CMS Primary Cares to Include New Track for High-Cost Patients

The U.S. Centers for Medicare & Medicaid Services (CMS) is planning to implement a payment model within its Primary Cares Initiative that would address the needs of patients associated with the highest health care costs. Few details about the model are available as the agency has not yet publicly announced the program. The program would […]

Hospice Industry Seeks Solutions to Issues in OIG Reports

Debate continues about how the hospice industry, as well as regulators, should respond to the reports on hospice care issued in July by the U.S. Department of Health and Human Services Office of the Inspector General (OIG) that included recommendations to the U.S. Centers for Medicare & Medicaid Services (CMS) on changing their processes for […]

CMMI Strategy Officer: Private Sector Will Emulate Primary Care First

A key goal of the Center for Medicare & Medicaid Innovation’s (CMMI) Primary Care First payment models is to create a “spectrum of models” to support patients suffering from serious illness from diagnosis through end of life. In addition to these government programs, the agency foresees that health care providers — including hospice and palliative care […]

Health Care Groups Urge Lawmakers to Relax Prior Authorization Rules

A group of 370 health care industry groups — including the American Academy of Hospice & Palliative Medicine, the American Medical Association and National Association of Social Workers — have signed a letter sent to Congress encouraging legislators to pass the Improving Seniors’ Timely Access to Care Act of 2019. If enacted, the legislation would […]

MedPAC Mulls 20% Cut to Hospice Payment Cap

The Medicare Payment Advisory Commission (MedPAC) is considering a recommendation that Congress reduce by 20% the annual aggregate payment cap for hospice care. Also under consideration is a potential recommendation to adjust the cap according to the wage index for different geographic regions to reflect the varying costs of care in different parts of the […]

Trump Seeks to Align Fee-for-Service Payment with Medicare Advantage Rates

As hospices await implementation of a Medicare Advantage hospice carve-in demonstration, President Trump has signed an executive order that seeks to bring Medicare fee-for-service rates in line with Medicare Advantage payments, among other provisions. The executive order is part of an effort to counter Medicare-For-All policies put forth by Democratic presidential candidates, which were the […]

Hospice Legislation Comes Closer to House Vote

The number of cosponsors for the Palliative Care and Hospice Education and Training Act has reached the 290 the bill needs to come to a vote in the U.S. House of Representatives. A second bill, the Rural Access to Hospice Act, will likely be folded into a larger yet-to-be-determined piece of legislation. If enacted, PCHETA […]

CMS Rule: Hospitals to Inform Patients of Post-Acute Quality Data

The U.S. Centers for Medicare & Medicaid Services (CMS) has published a final rule on hospital discharge planning that underscores the need for hospices to leverage their publicly reported quality metrics as a competitive advantage. The new rule requires hospitals to inform patients about their choices related to post-acute care providers including those organizations’ performance […]

Modernizing the Medicare Hospice Benefit

The Medicare Hospice Benefit is aging along with the patients it is designed to serve. Nearly 40 years since its inception, it may be time to re-examine aspects of the program in light of the ways that patient populations and the larger health care system have changed.  The hospice benefit was established as a demonstration […]

On the Horizon: Value-Based Hospice Care

The U.S. Centers for Medicare & Medicaid Services (CMS) is experimenting with the concept of including hospice in value-based payment models, as evidenced by the forthcoming Medicare Advantage carve-in, the Medicare Care Choices model and the Primary Care First initiative. While the agency has no immediate plans to transform the Medicare Hospice Benefit’s per diem […]