Evaluation of the Medicare Care Choices Model: Annual Report 4
The Medicare Care Choices Model (MCCM) tested whether offering eligible beneficiaries the option to receive supportive services at the end of life without forgoing payment for treatment of their terminal conditions (which is required to enroll in the Medicare hospice benefit) improved the quality of care, increased beneficiaries’ satisfaction, and reduced Medicare expenditures. Eligible beneficiaries were referred to participating hospices and could voluntarily enroll in the model over a five-and-a-half-year period from January 1, 2016, to June 30, 2021. The model ended December 31, 2021.
Outcomes generally aligned with the expectations of the model. Specifically, MCCM beneficiaries were more likely to enroll in the Medicare hospice benefit than matched comparison beneficiaries, less likely to use hospital services and other health care services, and more likely to receive better-quality end-of-life care in the period between enrollment in MCCM and death. Decreased use of resource-intensive services, driven by earlier enrollment in the hospice benefit, resulted in lower Medicare expenditures. These findings might not generalize to other settings, however, given the small number of hospices that participated in MCCM and the small percentage of eligible beneficiaries that enrolled.