Evaluation of the Medicare Care Choices Model: Fifth and Final Annual Evaluation Report

The Centers for Medicare & Medicaid Services (CMS) launched the Medicare Care Choices Model (MCCM) in January 2016 and administered it for six years, through December 2021. The model tested whether offering eligible beneficiaries the option to receive supportive and palliative care services through hospice providers without forgoing payment for the treatment of their terminal conditions (which is required to enroll in the Medicare hospice benefit) improved beneficiaries’ quality of life and care, increased their satisfaction, and reduced Medicare expenditures. CMS was also interested in whether MCCM led to earlier election of the Medicare hospice benefit. This fifth and final evaluation report uses mixed methods to evaluate model implementation, estimate the impact of MCCM on beneficiaries’ outcomes, and identify the facility characteristics and implementation factors associated with successful outcomes.

MCCM provided access to supportive and palliative care services not normally covered through Medicare Part A or B. By providing high-quality services and increasing use of Medicare’s hospice benefit, participating hospices achieved MCCM’s goals of improving enrollees’ quality of life and care, attaining high satisfaction, and reducing enrollees’ Medicare expenditures and acute care service use for a limited group of enrolled beneficiaries. The model’s effects were widespread, although larger for certain beneficiary subgroups. These findings point to the importance of transforming care delivery to improve terminally ill beneficiaries’ and caregivers’ experiences and reduce costly usage of services that might be inconsistent with beneficiaries’ preferences. Although there are concerns about the generalizability of these findings, MCCM is a promising approach to increasing hospice use.

Findings at a glance.

Learn more about MCCM.