Medicare advantage and telehealth are key hospice policy priorities for the National Alliance for Care at Home.

On the home health front, the organization is also embroiled in efforts to stave off proposed payment and Medicaid cuts. The Alliance came into being last year with the merger between the National Hospice and Palliative Care Organization and the National Association for Home Care & Hospice.

Hospice News spoke with Alliance CEO Dr. Steven Landers about how the two legacy organizations are integrating, the hospice public policy landscape and how providers can get involved at a grass roots level.

Regarding the merger, would you say that the integration of the two legacy organizations is complete at this point, or is it still a work in progress still?

I would say it’s like 90% or more complete. We have one board that’s working well together and on one team, our staff know their roles and are working hard to support the members and the mission. 

There are some small things, documentation, various accounts and technical things that need to be cleaned up, but by and large the integration is complete.

Would you say that the Alliance is more than the sum of its parts? And if so, in what ways?

We want to have this kind of 1-plus-1-equals-3 type of opportunity. And some of the things that I’ve seen that are encouraging in that regard have been on the advocacy front. So, we brought together advocacy talent, real experts. Our team of policy and regulatory leaders is second to none, and they’re working well together. 

We were also able to bring in some additional new people that weren’t part of the legacy organizations, and they’re really doing high quality work at a level that I don’t think either of the legacy organizations would have been able to do on their own. That’s a real positive.

We’re seeing a lot of amplification in our media and social media work. We’ve had some grassroots social media posts and things that are getting hundreds of thousands of impressions, and our outreach on media and social media is getting more views than ever before.

I see some of the business partners and technology companies, it seems like they’re getting a bigger audience, and that they’re getting some additional eyeballs on their products and services.

Are you aware of any discussions taking place in the U.S. Department of Health & Human Services or elsewhere in the executive branch about including hospice in Medicare Advantage. Or are those conversations happening more on the legislative side?

I don’t have any concrete examples of an administrative conversation on that front. I can’t say that that means it hasn’t happened. But it happens more in the legislative realm than administrative.

What are you hearing from your members about the Hospice Outcomes and Patient Evaluation (HOPE) tool implementation and how that’s progressing?

There have been some situations where data submissions have been rejected inappropriately, and it’s caused some frustration. We’ve been collecting that information and helping with feedback to the government.

However, by and large it is going smoothly in terms of the data collection. We are continuing to monitor that. And if some of those issues become more generalized or prominent we’ll push on [the U.S. Centers for Medicare & Medicaid Services (CMS)] for some degree of delayed enforcement of any penalties or consequences. But you know, that’s been the flavor of the feedback thus far.

What are the Alliance’s top policy priorities when it comes to hospice?

Broadly speaking, our policy partners are around expanded access to care and preserving access to care, eliminating waste, fraud and abuse in hospice, and promoting quality care and helping to grow the workforce. So, depending on the legislative and the policy climate, certain things have become more focused at certain times.

The dire implications of a Medicare Advantage taking over hospice that has been a very high priority in terms of our time, energy and resources in recent months. We want to make sure this Congress doesn’t make that type of a mistake for our national treasure hospice program.

We also, from an access standpoint, have been very vocal on the telehealth flexibilities related to face-to-face certification, and are incredibly disappointed, and, quite frankly, angry that this shutdown has allowed for the lapse of those flexibilities because it’s an access issue. We’re hearing about examples of people not being able to get care because of this.

We have pushed the administration to use enforcement discretion during this period. However, we still would not recommend that any provider continue to use telehealth for face-to-face, because it could be construed as inappropriate billing for services.

What are some ways that hospice providers can advocate for themselves with their policymakers at the state or federal levels?

That’s one of the top goals for the Alliance, to help facilitate and support that engagement, because it’s sometimes daunting and not easy as an individual or independent organization to get involved in policy and advocacy.

They can get involved through things like our advocacy week activities, where we coordinate [Capitol] Hill visits, our legislative action center and grassroots platform, where there’s very straightforward step-by-step instructions of how to send communications to your members of Congress or to the administration.

I think these things become much more evident when there is a heated issue before us, such as next year when we get into the rulemaking season for hospice, or if there’s any new policy that’s brought forward. I think, just in any way, shape or form, trying to know or have some relationship with your state and local elected officials is critical. It’s good to build those relationships where there’s not a crisis or a hard ask, and there’s just an effort at relationship building.

Taking a member of Congress or another elected official out on a home visit or to a hospice residential care facility to just help them learn about the work that’s being done is one of those valuable things.