The Latest on Viruses

National Institute for Health Care Management (NIHCM)

As COVID-19 hospitalizations are declining, many hospitals are updating the traditional hospital design model to better accommodate the next pandemic. Some familiar viruses, such as influenza, have returned in unexpected ways while other viruses, including monkeypox and enterovirus, have become more prevalent. 

• Influenza: With COVID-19 precautions continuing to weaken and fewer individuals immunized against influenza, health officials are warning that this fall and winter may be an exceptionally severe flu season and that cases may begin to rise earlier than usual. The projected rise in flu and COVID-19 cases this winter could result in the long-feared "twindemic."

• Poliovirus: The US was recently designated as a country where circulating vaccine-derived poliovirus has been reported, joining a list with 30 other outbreak countries. 

• Monkeypox Cases: The US reported almost two-fifths of the world’s monkeypox cases. While new cases and serious complications are still occurring, transmission in the US appears to be slowing down. The CDC recommends that the monkeypox antiviral be reserved only for people at high risk for severe disease.

• Perception of Monkeypox: Awareness of monkeypox surged over the summer in the US and public health experts continue to warn about stigmatizing monkeypox messaging as was the case during the HIV/AIDS epidemic. Increased awareness of monkeypox has also been accompanied by increased scrutiny for many individuals with skin conditions. For those that have contracted the lesion-causing virus, it continues to impact both physical and mental health.

• EV-D68 in Children: In September, the CDC issued a health advisory about the nationwide increase in pediatric hospitalizations with severe respiratory illness who also tested positive for rhinovirus or enterovirus EV-D68. In rare cases, this virus can cause polio-like symptoms in children.

Hospice VBID Model to Expand in 2023

HomeCare via NAHC

WASHINGTON, D.C. (October 4, 2022)—On Sept. 29, 2022, the Centers for Medicare & Medicaid Services (CMS) released the list of Medicare Advantage (MA) plans that will participate in the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model during Calendar Year (CY) 2023, including those that will participate in the MA VBID Hospice Benefit Component (an offshoot of the larger VBID model which began operation in January 2021).

For CY 2023, 15 plans are participating in the Hospice Benefit Component (two more than in 2022). These 15 organizations will test the inclusion of the Part A hospice benefit in MA benefits through 119 plan benefit packages (PBPs). The estimated number of hospice enrollees who will be part of the model starting in 2023 is not yet known; during CY 2022 CMS estimated that approximately 20,000 hospice enrollees would be part of the model.

While the VBID Hospice Benefit Component will be offered in 25 states and territories during CY2023 (up from 22 states and territories in CY 2022), no single plan will offer hospice state-wide. Two plans that participated in 2022 will no longer be participating in 2023—AvMed (which operated in Florida) and Intermountain Health Care (which operated in select counties of Idaho and Utah). The VBID Hospice Component will be offered by two plans in areas of six states and territories (California, New York, Ohio, Oregon, Pennsylvania and Puerto Rico).

If you are a hospice provider and the VBID Hospice Benefit Component is offered in your state and you are interested in determining whether it will be offered in your service area, CMS has posted a link on the VBID Page titled, “CY 2023 Hospice Benefit Component Model Participant Service Area and Contact Information”. This Excel spreadsheet contains information related to the states, zip codes and counties where the various PBPs will be operating.

Open Enrollment Starts 10/15. Are You Ready for Open Enrollment? Prepare by Previewing 2023 Health and Drug Plans Now.

Medicare Open Enrollment runs from October 15 to December 7, 2022. During this time, people eligible for Medicare can compare 2023 coverage options on Medicare.gov. Medicare.gov provides clear, easy-to-use information, as well as an updated Medicare Plan Finder, to allow people to compare options for health and drug coverage, which may change from year to year.

Medicare Plan Finder was updated with the 2023 Medicare health and prescription drug plan information on Saturday, October 1, 2022 to allow people to begin previewing health and drug plans before the enrollment period opens on October 15. 1-800-MEDICARE is also available 24 hours a day, seven days a week to provide help in English and Spanish as well as language support in over 200 languages. People who want to keep their current Medicare coverage do not need to re-enroll.

To view options for health and drug coverage, please visit the Medicare Plan Finder on Medicare.gov.

NHPCO Releases COVID-19 Hospice 1135 Waiver Easy Reference Guide

NHPCO has prepared a summary of COVID-19 Hospice 1135 Waivers, their provisions, and their expiration dates as an easy reference. The next 90-day extension of the COVID-19 Public Health Emergency must be announced by October 13, 2022. NHPCO will share further information following this announcement.