MedPAC: No 2021 Pay Raise for Hospice, Calls for Payment Cap Cut

The Medicare Payment Advisory Commission (MedPAC) at its January meeting unanimously voted to recommend to Congress that no Medicare payment increases for hospices be implemented in Fiscal Year 2021, as well as a 20% reduction in the aggregate payment cap. These proposals are not a done deal. Congress would have to accept these recommendations before […]

Medicare Advantage Plans Offering Palliative Care Quadrupled for 2020

A rising number of Medicare Advantage plans are offering home-based palliative care as a supplemental benefit. This year, 61 plans offer a palliative care benefit compared to 15 during 2019, a new Duke University report indicates. Hospices provide about 50% of home-based palliative care in the United States according to the Center to Advance Palliative […]

Former Anthem COO Brad Smith Tapped to Lead CMMI

Brad Smith, most recently chief operating officer of Anthem’s Diversified Business Group, will become the new director for the Center for Medicare & Medicaid Innovation (CMMI). Smith is the co-founder and former CEO of community-based palliative care provider Aspire Health, a potential signal that palliative care could become a CMMI priority.  CMMI is the component […]

CMS Accepting Applications for Medicare Advantage Hospice Carve-In

The U.S. Centers for Medicare & Medicaid Services (CMS) has issued a Request For Applications (RFAs) for Medicare Advantage plans to offer the Medicare Hospice benefit to their enrollees in the Medicare Advantage Value Based Insurance Design (VBID) Model. The long awaited and much debated Medicare Advantage hospice carve-in demonstration is set to begin Jan. […]

Hospice Advocates Push for CMS to Delay Medicare Advantage Carve-In

The National Hospice and Palliative Care Association (NHPCO) has called on the U.S. Centers for Medicare & Medicaid Services (CMS) to delay the start of the Medicare Advantage hospice carve-in demonstration beyond its current expected state date of January 2021. CMS earlier this year announced that it would test coverage of hospice care through Medicare […]

California’s Palliative Care Rule a Potential Foundation for National Model

As stakeholders call for a dedicated Medicare benefit for the growing field of community-based palliative care, one government-led payment model is going strong in California through Medi-Cal, the state’s Medicaid program. Effective Jan. 2018, the state’s Senate Bill 1004 (SB 1004), requires Medi-Cal managed care plans to cover palliative care for patients suffering from cancer, […]

MEDPAC Calls for 20% Cut in Hospice Payment Cap

The Medicare Payment Advisory Commission (MEDPAC) intends to recommend a 20% reduction to hospice aggregate payment cap, according to a presentation given at the commission’s most recent meeting. This echoes similar recommendations from the commission in prior years. Though MEDPAC has urged lawmakers to pursue these cuts several years running, Congress has yet to slash […]

Hospices Can Now Apply to Primary Care First Direct Contracting Models

Hospice and palliative care providers may now apply to participate in the direct contracting payment models that exist under the auspices of the U.S. Centers for Medicare & Medicaid Services’ (CMS) Primary Care First Initiative. The direct contracting options include three voluntary payment models that are designed to help CMS and health care providers reduce […]

OIG: Hospice Nurses Failed to Assess Aides in 99,000 Cases

Hospice nurses did not perform a home visit to assess the quality of care provided by hospice aides in an estimated 99,000 instances during 2016, according to a new report from the U.S. Department of Health & Human Services Office of the Inspector General (OIG). In another 5,000 cases the visits were not documented properly.  […]

For-Profit Hospices See More Live Discharges than Nonprofits

Live discharges from hospice, which often attract the attention of regulators, are more common among for-profit hospices than nonprofits, the Government Accountability Office (GAO) has found. For-profits were also less likely to visit patients during the last three days of life. GAO reported that in 2017 more than 22% of Medicare beneficiaries who enrolled in […]