[UPDATED] New Hospices Cropping Up in Fraud Hotbeds Amid Ongoing Program Integrity Push

A new report is casting doubt on the heightened regulatory efforts seeking to curb fraud, waste and abuse from hospice agencies in select states. The questionable success of those oversight efforts is best reflected in the fraud hotbed of California, which continues to see a swarm of new hospices emerging and receiving federal funding, despite […]

Hospices’ Unanswered Questions: Filling the Research Gaps

Research around hospice care has come a long way. But data gaps exist when it comes to expanding understanding of some aspects of end-of-life care delivery. A range of researchers has amassed a growing base of data on hospice, with some common themes tied to quality outcomes, costs, length of stay and general inpatient care. […]

2023’s Most Impactful Hospice Regulatory Moves

Program integrity issues that have heated up in the hospice space during the past five years reached a boiling point in 2023. Hospice providers have seen an array of increased regulatory oversight in 2023. That momentum has been fueled by two main concerns among regulators — risks of patient safety and evidence of malfeasance in […]

Top Lawmakers for Hospices to Watch in 2024

Hospice providers will be looking to Congress in 2024 to address issues related to program integrity, quality improvement and industry-wide workforce pressures. As legislative efforts develop, hospices may want to focus their attention on a few key legislators. Though hospice is largely a community-based business, actions on the national level can have a huge impact. […]

Hospice Industry Groups Lobbying Congress to Change CMS’ Special Focus Program

The four largest hospice industry organizations are urging congressional lawmakers to mandate changes to the Special Focus Program (SFP) currently set to begin in 2024. The U.S. Centers for Medicare & Medicaid Services (CMS) last week issued its 2024 home health payment rule, which contained several hospice provisions. Among them was the Jan. 1 implementation […]

Hospice Industry Groups: CMS Must Retool Proposed Special Focus Program to Ensure Accuracy, Fairness

The U.S. Centers for Medicare & Medicaid Services’ (CMS) proposed 2024 home health rule includes plans to implement a hospice Special Focus Program, but some stakeholders contend that some aspects are flawed. Three of the largest hospice, home health and senior services advocacy groups submitted comments to CMS on the proposed rule — LeadingAge, the […]

How Emerging Hospice Regulations Could Impact Providers

Increased hospice oversight aimed at curbing fraud in the industry could come with a mixed bag of financial and operational impacts for providers. The U.S. Centers for Medicare & Medicaid Services (CMS) has honed in on hospice program integrity, rolling out a swath of new measures to reduce fraud, waste and abuse in the space. […]

VBID Hospices Operate in a ‘Teeter-Totter’ Landscape

Evolving network adequacy requirements within the value-based insurance design (VBID) model demonstration have some hospices concerned that Medicare Advantage payers may have narrowed views on reimbursement and access.  This year the U.S. Centers for Medicare & Medicaid Services (CMS) introduced changes to the VBID model that included modifications to network adequacy requirements for Medicare Advantage […]

Quality Data, Cost Control: Hospices’ ‘True North’ in Medicare Advantage

Medicare Advantage plans are connecting the dots between quality scores and care delivery costs. When choosing a hospice to work with, payers in the Medicare Advantage (MA) realm zero in on providers’ quality scores and its patient population growth potential, according to Frontpoint Healthcare CEO Brent Korte. Consequently, those are key data pieces for hospices […]

How Palliative Care Generates Savings, Boosts Hospice Utilization

Past payment model demonstrations that included community-based palliative care offer a window into how these services could generate cost savings and improved quality. Among those demos is the Medicare Care Choices Model (MCCM), which ran between 2016 and 2021. The model illustrated palliative care’s potential for driving down health care costs for seriously ill patients, […]