Lawmakers are bringing greater attention to a pair of bipartisan Senate bills designed to improve access to community-based palliative and hospice care services.
Stakeholders in a recent Senate Comprehensive Care Caucus briefing on Thursday focused on two pieces of legislation aiming to integrate more innovative, home-based and person-centered care models for serious and terminally ill patients. Both the Expanding Access to Palliative Care Act and the Improving Access to Transfusion Care for Hospice Patients Act are designed to address access, reimbursement, workforce and care delivery approaches.
If enacted, the bills would allow the Center for Medicare and Medicaid Innovation (CMMI) to test new payment models intended to reduce barriers to timely, coordinated care. The bipartisan briefing was hosted by Senators Jacky Rosen (D-Nev.), Deb Fischer (R-Neb.), Tammy Baldwin (D-Wisc.) and John Barrasso (R-Wy.), who underscored growing demand amid persisting challenges.
“Having stepped away from my career to take care of my aging parents and in-laws, I know just how important it is that families have access to high-quality palliative and hospice care for their loved ones,” Rosen said in a statement. “I’m glad to work across party lines to introduce these bipartisan bills and help make palliative care more accessible and available.”
The reintroduced Expanding Access to Palliative Care Act, unveiled in 2021, proposes to test a payment model that would provide community-based palliative care and care coordination for high-risk Medicare beneficiaries. The proposed model would allow interdisciplinary teams to provide coordinated palliative care 24/7 to Medicare beneficiaries with serious illnesses or injuries, according to the bill’s language.
If enacted, the legislation would require CMMI to establish ways to compare patient outcomes with nonparticipants, including duration of hospice stays, among other measures. The proposed payment demonstration would replace the Medicare Care Choices Model, which sunsetted in 2021.
The legislation could move the needle forward toward stronger patient and family caregiver support, according to Dr. Steve Landers, CEO for the National Alliance for Care at Home.
“The reintroduction of the Expanding Access to Palliative Care Act is a meaningful step toward ensuring patients and families can receive high-quality care when and where they need it,” Landers said in a statement shared with Palliative Care News. “Building on the success of the Medicare Care Choices Model, we believe a concurrent care approach within hospice should be developed for national dissemination.”
Meanwhile, Sens. Rosen, Barrasso and Baldwin also re-introduced the Improving Access to Transfusion Care for Hospice Patients Act, which stalled during Senate review in 2023. If enacted, the legislation would require CMMI to design a payment demonstration model featuring coverage of blood transfusion services within the Medicare Hospice Benefit. It proposes to allow providers to bill Medicare separately for transfusion services in addition to the daily hospice per diem.
Patients with blood-related conditions historically have low rates of palliative care and hospice utilization. A lack of home-based blood transfusion access serves as a main barrier to increasing utilization, according to research published in the Journal of Pain and Symptom Management.
Stakeholders and providers have “long-championed” a payment model that would close gaps of care for seriously ill individuals and their caregivers, according to the American Academy of Hospice and Palliative Medicine (AAHPM). The reintroduced bills could provide better reimbursement to support palliative care programs of all sizes, structures and across diverse geographic regions, according to AAHPM Chief Medical Officer Dr. Kristina Newport.
“We are proud to endorse the bipartisan Expanding Access to Palliative Care Act, which proposes testing a community-based palliative care model,” Newport said in the Senate briefing. “We commend Senators Rosen, Barrasso, Baldwin and Fischer — co-chairs of the Senate Comprehensive Care Caucus — for their leadership in introducing this vital legislation and their dedication to expanding access to palliative care. This effort will help align treatments with patients’ unique goals and preferences, enabling more care to be delivered in the settings where patients live.”
Reintroducing both the transfusion and palliative care bills could provide improved payment incentives, said Dr. Robert Parker, chief clinical officer of Kindful Health, in the Alliance statement. Lagging palliative care payment has been a persisting challenge impeding the ability to grow and sustain programs.
Stronger reimbursement can help pave the way for better accessibility and quality of life among medically fragile patients and their families, Parker indicated.
“Palliative care centers the patient, their goals, their values and their comfort,” Parker said in the Alliance statement shared with Palliative Care News. “It can be provided at any stage of a serious illness, but its impact is especially profound at the end of life, when it allows patients to focus on what matters most. Sometimes, the most meaningful intervention isn’t another procedure or a hospital stay in an unfamiliar place; it’s a thoughtful conversation, a personalized care plan and a strong support system. Expanding access to community-based palliative care equips clinicians to meet people where they are, with compassion, clarity and respect. That’s the kind of care everyone deserves.”
