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While some innovative technology trends have aided in improved rural hospicecare delivery, regulatory and reimbursement challenges remain a pain point for providers trying to burgeon access among hard to reach, underserved communities, Graham told Hospice News. How does Stillwater Hospice approach growth?
He was so intrigued that he gathered a few volunteers and began Hospice of the Valley, which was largely a volunteer organization living off of a few grants here and there prior to when hospiceMedicare reimbursement came around in the early 1980s. Over the years, Hospice of the Valley has grown.
The research examined Medicarehospice beneficiary data including timely start of care following patient admission, disenrollment and live discharge rates, volume of patient visits, length of stay and billing claim amounts. Centers for Medicare & Medicaid Services’ (CMS) Care Compare site.
Efforts to establish potential payment mechanisms for high-acuity palliative services within the MedicareHospice Benefit will require greater clarity from regulators, according to the Coalition to Transform Advanced Care (C-TAC). The use of the term ‘palliative’ for treatments in this RFI was problematic.”
The hospice community is contributing input to the development of the forthcoming HospiceCare Accountability, Reform, and Enforcement (HospiceCARE) Act. NPHI has consistently advocated for reform to the Medicarehospice benefit reimbursement methodology.
Levy recently sat down with Hospice News to discuss the array of regulatory and legislative evolutions on the horizon in hospicecare delivery. Centers for Medicare & Medicaid Services (CMS)] and Congress. What are some of the biggest regulatory priorities when it comes to hospicecare delivery?
If enacted, the HospiceCare Accountability, Reform and Enforcement (HospiceCARE) Act could open up reimbursement pathways for high-acuity palliative services during a time when demand and costs are rising. The drafted HospiceCARE Act included potential avenues to improve payment for high-acuity palliative treatments.
and Susan Collins (R-Maine) introduced the Improving Access to Advance Care Planning Act to the Senate designed to promote greater access to those services among Medicare beneficiaries. We’re trying to make this conversation as easy as possible to have,” Gurian told Hospice News. million, Grant told Hospice News.
Strong performance on the HospiceCare Index is becoming increasingly essential to securing payer and referral contracts and will be a key consideration in the federal government’s forthcoming Special Focus Program (SFP). The HospiceCare Index can be a referral driver. You definitely do not want to be at that bottom 10%.”
As Jimmy Carter marks his sixth month in hospicecare, the provider community is raising awareness by saluting the former president. The National Hospice and Palliative Care Organization (NHPCO) convened a group of hospice leaders at Times Square in New York City to commemorate Carter’s hospice experience.
Centers for Medicare & Medicaid Services (CMS) designed the HospiceCare Index (HCI) to paint a picture of care processes that occur between a patient’s admission and discharge, but as currently designed it may not be an effective measure of quality. appeared first on Hospice News.
A revolution is needed in hospicecare, complete with a new mindset, updated care models and redesigned payment systems, Dr Monisha Pujari, medical director for Longleaf Hospice, told Hospice News. Hospice News spoke with Pujari about her vision for hospicecare and what it would take to make it a reality.
Centers for Medicare & Medicaid Services’ (CMS) 2025 proposed hospice rule contained requests for information (RFIs) that could signal changes in the agency’s thinking on key issues. Through RFIs, CMS tries to take the pulse of providers’ positions on certain questions that could impact the MedicareHospice Benefit.
The data come at a time when regulators are mulling over the future outlook of high-acuity services in end-of-life care. Legislators have also increasingly recognized a need to open up reimbursement pathways for high-acuity palliative care services as demand and costs swell.
Regulators are sharpening their focus on several aspects of hospice quality data to help weed out fraud, waste and abuse. Hospice Quality Reporting Program requirements have seen an overhaul in recent years as the U.S. Centers for Medicare & Medicaid Services’ (CMS) works to curb malfeasance in the industry.
Among the significant changes coming this year is the end of the hospice component of the value-based insurance design (VBID) model, as of Dec. Commonly known as the “carve-in,” the program was designed to test hospicecare coverage through Medicare Advantage, as well as some coverage of palliative care and transitional care.
Palliative care lacks a standardized definition within current value-based reimbursement systems, making it difficult to determine the full scope of services for seriously ill patients. Palliative care services are intended to address physical, psychosocial, social and spiritual needs of seriously ill individuals.
And as we say in hospice, I kind of got the bug. I was kind of just doing it to learn to give back and didn’t really know what hospice was, certainly not the modern day Medicare benefit. As I did that, I found a volunteer coordinator position open with Heartland Home Health and Hospice in Kansas City, Missouri.
Caris Healthcare provides adult and pediatric hospicecare to more than 40,000 patients and families across 28 locations in Georgia, Missouri, South Carolina, Tennessee and Virginia. Additional services include palliative care, a veterans program and care coordination. On Wednesday, the U.S.
Centers for Medicaid & Medicare Services (CMS) included updates to some of these initiatives in its 2024 proposed hospice payment rule. In addition, the Hospice Outcomes & Patient Evaluation (HOPE) tool, currently in a testing phase, is anticipated to replace the Hospice Item Set (HIS).
She was a home health and hospice nurse and loved providing end-of-life support. Our dream initially was to have a hospice house for patients that needed higher levels of symptom management. We obtained our Medicare license in June 2015, and everything really started by faith. I was in restaurant management.
But insufficient payment pathways represent a large hurdle for palliative care’s growth potential, Kulik said. “If If palliative care is a common provision of services in the marketplace, then the investor world is definitely looking at that,” Kulik told Palliative Care News. “No They’re going to try to spur growth.
