Beginning January 1, 2021, the Centers for Medicare & Medicaid Innovation (CMMI), launched the Hospice Benefit Component of the Value-Based Insurance Design (VBID) Model. The effort is a test to include hospice care benefits in Medicare Advantage (MA) plans.i

CMMI aims to test the impact on care delivery and quality of care in allowing members who have elected hospice care services to receive all the benefits of their MA plans, which were traditionally only covered under Medicare Part A. In addition, members who elect in-network hospice care providers will be eligible for additional hospice supplemental benefits through their Humana MA plans.

Humana is one of thirteen insurance companies participating in the Hospice Benefit Component in 2022, and began with MA plans in Atlanta, Cleveland, Denver, the Louisville, Ky., metro area (including southern Indiana), and the Richmond-Tidewater region of Virginia in 2021. For year two (2022), Humana is expanding in the current plan coverage areas and entering into Wisconsin. Of the thirteen participating companies, Humana offers one of the largest number of plans that include the hospice care benefit.ii

What does this test mean for me as a member of one of the participating Humana Medicare Advantage plans?

Participating plans include Humana Gold Plus plans in Atlanta, Denver, Louisville, Ky., and Richmond/Tidewater, Va., and Humana Choice plans in Atlanta and Louisville, and Humana Cleveland Clinic Preferred in Cleveland.

For these participating Humana plans, the new model provides a more seamless transition to hospice care, or from palliative care to hospice, along with improved coordination of your care between providers and your doctors. When a member is facing an advanced illness, coordination of care is imperative to allow members and their families to focus on their time together.

What are palliative care and hospice care?

Palliative care is provided by a team of doctors, nurses, and other specialists who work with a patient's doctors to provide an extra layer of support. Palliative care is appropriate at any age and at any stage in a serious illness and can be provided together with healing treatments.iii

Hospice care is a support service for anyone facing a terminal illness diagnosis. Hospice care services are meant to provide relief of pain and other symptoms a person may be experiencing associated with terminal illness and related conditions.iv

Services provided by palliative and hospice care typically include the following:

  • Creating a treatment plan
  • Pain and symptom management
  • Medication management
  • Emotional support

Humana understands members’ unique healthcare needs change over time, and we want to help you meet those needs the way you want. Humana has also added supplemental benefits to the participating Hospice VBID plans to further support the member care experience.

Member care experiences with Humana’s Medicare Advantage Hospice VBID model

Jerry’s return to independence

Jerry elected hospice care in the spring, and he felt a lack of independence due to his loss of mobility, which is related to his medical condition. Jerry shared with his hospice care provider during a home visit that he’d been considering the purchase of a lift mechanism for his vehicle so he could have more freedom and mobility. His provider explained the hospice care assistance supplemental benefit Jerry had as part of his participating Hospice VBID Humana Medicare Advantage planv.

Jerry took advantage of his benefit to assist in the cost of the lift installation. He now uses his lift with the push of “one simple button,” and he can go out and grab a burger or run an errand and has regained some of the independence he was missing.

Carolyn’s assistance with service coordination

Carolyn’s loved one elected hospice care, and with their declining health, household tasks such as lawn care became difficult to manage. Carolyn called Humana to learn more about the supplemental coverage included in her loved one’s planvi. Using the hospice care assistance allowance, Carolyn was able to work with Humana to schedule ongoing lawn care services.

Carolyn called Humana after her loved one’s passing to share her gratitude. “Please don’t stop this program. I cannot express enough - thank you for what your program does. It makes a difference.”

What we do at Humana is more than health insurance, and more than healthcare. Because to us, people are more than a policy number or a name on a chart. People are people—and being treated like one is just better for your health.

Disclaimer

Medicare approved Humana Medicare Advantage plans offered in Atlanta, Cleveland, Denver, Louisville metro area, and Richmond-Tidewater region of Virginia to provide supplemental benefits as part of the Value-Based Insurance Design program. This program lets Medicare try new ways to improve Medicare Advantage plans.

Sources

  1. “VBID Model Hospice Benefit Component Overview,” CMS.gov, last accessed December 1, 2021, https://innovation.cms.gov/innovation-models/vbid-hospice-benefit-overview.
  2. “Humana the Most Prominent Payer in the Medicare Advantage Hospice Carve-In,” Hospice News, last accessed December 1, 2021, https://hospicenews.com/2020/09/29/humana-the-most-prominent-payer-in-the-medicare-advantage-hospice-carve-in/.
  3. “What Are Palliative Care and Hospice Care?,” National Institute on Aging, last accessed December 1, 2021, https://www.nia.nih.gov/health/what-are-palliative-care-and-hospice-care.
  4. “What Are Palliative Care and Hospice Care?”
  5. “Humana Gold Plus Medicare Advantage HMO plans,” Humana, last accessed December 1, 2021, https://www.humana.com/medicare/medicare-advantage-plans/humana-gold-plus-hmo.
  6. “Humana Gold Plus Medicare Advantage HMO plans.”