Social Determinant Needs Greater Among Medicare Advantage Patients

Hospices gearing up for a Medicare Advantage carve-in demonstration in 2021 may place greater emphasis on addressing social determinants of health, as Medicare Advantage beneficiaries are increasingly affected by a lack of associated services, according to a report from consulting firm Avalere Health. Patients with dual eligibility for Medicare and Medicaid are the most affected, […]

Upswing in Hospice Utilization, Length of Stay

An upward trend in hospice utilization during 2018 brought a record number of patients into hospice for longer periods of time, according to a report from Atlanta-based research firm Excel Health. Hospice utilization among Medicare beneficiaries climbed above 50 percent during 2018, the highest rate since the 1983 inception of the Medicare Hospice Benefit. Meanwhile […]

Hospices Adjust to Encounter Data Under Medicare Advantage Carve-in

When Medicare Advantage begins to cover hospice under the 2021 carve-in, hospices and payers will have a new set of numbers to think about: Encounter data. These detailed records of a patient’s health condition and health care services will likely affect the way hospices participating in Medicare Advantage will be reimbursed, but industry observers have […]

Half of Hospices Unprepared for Regulatory Audit

Fewer than 50% of hospices indicated that they were ready for a federal audit or additional document request, according to a recent survey by Optima Health. As hospices come under increasing regulatory scrutiny, ensuring complete and accurate documentation is a growing concern. “The quality of a hospice provider’s documentation can determine the outcome of a […]

Medicare Service-Intensity Payments Not Improving Quality of Care

Evidence suggests that Medicare’s service intensity add-on (SIA) payment structure for hospices is boosting payments but thus far has failed to improve the quality of care. The US Centers for Medicare & Medicaid Services (CMS) introduced SIA in 2016 to give hospices a greater financial incentive for improving care during the last seven days of […]

Payors Report Substantial Increases in Medicare Advantage Enrollment

Leading U.S. insurance companies have reported a surge in Medicare Advantage membership during the 2019 enrollment period. Humana on Feb. 6 was the latest to report, citing a full year 2019 individual Medicare Advantage membership increase of 375,000 to 400,000 members, up 12% to 13% from 2018. Earlier this week Centene and WellCare also reported […]

Regional Disparities Exist for Hospice Length of Stay

The length of stay for hospice patients in the south and western regions of the United States were higher than those in other regions during the second quarter of 2018. This according to a December report released by PlayMaker Health, a health care sales and marketing software company. In the southern United States, the average […]