Turn-Key Health Palliative Care Solution Gives Medicare Advantage Organizations Competitive Edge in Bid to Meet Requirements of CMMI Hospice Carve-In
VBID application process open to Medicare Advantage Organizations (MAOs), with applications due by 11:59 p.m. EST,
Monday, March 16, 2020
PHILADELPHIA – January 30, 2020 – Turn-Key Health (TKH) serving health plans, provider organizations and their members who experience a serious or advanced illness, is providing Medicare Advantage Organizations (MAOs) with a community-based palliative care (CBPC) solution and the industry expertise to gain a competitive advantage in meeting the requirements of the Centers for Medicare & Medicaid Services Innovation Center (CMMI) Request for Applications (RFA) to participate in an expansion of the Value-Based Insurance Design (VBID) Model that includes hospice coverage in plan design, 2021. Contact TKH here for more information and opportunities to partner.
Participating MAOs must provide the full scope of hospice benefits as currently defined in the Social Security Act (SSA), including requirements for beneficiaries to meet the definition of “terminally ill.” They must also have a strategy around access and delivery of palliative care services for beneficiaries who are not eligible for or have chosen not to receive hospice services. For more details visit here.
“By embedding our CBPC solution in their submissions and leveraging the unique market insights from TKH leadership, MAOs can better meet the key application components and strategy requirements around access and delivery of palliative care for certain beneficiaries not receiving hospice benefits” says Greer Myers, president, TKH.
Turn-Key’s Palliative Illness Management™ (PIM), a rapidly scalable solution for seriously ill insured member populations, is an innovative, high-touch, home-based program designed to engage members to better align their goals of care with an individual approach to healthcare services. The PIM model includes predictive analytics to identify members who are at risk of overmedicalization and/or would benefit from palliative care, specially trained palliative clinicians who provide home-based care supported by palliative assessments and customized workflows embedded in Turn-Key’s platform. Members receive support for advanced care planning (ACP) and an evidence-based process to document and communicate their goals of care. The PIM team also develop individualized palliative care plans to coordinate services with the MAO and the member’s health care team, address symptoms and other medical care needs, social determinates of health, and the needs of caregivers. This approach enables better care coordination, enhances the patient experience and improves outcomes.
Turn-Key has proven success in assisting MAOs in the development and strategy around the access and delivery of palliative care services for beneficiaries in both urban and rural areas. Our model design is flexible to allow for collaboration and coordination with existing MAO programs and the needs of special beneficiary populations. We have demonstrated success in convening partnerships for care transition process with participating MAOs. We work with in-network hospices and outside hospice providers to provide transitional and concurrent care to address patient needs that related to their terminal condition and serious illness.
Turn-Key Health provides data analytics for MAO and provider performance across the Model on multiple quality domains: (i) Beneficiary Identification and Enrollment for Palliative Care, (ii) Advanced Care Planning and Goals of Care Experience; (iii) Enrollee and Caregiver Experience; (iii) Bi-directional Referrals and Communication of Need across the continuum to Address Beneficiaries’ Social Determinants of Health (iv) Care Coordination for Serious Illness and at End of Life; and (v) Palliative Care Quality, Hospice Election and Utilization.
TKH resources boost MAO capabilities to address six key requirements for the CMMI Hospice Carve-In:
- Palliative care resources targeted to any appropriate sub-population(s)
- Care coordinated for enrollees, including how providers will develop an individualized plan of care inclusive of all relevant services and providers
- Continuing care provided to enrollees to meet their needs as their illness advances and as enrollees’ needs change based on participating MAOs’ providers’ continuing care assessments
- Advance care planning offered through the Wellness and Healthcare Planning (WHP) requirement of the model
- Medical, counseling and social services made available as clinically necessary and appropriate
- A seamless transition from palliative care to hospice services provided for beneficiaries who wish to elect hospice
“TKH is stepping up with the programs and expertise to support MAOs that seek participation in the VBID Model,” says Myers. “Our solution takes a proactive approach across entire populations to improve the value of care provided, reduce barriers to high value treatments and improve outcomes. This includes helping MAOs to meet goals that impact cost and quality of care for enrollees as they relate to the hospice benefit, addressing the need to provide palliative care services to members as part of the RFA and fostering partnerships between MAOs and hospice providers.”
Myers adds, “TKH is serving as a care coordination and care continuum bridge between hospices and MA plans, organizations that have never coordinated with each other. As a leading authority in this new healthcare era, we offer in-depth knowledge into vetting hospices and identifying effective partners for optimal VBID strategies.”
About Turn-Key Health
Turn-Key Health serves health plans, provider organizations and their members who are experiencing a serious or advanced illness. Its Palliative Illness Management™ (PIM™) model introduces a new, innovative option to improve care quality, address costs and reduce burdens associated with life-limiting illnesses.