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 […]
U.S. Centers for Medicare & Medicaid Services
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 […]
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 […]
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 […]
Implementation of the Medicare Advantage hospice carve-in has been challenging for both payers and providers, though a recent analysis indicates that it may get easier over time. The U.S Centers for Medicare & Medicaid Services (CMS) commissioned the RAND Corp. to conduct the analysis of the program, formally called the hospice component of the value-based […]
The U.S. Centers for Medicare & Medicaid Services (CMS) has been gradually implementing changes to the hospice survey process and enforcement remedies, including civil monetary penalties in some instances. Congress approved the survey changes and enforcement actions through the Consolidated Appropriations Act of 2021, which incorporated language from the Helping Our Senior Population in Comfort […]
Health plan participation in the hospice component of the value-based insurance design model (VBID) will fall in 2024. For calendar year 2024, 13 Medicare Advantage Organizations (MAOs) will participate in the program’s hospice component, providing coverage through 78 health plans in 19 states. In 2023, 15 MAOs participated in hospice VBID, including 119 health plans […]
The U.S. Centers for Medicare & Medicaid Services (CMS) is on the right track with several new rules designed to improve hospice program integrity, but some could use some fine-tuning, according to the National Hospice and Palliative Care Organization (NHPCO). The hospice advocacy group today issued public comments on CMS’s proposed home health rule for […]
Three principles are guiding the U.S. Centers for Medicare & Medicaid Services’ (CMS) 2024 updates to the Accountable Care Organization Realizing Equity, Access and Community Health (ACO REACH) model: care coordination, managing health equity-related risks and social determinants of health. Among a number of new requirements, the agency will also require participating organizations to develop […]
The U.S. Centers for Medicare & Medicaid Services (CMS) is considering administrative action against 400 hospices, which could include revocation of their Medicare certification. The agency has been mobilizing against hospice fraud this year. In addition to new regulations and updated survey processes, CMS has been conducting unannounced onsite visits. To date, CMS personnel have […]