The U.S Centers for Medicare & Medicaid Services (CMS) is implementing a “period of enhanced oversight” for new hospices in California, Nevada, Arizona and Texas. A key component of the enhanced oversight includes a medical review of claims before a Medicare Administrative Contractor (MAC) will pay them. These actions follow reports of potentially unethical or […]
The Kidney Care Choices (KCC) model is among the reimbursement streams that is widening payment for palliative care services. It could also help improve utilization of serious illness and end-of-life care. Patients with chronic kidney disease can often receive fragmented care and expensive treatments. They also receive limited to no education about their health trajectories, […]
Increased regulatory and clinical oversight is needed to address common billing and documentation errors related to hospice general inpatient care, according to the U.S. Department of Health & Human Services (HHS) Office of the Inspector General (OIG). Inaccurate billing was among the driving forces behind the OIG’s recently announced nationwide audit of general inpatient hospice […]
A new cancer-focused payment model demonstration from the Center for Medicare & Medicaid Innovation (CMMI) could create opportunities for palliative care providers. The goals of the Enhancing Oncology Model (EOM), which went live on July 1, are to improve quality and reduce the cost of cancer care with augmented care coordination. While documents on the […]
The U.S. Centers for Medicare & Medicaid Services (CMS) has proposed a requirement that would prohibit hospice owners from selling their businesses within 36 months of Medicare enrollment. The agency included these plans in its proposed home health rule for 2024. This is the latest step in the agency’s efforts to improve hospice program integrity […]
When deployed at scale, palliative care can help achieve many of the health care systems current goals, including reduced costs, improved patient satisfaction and quality of life. Despite this potential, existing programs hit barriers created by misconceptions about palliative care among referring physicians, as well as health equity concerns, among others, according to an analysts […]
The U.S. Department of Health & Human Services (HHS) Office of the Inspector General (OIG) recently announced plans to launch a new audit that will focus on general inpatient hospice services. Longer general inpatient hospice stays and high-cost issues are reasons for the audit, dubbed the “Audit of Selected, High-Risk Medicare Hospice General Inpatient Services,” […]
The nation’s total health care spend is expected to swell by 5.4% annually between 2022 and 2031, reaching $7.1 trillion. Meanwhile, Medicare hospice spending is expected to more than double by 2032. These data from the U.S. Centers for Medicare & Medicaid Services (CMS) Office of the Actuary also project that health care expenditures will […]
Increasingly, both policymakers and providers are seeing potential opportunities to reform the Medicare Hospice Benefit, including the prospect of concurrent care. Driving these conversations is the need to lighten the nation’s heavy health care spend, which in 2021 reached $4.3 trillion, according to the U.S. Centers for Medicare & Medicaid Services (CMS). Questions are also […]
A new primary care-focused payment model demonstration could create new partnership opportunities for hospice and palliative care providers. The U.S. Centers for Medicare & Medicaid Services (CMS) has unveiled the Making Care Primary (MC) model, which will launch in July 2024 in eight states — Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North […]
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