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 […]

Hospices Ready Themselves for the Medicare Advantage Carve-In

Though hospices remain in the dark about the inner workings of the forthcoming Medicare Advantage carve-in, some are using their knowledge and experience in working with payers to take the first steps toward implementation. The U.S. Centers for Medicare & Medicaid Services (CMS) earlier this year announced that it would test coverage of hospice care […]

MA Carve-In Could Forego 6-Month Prognosis Rule for Hospice

Medicare Advantage plans would not necessarily be bound by Medicare’s six-month terminal prognosis requirement under a forthcoming hospice carve-in. Medicare Advantage plans are offered by private insurance companies approved by CMS, and include HMO, PPO, and fee-for-service plans among other options. The program represents an integrated care model that is designed to promote coordination of […]

CMS Final Rule Could Lead to More Hospice Audits

The U.S. Centers for Medicare & Medicaid Services (CMS) issued its annual final rule for hospice payments in Fiscal Year 2020, including a payment rebasing that raises rates 2.7% for three higher-acuity levels of care and cuts routine home care by a corresponding 2.7%. With regulatory scrutiny on the rise, some hospice providers are concerned […]