A new study showed how the Centers for Medicare and Medicaid Services (CMS) Medicare Care Choices Model (MCCM) provided benefits in terms of end-of-life care for older adults and cost savings.
The model let eligible Medicare beneficiaries receive conventional treatment for terminal conditions along with supportive and palliative care from participating hospice providers. People in the model program could continue getting Medicare fee-for-service coverage to treat their terminal conditions — which wouldn’t have been allowed if they chose to use Medicare’s hospice benefit.
A new study in Health Affairs that was published Monday used claims data to estimate the differences in average outcomes from enrollment to death between people in the program who died. They matched people in the program with those using the traditional Medicare benefit.
Some of the findings: People who participated in a trial of the model were 15 percentage points less likely to receive an aggressive life-prolonging treatment within their last 30 days of life. The participants got to spend more than five more days at home compared to people not enrolled in the model program. MCCM lowered net Medicare expenditures by 13% and decreased inpatient admissions by 26%. The model also reduced outpatient emergency department visits by 12%, while hospice use went up by 18 percentage points. People in the model program were less likely to die in an inpatient facility by 11.4 percentage points compared to people in the traditional Medicare program.
People in the model program had lower Medicare spending than people in the traditional program, on average. The average Medicare Parts A and B spending per person was $46,810 for model participants compared to $56,385 for traditional beneficiaries — a 17% difference.
Even though CMS didn’t expand the model, the authors said their results show that the MCCM model is promising in terms of possibly transforming how people receive end-of-life care.
