Breaking down the payment barriers that impede access to palliative care will take building up a reimbursement structure that more narrowly defines service scope and sets specific parameters for quality. The nation’s fragmented payment structures for palliative care reimbursement create opportunities for regulators to examine the facets of these different models across varied geographic areas […]
Strains on reimbursement, referrals and staffing represent the biggest obstacles to palliative care providers’ viability and growth. It takes time to build up the payment, referral and workforce resources needed to support a sustainable palliative care program, according to Dr. Stephen Goldfine, chief medical officer at Samaritan Healthcare & Hospice. The New Jersey-based nonprofit offers […]
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 […]
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 […]
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 […]
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 […]
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