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Centers for Medicare & Medicaid Services (CMS) recently elaborated on its plans to expand public education campaigns designed to help protect hospice beneficiaries from fraudulent actors in the space. Program integrity concerns have heated up in the hospice industry.
New trends in hospice care delivery are pointing to a growing need for improved equitable access and diversified services that address a broader range of disease-specific patient needs. Hospice providers have been expanding the depth of their interdisciplinary disease-specific programs to meet that need, Ware said.
Hospices have grown increasingly frustrated by fraudulent operators in the space and how their activities affect legitimate operators’ financial health. This is the second of a two-part Hospice News series that explores how fraud, waste and abuse in the hospice space could create headwinds for the industry at large.
Hospices coast-to-coast have undergone leadership transitions, including changes in legal executives and a slew of newly appointed CEOs, among other roles in the industry. Texas-based New Day provides home health, hospice, palliative and personal care services across 31 locations in Illinois, Kansas, Missouri and in its home state.
The Medicare Payment Advisory Commission (MedPAC) has recommended to Congress a freeze on hospice payment increases starting in 2026. In its annual report to Congress, MedPAC urged policymakers to eliminate hospice base-rate increases for 2026. The 2021 aggregated Medicarehospice margin was 10.4%, according to MedPAC.
trillion in 2023, a new analysis by the U.S. Centers for Medicare & Medicaid Services (CMS) found. This growth took place at a faster pace in 2023 than prior years. Total Medicarehospice spending accounted for $25.7 Total Medicarehospice spending accounted for $25.7 About 21% of U.S.
Centers for Medicare & Medicaid Services (CMS) recently announced that its Medicare Shared Savings Program (MSSP) yielded more than $2.1 billion net savings in 2023 — the largest amount in the program’s inception more than a decade ago, according to the agency. ACOs participating in MSSP earned an estimated $3.1
Hospice of the Chesapeake has unfurled a new dementia care program aimed at providing improved emotional, educational and practical support for patients and their caregivers as their conditions progress. The new program provides patients and their caregivers with direct support from Hospice of the Chesapeake’s interdisciplinary care team.
Quality, compliance and financial stability are top of mind in hospice merger and acquisitions (M&A) as this year comes to an end. Growing demand is among the constants driving investor interest in the hospice space, according to Tom Lillis, partner at the Kentucky-based firm Stoneridge Partners Strategic Consulting.
NYSE: EHAB) is projecting strong hospice growth in the next year fueled in part by investments in technology and workforce development. The home health and hospice provider is in part leveraging technology to fuel its plans, Jacobsmeyer said during the Bank of Americas Securities 2024 Home Care Conference. Enhabit Inc.
These evolving regulations have hospices concerned that a lack of virtual access to their services could have significant impacts on quality and health disparities. Weve inherited a kind of accelerated movement toward a new normal during the pandemic, Fratkin told Hospice News.
Hospice News explores the issues garnering growing attention in end-of-life care delivery in seven of this years hidden gem stories. Topics span trends related to program integrity, workforce development, health equity, service diversification and the keys to hospices growth strategies. billion acquisition of LHC Group in 2023.
s (Nasdaq: AMED) hospice segment has seen headwinds impact admissions growth as the company awaits its pending acquisition by the UnitedHealth Group (NYSE: UNH) subsidiary Optum. The company’s hospice segment revenue reached $207.9 Gross margin for the hospice segment fell slightly to 42.9% Amedisys Inc.’s year-over-year.
Rising demand for end-of-life care is pushing hospice growth opportunities to the forefront in value-based reimbursement. More payers in this arena are increasingly recognizing the depth of potential beneficial outcomes when it comes to collaborative hospice partnerships. billion in 2022, Medicare (MedPAC) reported.
Montana-headquartered Stillwater Hospice has found a successful rhythm to strategic rural-based growth and sustainability. Launched in 2017, the hospice company serves predominantly rural-based populations in Montana, northern Wyoming and South Dakota. If youre a rural hospice, you may have higher reimbursement needs.
Centers for Medicare & Medicaid Services (CMS) has not responded to congressional concerns about the hospice Special Focus Program (SFP). Set for 2025 implementation, the SFP promises to identify hospices delivering poor quality care and target them for improvement remedies. 2023, they and Reps.
The hospice industry is undergoing a transformative period of rising demand and regulatory changes. Levy recently sat down with Hospice News to discuss the array of regulatory and legislative evolutions on the horizon in hospice care delivery. I was promoted chief government affairs officer in 2023.
Fleece was among several post-acute care leaders who appeared at the hearing, representing home health, hospice, skilled nursing facilities, rehabilitation hospitals and other stakeholders. Empath now serves 1 in 5 hospice patients in its home state, the company reported. Centers for Medicare & Medicaid Services (CMS).
More than a dozen hospice advocacy groups have called on congressional leadership to intervene in a proposed 2.7% bump in Medicare payments, which they say is insufficient in light of COVID-19 and staffing headwinds. CMS in April released the 2023 proposed payment rule for hospice providers, including the 2.7%
The seed for Texas-based Pallicare was planted at a chance meeting at a 2021 conference between Jonathan Fluhart, a management professional with a background in aerospace, technology, and hospice industries, and nurse practitioner Tiffany Hughes. PalliCare, the partners also decided, would not rely on larger organizations.
Centers for Medicare & Medicaid Services (CMS) will give hospices a 3.8% bump in their per diem payments for 2023, according to a final rule published today. The rule also increases the hospice aggregate cap for next year by a corresponding 3.8% The post CMS Final Rule Gives Hospice 3.8% to $32,486.92.
