NHPCO NewsLine Winter 2020 - 24

continued

4,988 beneficiaries enrolled in MCCM out of over
18,000 beneficiaries referred; 3,603 of these
enrollees died as of September 30, 2019.
MCCM enrollment remained concentrated in a small
number of hospices: 9 hospices enrolled 54% of all
MCCM beneficiaries. Top enrolling MCCM hospices
were more likely to be located in urban areas and to
enroll somewhat fewer minorities, but other
characteristics, including size, were not significantly
different across MCCM hospices.

Key Findings
* MCCM led to a 25 percent decrease in total
Medicare expenditures, which generated $21.5
million in net savings between January 1, 2016 and
September 30, 2019, largely by reducing inpatient
care through increased use of MHB by the 3,603
Medicare beneficiaries who enrolled in the model
and died during this period.
* Beneficiaries in MCCM were 20 percent more likely
to enroll in the Medicare hospice benefit and
elected MHB one week earlier, on average, than the
comparison group (two weeks earlier when
including beneficiaries who enrolled in MCCM more
than a year prior to death).
* MCCM hospices provided high-quality care to most
enrollees, and most caregivers were highly satisfied
with the care received through the model and
transitions to MHB. At the same time, the
documentation of comprehensive assessments and
advance care planning discussions varied widely
across hospices.

model to show statistically significant savings. The
results show that concurrent care, and even an
expansion of some of the requirements within
MCCM, could make a meaningful difference in both
the quality and the cost of end-of-life care. "
" NHPCO and the [Hospice Action Network] would
really like to launch a second-generation Medicare
Care Choices model. We feel that CMS could take
the positive results that they have seen within this
model and expand it to test community-based
palliative care, " Acs said. " We would like to increase
the number of diagnoses that would be included in
those eligibility requirements. The big one is
removing the six-month prognosis requirement. The
evaluation findings did suggest that individuals with
serious illness and their caregivers would benefit
from supportive care earlier in the disease
trajectory, " Acs noted.

Download these Reports from the CMS
Innovation Website
* Two Pager: At-A-Glance Report (PDF)
* Medicare Care Choices Model - Third Annual Report
(PDF)
* Medicare Care Choices Model - Third Annual Report
Technical Appendices (PDF)
* Medicare Care Choices Model - Third Annual
Perspective Report (PDF)
Medicare Care Choices Model (MCCM)
Findings at a Glance

* Increase beneficiary access to
supportive services provided
by hospices, while a
beneficiary still seeks curative
treatment
* Improve quality of life and
beneficiary and family
satisfaction with care at the
end of life
* Inform new payment
approaches for the Medicare
and Medicaid programs

The Medicare Care Choices Model (MCCM) offers eligible Medicare
beneficiaries the option to receive supportive services from participating
hospices while continuing to receive treatment for their terminal condition
through fee-for-service Medicare. Participating hospices receive $400 per
beneficiary per month.
Beneficiary enrollment started on January 1, 2016 when the first cohort of
hospices began implementing MCCM, followed by a second cohort on
January 1, 2018. The model was recently extended an additional 12
months, through December 31, 2021.

* Diagnosis of cancer,
congestive heart failure,
chronic obstructive
pulmonary disorder, or
HIV/AIDS
* Prognosis of 6 months or less
to live documented by a
certificate of terminal illness
signed by the beneficiary's
physician
* Continuous Part A and B
enrollment in prior 12 months
* No election of the Medicare
or Medicaid hospice benefit in
the last 30 days
* At least 1 hospital encounter
and 3 office visits in the past
12 months
* Residence in a traditional
home, not a long-term care
facility, in the last 30 days

24

Newsline / Winter 2020

Medicare Care Choices Model
(MCCM)

Evaluation of the
Medicare Care
Choices Model

Third Annual Evaluation Report
October 2020

For information on the model and to download the independent evaluation report
discussed in this document, please visit
https://innovation.cms.gov/innovation-models/medicare-care-choices

Location of MCCM Hospices

Technical Appendices

ANNUAL REPORT 3
Contract # HHSM-500-2014-000261/T0005

85 MCCM hospices (60%) of the original 141 participants remained in the model as of
September 30, 2019.
4,988 beneficiaries enrolled in MCCM out of over 18,000 beneficiaries referred; 3,603 of
these enrollees died as of September 30, 2019.
MCCM enrollment remained concentrated in a small number of hospices: 9 hospices
enrolled 54% of all MCCM beneficiaries. Top enrolling MCCM hospices were more likely
to be located in urban areas and to enroll somewhat fewer minorities, but other
characteristics, including size, were not significantly different across MCCM hospices.

This document summarizes the evaluation report prepared by an independent contractor. To learn more about MCCM and to download the Third
Annual Evaluation Report, visit https://innovation.cms.gov/innovation-models/medicare-care-choices

The findings from the report are promising and
reinforce the call for a Community-Based Palliative
Care demonstration model. In an interview with
Hospice News (11/03/2020), Annie Acs, NHPCO
director of policy and innovation said, " The Medicare
Care Choices Model is on track to be the sixth
[Center for Medicare & Medicaid Innovation (CMMI)]

CMS Perspective:

Evaluation of the
Medicare Care
Choices Model

PARTICIPANTS
MCCM eligibility criteria

NHPCO Response

Evaluation of January 1, 2016 - September 30, 2019

MODEL OVERVIEW
MCCM is designed to

ANNUAL REPORT 3
Contract # HHSM-500-2014-000261/T0005

O C TO B ER 2 0 2 0

O C TO B ER 2 0 2 0

SUB MITTED TO:
Lynn Miescier, PhD, MHA
Contracting Officer's Representative
Centers for Medicare & Medicaid Services, CMS/CMMI/RREG
7500 Security Boulevard
Baltimore, MD 21244

SUBMITTED TO:
Lynn Miescier, PhD, MHA
Contracting Officer's Representative
Centers for Medicare & Medicaid Services, CMS/CMMI/RREG
7500 Security Boulevard
Baltimore, MD 21244

SUB MITTED B Y:
Abt Associates
6130 Executive Boulevard
Rockville, MD 20852

SUBMITTED BY:
Abt Associates
6130 Executive Boulevard
Rockville, MD 20852

U.S. Department of Health & Human Services
Centers for Medicare & Medicaid Services
Center for Medicare & Medicaid Innovation
Research and Rapid Cycle Evaluation Group & Patient Care Models Group
2810 Lord Baltimore Drive, Suite 130
Baltimore, MD 21244
NHPCO NewsLine Winter 2020

Table of Contents for the Digital Edition of NHPCO NewsLine Winter 2020
