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, […]
Two of the largest advocacy groups for the home health and hospice industries are one step closer to joining forces. In a joint announcement on Thursday, the National Association for Home Care & Hospice (NAHC) and the National Hospice and Palliative Care Organization (NHPCO) revealed that their respective boards have signed a non-binding letter of […]
As regulatory agencies crack down on hospice spending, providers can benefit from recognizing the links between revenue cycle management and compliance. Regulatory activity is increasing on multiple fronts. For example, the U.S. Department of Health & Human Services (HHS) Office of the Inspector General (OIG) has launched a nationwide audit of general inpatient hospice services […]
The 2024 final hospice payment rule included a modest payment increase for general inpatient care (GIP) at a time when regulators are zeroing in on increased utilization and longer stays. The U.S. Centers for Medicare & Medicaid Services (CMS) included in the rule a 1.031% increase to hospice GIP services. Daily rates for general inpatient […]
Both innovative opportunities and cost challenges underly quality and health equity components of the U.S. Centers for Medicare & Medicaid Services’ (CMS) recently finalized hospice payment rule. The final rule included some key updates — and raised important questions — in the agency’s planned changes to quality measures and data collection, including those related to […]
Rising regulatory scrutiny around length of stay may be having adverse impacts on health care costs and quality, hospice leaders said in a recent Congressional briefing. Fear of regulatory attention, audits or post-payment reviews related to longer stays could drive some hospice providers to discharge patients who can still benefit from their services, according to […]
The U.S. Centers for Medicare & Medicaid Services (CMS) is giving hospices a 3.1% increase to their per diem payments for 2024, according to a final rule published Friday. That will translate to a $780 million bump to hospice payments next year compared to Fiscal Year 2023, according to CMS. The finalized rule also raises […]
Payers and private equity investors are among the new entrants stepping deeper into the hospice space. This trend has heated up competition and merger and acquisition (M&A) activity, while posing opportunities for strategic growth in an evolving value-based landscape. The hospice industry has seen a swath of new entrants amid record-level transaction volume and soaring […]
A restructuring of the Medicare Hospice Benefit could have impacts on merger and acquisition activity in the industry. Calls for changes to hospice eligibility and length of stay are growing louder among industry stakeholders. A main concern being voiced to the U.S. Centers for Medicare & Medicaid Services (CMS) is that the current six-month prognosis […]
Palliative care lacks a standardized definition within current value-based reimbursement systems, making it difficult to determine the full scope of services for seriously ill patients. Palliative care services are intended to address physical, psychosocial, social and spiritual needs of seriously ill individuals. However, the full breadth of interdisciplinary services involved in palliative care has yet […]
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