New ACO Primary Flex Model Could Increase Hospice, Palliative Care Access

The Centers for Medicare & Medicaid Innovation (CMMI) has unveiled a new primary care-oriented Accountable Care Organization (ACO) payment model that holds opportunities for hospices.  This demonstration reflects a push by the U.S. Centers for Medicare & Medicaid Services (CMS) to reduce fragmentation in the health care system by strengthening primary care as a hub […]

Frontline Hospice Staff Need to Understand New CMS Survey Methods

In case you missed it, Hospice News has launched a new specialty publication for palliative care professionals. You can subscribe to Palliative Care News here: Subscribe today! Ensuring staff are educated around revisions to hospice survey processes will be key to navigating ongoing regulatory changes in the industry. Revisions to hospice surveys have been in the pipeline […]

CMS to Sunset Hospice VBID in 2024

The U.S. Centers for Medicare & Medicaid Services will end the hospice component of the value-based insurance design model (VBID) as of Dec. 31. Often called the “hospice carve-in,” the program was designed to test coverage of hospice care through Medicare Advantage, in addition to some coverage of palliative care and transitional care. The hospice […]

Lack of Awareness Challenging Palliative Care’s Plight in the Hospice VBID Landscape

A main barrier to palliative care growth in the Medicare Advantage hospice carve-in is a lack of understanding of these services among beneficiaries, as well as inconsistent service delivery. The value-based insurance design (VBID) model is among the payment avenues that allows Medicare Advantage plans to cover palliative care as a supplemental benefit. When the […]

‘Long-Term Business Viability’ a Top Driver of Hospice VBID Participation

Providers see sustainability and expanded service growth as main draws to participating in the Medicare Advantage hospice carve-in. However, these opportunities come alongside administrative and billing challenges, among others. Hospice participation in the value-based insurance design (VBID) model has been slowly increasing over the past two years, a trend anticipated to continue as more providers […]

Caregiver Support a ‘Significant’ Priority in CMMI Models, VBID

Unmet caregiver needs are a top issue to address in developing end-of-life care models encircling the Medicare landscape. Among top priorities in current and future payment models is to improve care for those with serious and terminal illnesses, which includes caregiver support, according to Purva Rawal, chief strategy officer for the Center for Medicare and […]

CMS: Concurrent Hospice Care Improves Quality, Reduces Costs

Allowing patients to receive concurrent hospice and curative care reduces health care costs and improves quality. The U.S. Centers for Medicare & Medicaid Services (CMS) has released its fifth and final report on the Medicare Care Choices Model (MCCM), which studied the effects of allowing individuals to receive hospice care without foregoing other treatments.  The […]

[UPDATED] CMS Finalizes Hospice Special Focus Program, 36-Month Rule

The U.S. Centers for Medicare & Medicaid Services (CMS) has finalized its 2024 home health rule, including the implementation of a hospice Special Focus Program (SFP). The rule also finalizes the proposed “36-month”rule for hospice providers. The requirement mirrors a regulation that has existed for several years for home health agencies. The final rule forbids […]

Building a ‘More Person-Centered Health System’: Palliative Care in Value-Based Models

Forthcoming Medicare payment models will likely focus on disease-specific programs that bear similarities to palliative care. Emerging reimbursement demonstrations have placed a stronger emphasis on addressing a more diverse group of patients with high levels of care needs and complex health trajectories. Examples include the Value-Based Insurance Design (VBID) demonstration, the Accountable Care Organization Realizing […]

How CMS’ 2024 Risk Adjustment Rules May Affect Palliative Care Companies

Depending on how stakeholders play their cards, the U.S. Centers for Medicare & Medicaid Services’ (CMS) updated risk adjustment policy could lead to tightened belts — or a golden opportunity — for palliative care providers in Medicare Advantage. Much of the palliative care delivered to U.S. patients is now reimbursed through risk-based models like Medicare […]