Manatt Health Partner Edo Banach was quoted in Hospice News on the impact that Medicare Advantage transparency efforts may have on hospice reimbursement.
Amid the Biden-Harris administration’s push to reduce health care and prescription drug costs, the U.S. Centers for Medicare & Medicaid Services recently released a Request for Information on ways to improve data sharing and transparency in Medicare Advantage after the White House recently announced a potential bill to increase data transparency for supplemental benefits under the plan. Greater transparency for individuals enrolled in Medicare Advantage could lead to the development of improved quality measures in serious illness and end-of-life care, according to Banach.
“This is another step in the administration’s goals that attempt to make sure Medicare Advantage plans are being held accountable,” Banach said. “Part of that is making sure we continue to make Medicare a more equitable and accessible program in every way. It’s important that we have a level of insight and transparency in Medicare Advantage data to have more flexibility to add supplemental benefits that serve more diverse populations. That is something we’re going to get with enhanced transparency and more robust data.”
The Request for Information indicates that regulators are planning to have quality data transparency play a role in shaping future hospice payments and outcomes, especially as value-based insurance design (VBID) and other reimbursement benefits develop.
“It’s not just about enhanced transparency, but going a step further around greater flexibility and payment incentives around it,” Banach said. “What’s really necessary are these binding, sticky requirements that will allow providers to get paid more and have more flexibility in their services. With hospice carved into VBID, we’re still seeing how that’s playing out. It’s important for that data to be shared and really help inform consumers and providers [on] the benefits available and what people are actually getting. Transparency is crucial to how we determine which benefits are being provided, and whether they are being provided equitably for people who are 65 and older.”
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