Program integrity issues that have heated up in the hospice space during the past five years reached a boiling point in 2023. Hospice providers have seen an array of increased regulatory oversight in 2023. There is scrutiny on hospice care [that’s] setting the stage for the next phase of what hospice oversight looks like.
The company is a value-based organization that partners with primary care physicians nationwide to jointly take on the total cost and quality of care for their senior patients through Medicare Advantage or the the U.S. Net loss was $118 million in the third quarter of 2024 compared to a net loss of $31 million in the third quarter 2023.
Margin pressures from the proposed cuts to Medicare home health rates could impact palliative care and hospice. Centers for Medicare & Medicaid Services (CMS) in June released its proposed home health reimbursement rule for 2023, which included a 4.2% pay hike for hospice care in 2023.
Centers for Medicare & Medicaid Services recently recognized Bloom as a top performing High-Needs Accountable Care Organization under the agency’s Realizing Equity, Access and Community Health (ACO REACH) model. days at home during 2023. They’re signing me now to hospice, and I’m going there to die.
Medicare fee-for-service programs made $31.23 billion in improper payments during 2023, though a smaller proportion of those dollars went to hospices than in years prior. Hospices received nearly 5.4% of improper payments from Medicare in 2023, down from 12% in 2022, according to a new report from the U.S.
The hospice component of the value-based insurance design (VBID) model will begin its third year on Jan. 1, 2023, meaning that some of the program’s rules will change. Centers for Medicare & Medicaid Services (CMS) has indicated that hospices should ensure that their billing staff is familiar with the 2023 modifications.
ACOs can give palliative providers an opportunity to be paid properly for their scope of services, particularly if theyre contracting with an ACO under an arrangement with Medicare, which launched a program called ACO Realizing Equity, Access and Community Health (ACO REACH) in 2023. According to the U.S.
Most hospices are sliding into 2023 between a rock and a hard place, beset by headwinds, labor shortages and questions with no easy answers. Government oversight of hospice providers will tighten during 2023. Hospices have faced ever-intensifying scrutiny from regulators in recent years. Be ready for regulation.
For the time being, Medicare Advantage may be providers’ best bet for palliative care reimbursement. Centers for Medicare & Medicaid Services (CMS) also allows Medicare Advantage plans to cover palliative care as a supplemental benefit. She is also co-founder of the company’s hospice and home health service segment.
Reimbursement for community-based palliative care is gaining ground in the Medicare Advantage realm. Palliative care is among the wide range of supplemental benefits that exist within the Medicare Advantage payment landscape. This is a rise from 180 MA plans in 2023 offering palliative services and 64 MA plans in 2020.
If you were to write a book about hospice in 2023, what would you call it? To help answer that question, Hospice News asked the CEOs of eight providers how they would title a book about the state of the field today. Croix Hospice, AccentCare, Chapters Health System, Alivia Care, Enhabit, Inc., Heath Bartness, CEO, St.
The health care space — including hospice — is increasingly shaped by numbers. During the past several years hospice providers have had to become experts in data management in order to remain competitive. Hospices’ cost-savings potential A study published in March revealed that hospice saved Medicare roughly $3.5
Only 10 new Medicare Advantage (MA) plans will offer home-based palliative care as a primarily health-related benefit for 2023, but payers may be offering those services through other programs. Among Medicare Advantage supplemental benefits, in-home support services and caregiver support saw the most year-over-year growth for 2023.
Though nonprofit hospices now represent a smaller slice of the industry than in years past, they continue to care for more than half of patients in the United States who elect the benefit. The number of hospices operating nationwide rose to 5,3,58 in 2021, according to the Medicare Payment Advisory Commission.
s (NYSE: EHAB) M&A journey has narrowed towards hospice, diverting less in home health’s direction. Reimbursement uncertainties, shrinking pools of available assets, and rising valuations in the home health space are forces steering the company’s sights towards hospice, according to Enhabit executives. Acquisitions contributed $36.3
SCAN Group and CareOregon have agreed to join forces in 2023 as a new organization called HealthRight Group. The new nonprofit will combine SCAN’s Medicare portfolio with CareOregon’s predominantly Medicaid health plans. The legacy SCAN would become the Medicare division of the company. Possible expansion into hospice.
While home health operators brace for the impact of the meager 2023 reimbursement rates, hospices likewise must prepare for a ripple effect. Centers for Medicare & Medicaid Services (CMS) recently established a 0.7% base rate payment increase for home health care in 2023. While this is an improvement from the 4.2%
Centers for Medicare & Medicaid Services will end the hospice component of the value-based insurance design model (VBID) as of Dec. 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 space — and the health care system at large — is in a state of flux, driven by value-based reimbursement models, an expanding home-based care continuum and industry-changing transactions. ’s (NASDAQ: AMED) trajectory in 2023 is a tale of three companies, and they should be watched for three reasons.
Federal regulators are cracking down on the private insurers that administer Medicare Advantage (MA) plans. That growth has continued into 2023, with at least 157 plans offering home-based palliative care, according to data from Washington, D.C.-based based research and consulting firm ATI Advisory.
A slew of fraudulent hospices in California are dodging consequences by shuffling patients around between provider numbers. That’s according to multiple sources who spoke with Hospice News, expressing their concerns about patterns of fraud continuing even as government regulators crack down on the sector.
The hospice component of the value-based insurance design (VBID) demonstration will include elements designed to promote health equity in 2023. Centers for Medicare & Medicaid Services (CMS) that health equity will be a key component of their payment model demonstrations going forward. “Health outcomes are unequal.
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. million in 2023.
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