The Centers for Medicare and Medicaid Services (CMS) introduced the Hospice Benefit Component of the Medicare Advantage Value-Based Insurance Design (VBID) model to help patients needing end-of-life care transition seamlessly to hospice care.
With the VBID model’s extension through 2030, participating Medicare Advantage Organizations (MAOs) will be permitted, starting in 2026, to restrict their enrollees from receiving hospice services from hospice providers that are not in their network.
This means it is now more important than ever before for hospice providers to cultivate strong, collaborative relationships with MAOs.
To help providers build a stronger future in the VBID environment, Axxess created a one-page reference guide that highlights important changes happening with the model’s extension and how networking is critical to navigating them.
Zaundra Ellis, Vice President of Hospice Professional Services at Axxess, created the reference guide and detailed specific networking strategies and tools organizations can leverage to position themselves for lasting success in the VBID environment.
“Hospice organizations should always be looking for ways to network with payers,” said Ellis. “As it relates to VBID, we know that CMS currently covers 54% of beneficiaries leveraging managed care. This number is only going to increase. For hospices to remain competitive in the face of the growing managed care market, they need to develop specific strategies to network with each payer.”
Networking Strategies
“In 2026, MAOs will be driving hospice referrals to preferred providers,” Ellis said. She encourages hospice providers to be proactive and start networking with MAOs now to ensure preferred provider status in 2026.
“Don’t wait for the MAO to come to you,” said Ellis. “Each year CMS posts information about participating MAOs and their service areas. Being proactive will help to begin relationships early in the process, giving those hospice providers a head start.”
Ellis also urges hospice providers to position themselves as value-adds for MAOs by assisting with the development of their VBID programs.
“Many MAOs don’t have a handle on how to identify and contract with hospice organizations in their service areas,” said Ellis. “Hospice organizations have an exceptional opportunity to help inform the way that MAOs manage their VBID programs. This is of tremendous value to the MAO and strengthens the relationship with the hospice organization.”
Networking Tools
Ellis encourages hospice providers to leverage technology to maintain a robust QAPI program with data to support the quality of care they provide.
“Axxess Business Intelligence provides a QAPI component that’s custom-tailored to each organization based on their performance and quality metrics,” said Ellis. “Technology tools like this can be powerful networking resources for hospice providers to demonstrate to potential MAO partners the quality of care they provide.”
She also advises hospice providers to leverage reporting systems and contract management capabilities to streamline data sharing, communication and other processes with MAOs.
“Hospice providers should identify areas of their technology solutions, like drill-down reporting and contract management capabilities, that can be used to streamline data sharing, communication and other processes as they network, collaborate and work together with MAOs to provide the highest quality of care for shared patients,” said Ellis.
To download Ellis’ resource guide on networking to build a stronger future in the VBID environment, click here.
Axxess Hospice, a cloud-based hospice software, includes simple tools such as partner contract management and quality metrics reporting to help organizations position themselves for VBID success.
