Rarely does the Centers for Medicare & Medicaid Services succeed in shocking us. The large bureaucracy, which is not exactly known for its nimbleness, managed to do so this week when it abruptly cancelled the hospice component of the Value-Based Insurance Design Model.

In what one hospice consulting firm called “a stunning development,” CMS determined that the program, which is a slice of the VBID demo, was not working and would end it at the end of the year. It cited feedback about operational challenges and flagging participation among Medicare Advantage Organizations as reasons for sunsetting the program.

For those who wonder whether advocacy works, I’d chalk this up to a win for providers — and a clear example of advocacy in action. As the National Hospice and Palliative Care Organization noted in a press release following the CMS news Monday, the decision to terminate the program followed over five years of “of advocacy and engagement by NHPCO, including meetings and official filings with CMS’ VBID team in February 2024, August 2022, August 2021 and Spring 2020.”

Other hospice associations including the National Association for Home Care & Hospice and LeadingAge also can take credit for helping to bring down the so-called hospice carve-in of the VBID model.

No question the program was rife with problems. From payment inadequacy to administrative burdens, the hospice VBID model seemed to pose more trouble to hospice providers than it was worth. Those who understand hospice view the program with a respect approaching reverence, pointing out its unique interdisciplinary characteristics and sacred task in providing end-of-life care.

MA, with its tendency to impose cost-cutting measures, at least in this first iteration, did not seem to match up as an ideal partner. Still, CMS should not shy away from trying more innovative hospice models. The hospice VBID carve-in was built on the promise that MAOs would offer tangential services such as palliative care, concurrent care and supplemental benefits. While this did not come to fruition, in its statement, NHPCO actually nudged CMS to keep experimenting, referring to the success of the Medicare Care Choices Model, an end-of-life care model.

After all, just because one innovative hospice model flopped does not mean it did not move the needle or contribute to a knowledge base. CMS should receive praise for trying it — and also for having the wisdom to know when to scrap it.

Liza Berger is editor of McKnight’s Home Care. Email her at [email protected].