Hospice care provides services and support to individuals with terminal illnesses and their families, with a focus on comfort and quality of life. Although hospice has been studied extensively in Medicare, considerably less is known about Medicaid’s role in financing and delivering hospice care, including the populations served, state policy choices, utilization and spending, and the interaction between Medicaid and Medicare for dually eligible beneficiaries. Medicaid also plays a distinct role in hospice care, including allowing eligible children to receive hospice services without forgoing curative treatment for their terminal conditions and financing nursing facility room and board for hospice enrollees residing in those facilities. MACPAC has not previously conducted a comprehensive examination of the Medicaid hospice benefit.
In this session, MACPAC staff presented an overview of Medicaid hospice care, including the federal regulatory framework, eligibility and enrollment, covered services and care delivery, provider participation, payment and spending in Medicaid and the State Children’s Health Insurance Program (CHIP), and oversight and quality. The presentation highlighted differences between Medicaid and Medicare hospice coverage, as well as areas of state flexibility in administering the benefit. This session established a foundational understanding of the Medicaid hospice benefit and provided an opportunity for Commissioners to identify areas of interest and potential policy challenges to inform the Commission’s ongoing work.