Centers for Medicare & Medicaid Services’ (CMS) is seeking answers about hospice patients’ access to certain high-cost services. CMS included a series of requests for information (RFIs) in its proposed 2024 hospice payment rule. base rate increase for next year, which some in the hospice community have called inadequate.
Proposed federal legislation could advance the development of an evidence-based definition of “high-quality” bereavement care. However, from a statutory standpoint bereavement care is the least clearly defined aspect of hospicecare.
billion Medicare Advantage (MA) organization that covers more than 270,000 members. Centers for Medicare & Medicaid Services (CMS) Administrator Don Berwick. There, Jain helped establish the Center for Medicare & Medicaid Innovation (CMMI), which is charged with development and testing of value-based payment models.
NYSE: HUM) has signed a definitive agreement to sell a 60% stake in Kindred at Home’s (KAH) hospice and personal care business to the private equity firm Clayton, Dubilier & Rice (CDR) for $2.8 The company attributed this primarily to growth in its Medicare Advantage business and state contracts membership.
“When the [hopital] patient is discharged, thosewho have instructions to seek hospice are making up a greater percentage of that pool,” Bakkun told Hospice News. And that means that the the knowledge and awareness of hospicecare is growing.”. But this is definitely still not the norm.”. Case in point, the U.S.
As with nursing, the industry-wide labor shortage has impacted bereavement care, which is an underfunded service, according to Dr. Dawn Gross, palliative care physician at University of California, San Francisco (UCSF) Health. Gross is also a medical director at ANX HospiceCare.
As those problems proliferate, the National Hospice and Palliative Care Organization (NHPCO), the National Association for Home Care and Hospice (NAHC), LeadingAge and the National Partnership for Hospice and Healthcare Innovation (NPHI) have been speaking out not only individually, but collectively.
Centers for Medicare & Medicaid Services’ (CMS) auditing processes, a coalition of industry organizations indicated in a letter to the agency. We share the Administration’s goal of ensuring quality hospicecare. The post Hospice Industry Groups: CMS Must Reform Auditing Processes appeared first on Hospice News.
SEIU analyzed Medicare claims data showing that the average hospice transfer rate among HCA hospital discharges was nearly 40% above the national average in 2021 and represented a 50% growth rate over four years. For one, hospice utilization has been on a steady upswing nationally for several years. told Hospice News.
Though operators often feel siloed within the MedicareHospice Benefit, they are not shielded from the shifting currents in the health care system at large. Deal volume for behavioral health increased 33% in 2021, Hospice News’ sister site Behavioral Health Business reported.
Understanding payer priorities in defining the scope of quality is vital for hospices to thrive not only in traditional Medicare, but also in today’s value-based reimbursement climate. The nitty gritty details of data tracking and management matter when it comes to ensuring both a healthy bottom line and quality patient care.
“The stairs are steeper in UPIC audits, which I think are some of the most serious and costly audits for hospices to deal with,” Pekarske told Hospice News. Centers for Medicare & Medicaid Services (CMS) contracts UPICs to investigate instances of suspected fraud, waste and abuse. The volume has definitely been there.
Trinity Health has completed its acquisition of MercyOne Health, expanding its hospice footprint in Iowa. Trinity Health in April signed a definitive agreement with CommonSpirit Health to acquire MercyOne. Earlier this year Trinity Health acquired Iowa-based Above & Beyond Home Health Care and Hospice for an undisclosed sum.
He previously served as president of the National Association for Home Care & Hospice (NAHC) for 38 years prior to its affiliation with the National Hospice and Palliative Care Organization (NHPCO) in 2023 and was heavily involved in the establishment of the MedicareHospice Benefit.
But in time, her drive to improve patients’ quality of life led her to the hospice and palliative care fields. Templeton now is a hospice physician consultant at Weatherbee Resources as well as medical director for Texas-based Hendrick HospiceCare. What qualities or characteristics would such a person possess?
The possibility exists that hospicecare will change more in the next few years than it has during the previous four decades. The MedicareHospice Benefit turned 40-years-old in 2022, and in that time the program has remained fundamentally unchanged. For one, more people know about hospice. This is down from 51.6%
Developing an inpatient hospice center has been part of Oasis’ “vision” since the beginning, according to Oasis CEO Sade Bello and Hakeem Bello, director of business development. The faith-based hospice company received Medicare certification in 2015 and primarily serves an urban region around the Chicago area.
Control of these assets also allows payer organizations to better manage the financial risks that come with the value-based payment models that many expect will overtake traditional Medicare in coming years. The full impact of these deals will take shape over the next few years.
What is our role as hospice and palliative care providers in advocating for high-quality hospicecare? If you are interested in signing the position statement “Core Roles and Responsibilities of Physicians in HospiceCare”, click here. JAMA IM 2021 Hospice Acquisitions by Profit-Driven Private Equity Firms.
The program is designed to recognize up-and-coming industry members who are shaping the next decade of senior housing, skilled nursing, home health, and hospicecare. Centers for Medicare & Medicaid Services (CMS)] but commercial plans. You know, such a challenge for us is we see a Medicaid-heavy aand Medicare population.
You can subscribe to Palliative Care News here: Subscribe today! The Medicare Advantage hospice carve-in will be carved back out by the end of this year. Among other goals, the program was designed to test coverage of hospicecare through Medicare Advantage, as well as the delivery of palliative care and transitional care.
Unfortunately, there’s not a lot of data as it relates to palliative care utilization and the disparities, or the demographics related to that utilization, as it is compared to hospice. So, it’s definitely an area of opportunity, where there’s just much more research that’s needed related to palliative care.
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