Medicare Pilot Turns Hospice Care over to the Private Sector

Posted on by John C. Goodman

Medicare’s experiment gives private insurers the flexibility to both expand eligibility and rein in costs. The same insurers already manage most other care for roughly 30 million Medicare beneficiaries through the program known as Medicare Advantage.

The hope is they can take that experience and those skills, like coordinating care and vetting the quality of providers, and apply them to improve hospice. Because private insurers get paid a lump sum to manage each Medicare patient, they are also motivated to keep costs down.

Health News from NPR

4 thoughts on “Medicare Pilot Turns Hospice Care over to the Private Sector”

  1. As I reported in a previous post, Medicare hospice care is being abused. Nursing home patients are often enrolled in hospice, but they don’t die on schedule because they were never at risk of dying within six months. Putting Medicare Advantage in charge of hospice for their enrollees will be an interesting test.
    My previous post: https://www.goodmanhealthblog.org/hospice-care-is-a-great-idea-that-is-being-abused/
    Pro Publica also had an extensive article on hospice companies hiring recruiters in small towns and giving them quotas to fill from anyone they could find. Most of those recruited thought they were getting government freebies rather than enrolled in a program for people expected to die within six months.

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  2. About 50% of Medicare-eligible seniors have voluntarily enrolled in Medicare Advantage coverage. Because MA is fully-insured by private insurers, the liability for each such enrollment is transferred from Medicare to the private insurer.

    Now the government is seeking to determine if a private option can take on liabilities for Hospice – which has clearly been mismanaged by Medicare. The key will be whether, at the right price, both Medicare and private insurers can win on this arrangement. I suspect the answer is “yes”.

    Thus the privatization of Medicare continues.

    Quite a change from 2009 when Obama declared that he intended to shut down Medicare Advantage.

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  3. Another pilot program that will take 20 plus years for anyone to talk about.
    Like the MSA in Medicare. not one article written about the MSA since it’s been available since 2007. (Google “MSA”. I challenge you to find any articles written) Solves the problems with preexisting conditions in Medicare. Solves the problem with over utilization of Medicare.
    Solves the problem with Medicare solvency.
    The republican blueprint for healthcare reform is the law of the land today and not one policy wonk or politician can talk intelligently about it. How sad…

    The government pays the insurance premium for the insured.
    The government then funds the Medical Savings Account.
    the insured has choice of any Medicare provider with no networks just like original Medicare.

    Looks a lot like the blueprint for age-based tax credits for the rest of the population.

    But that would end employer base insurance literally overnight and we can’t kill that trillion-dollar golden goose waste of taxpayers’ money…

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  4. Pingback: Some Medicare Hospice Care Firms Are Better than Others – The Goodman Institute Health Blog

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