A rising number of Medicare Advantage plans are offering home-based palliative care as a supplemental benefit. This year, 61 plans offer a palliative care benefit compared to 15 during 2019, a new Duke University report indicates.
Hospices provide about 50% of home-based palliative care in the United States according to the Center to Advance Palliative Care, and the number of providers that are diversifying their services lines to include palliative care continues to increase.
Through Medicare Advantage, the U.S. Centers for Medicare & Medicaid Services (CMS) contracts with private insurance companies to provide coverage for Medicare beneficiaries. Law requires Medicare Advantage plans to cover all of the services offered by traditional Medicare, but also allows for certain supplemental benefits.
Historically these benefits were very limited, but the Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act (CHRONIC), passed by Congress in 2018, expanded the range of those benefits to include programs to address some social determinants of health as well as home-based palliative care…
“We see this as a positive direction in the availability and sustainability of palliative care services,” Saunders told Hospice News. “Having greater coverage of palliative care services — especially those home-based palliative care services, or in-home support — should be useful and remove one barrier for people to access them.”
…A concern for the plans themselves is that they can’t find enough palliative care providers to meet the growing demand.
“While the plans are offering these new benefits, there’s still a challenge in identifying providers who can actually deliver the services. Plans say that they are trying to offer home-based palliative care, but it’s hard to find sufficient numbers of providers, especially trained palliative care providers that can deliver those services,” Saunders said. “There’s also the challenge that simply offering services isn‘t enough. That’s got to be paired with plans working with the providers to communicate the options that are available to the beneficiaries and educating the beneficiaries and their families on those options.”
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