concurrent care, and hospice supplemental benefits was low in all years.
• Most insurers and in-network hospices continuing their participation in the model in 2023 indicated that implementation was manageable because beneficiary volume was low.
• The proportion of beneficiaries receiving care from in-network hospices grew, rising to more than half of beneficiaries starting hospice in 2023. In-network hospices were larger and more often chains than out-of-network hospices.
• The Hospice Benefit component was: 1) not associated with changes in levels of hospice enrollment in 2021 or 2022, and 2) associated with reductions in combined MA and Part D bids in 2021 and 2022 but not in 2023.

Publisher's note: The 2-page Findings at a Glance is available here, and as posted in our 3/31/25 newsletter, the full report is available here.