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The future of palliative care payment is reaching an uncertain, but potentially promising time in the Medicare landscape. But palliative providers have long-faced a challenging reimbursement trajectory in supporting their sustainability, she said during Hospice News virtual Palliative Care Outlook Summit.
Centers for Medicare & Medicaid Services (CMS) during the public health emergency have been extended several times. If they end as planned, hospice providers, as well as patients and families, could face potentially detrimental impacts, according to several hospice leaders. Hospice News photo by TBAR Productions.
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.
A federal jury has convicted Dr. John Thropay, a hospicemedicaldirector, on charges of health care fraud in a $2.8 Thropay was the medicaldirector of several hospice companies, including Blue Sky Hospice, based in Van Nuys, California. The former medicaldirector will be sentenced on May 28.
Today’s hospice leaders need to take a wide view into the range of challenges facing their interdisciplinary care teams, according to Dr. Andrew Mayo, chief medical officer at St. Croix Hospice. Croix Hospice in 2014 as an associate medicaldirector. Mayo joined St. Croix Falls, Wisconsin.
A federal judge has sentenced Jesus Virlar-Cadena, formerly a medicaldirector for the Texas-based hospice company Merida Group, to 50 months in prison for his role in a $152 million scheme. The Texas Medical Board suspended his medical license in 2019, when he pleaded guilty to the fraud charges.
Centers for Medicare & Medicaid Services (CMS) recently announced that its Medicare Shared Savings Program (MSSP) yielded more than $2.1 As of January 2024, roughly 480 ACOs are participating in MSSP, which include more than 608,000 clinicians who provide care to nearly 11 million Medicare beneficiaries.
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.
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 medicaldirector for Texas-based Hendrick Hospice Care. What qualities or characteristics would such a person possess?
The value-based agreement contracts Thyme Care with Humana Medicare Advantage plans, giving them access to their beneficiaries. Humana Medicare Advantage members who are eligible for the program in Michigan, New York, Illinois, Indiana, Tennessee, Pennsylvania and New Jersey may now receive services from Thyme Care.
Centers for Medicare & Medicaid Services (CMS) include five areas of social determinants of health: food and housing insecurity, transportation needs, utility difficulties and interpersonal safety. Dr. Darren Schulte, Dr. Tracy Romanello and Dr. Cameron Muir at the Hospice News ELEVATE event. Screening tools developed by the U.S.
She returns to the company after nearly three years at the helm of San Diego-based The Elizabeth Hospice as its chief strategy officer. Bliss has more than 18 years of hospice leadership experience, along with 12 years of managing hospice and home health operations across multi-site locations.
Risk-based contracts may be the future of palliative care reimbursement as Medicare Advantage continues to ascend. We really feel the future is in risk-based contracting, and we think that palliative care is an excellent vehicle to take on risk with payers, Baumgardner told Hospice News at the ELEVATE conference in Florida.
The workforce shortage and value-based care will shape the future of hospice, according to some providers. Centers for Medicare & Medicaid Services (CMS) has signaled its intention to align every Medicare beneficiary with a value-based payment system by 2030. Hospice is a great space in health care. Anderson said.
Centers for Medicare & Medicaid Services’ (CMS) proposed 2025 hospice rule contains clarifications on which physicians may certify patients for hospice enrollment. Clarification from CMS in these areas will be helpful to hospices, physicians and those reviewing hospice records for compliance.”
Centers for Medicare & Medicaid Services (CMS) has delayed the implementation of hospice certifying physician Medicare enrollment requirements. CMS delayed the date to enroll in or opt out of Medicare until June 3 for physicians who certify hospice services.
After more than a decade working in hospice leadership, Alli Collins came across something she had never seen before — a financially viable, all-volunteer provider that is not Medicare-certified. I am the new executive director for Hospice and Palliative Care of the Wood River Valley.
Buyers in a hot hospice M&A market are bringing compliance under a microscope as regulators keep a tight watch. All hospice transactions undergo some type of compliance review. But there’s nothing routine about these reviews in today’s current hospice regulatory environment. This includes the U.S.
Anti-kickback and health care fraud cases have recently cropped up in two southern states, with hospice personnel facing millions in fines and one owner facing imprisonment for their involvement. David Lovell, its founder and owner, launched the for-profit hospice in 2010, and the enterprise became Medicare-certified in 2012.
Texas-based Heart to Heart Hospice has launched a de novo in the West Columbia community in its home state. The new location is branded as Heart to Heart Hospice of the Riverbend and is now accepting patients. Similar to national demographic trends, a growing aging population is driving demand for hospice in Texas.
A federal court has sentenced Dr. John Thropay, a former medicaldirector for several hospice companies, to 37 months in prison for his involvement in a $2.8 million hospice fraud scheme. Among the companies for which Thropay worked was Blue Sky Hospice, located in Van Nuys, California.
Fraudulent hospices continue to proliferate, and some may be moving between states to escape regulators. Beginning in 2021, numerous reports emerged of unethical or illegal practices among hundreds of newly licensed hospices, particularly among new companies popping up in California, Texas, Nevada and Arizona.
Cameron Muir has been named as the new CMO of the National Partnership for Healthcare and Hospice Innovation (NPHI). His new title signals the organization’s strategic plans to reshape hospice care delivery through patient-centered, innovative approaches, according to NPHI CEO Tom Koutsoumpas.
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). This could result in deepening conflation of hospice and palliative care, the organization indicated. “We
Meanwhile, Medicarehospice spending is expected to more than double by 2032. Centers for Medicare & Medicaid Services (CMS) Office of the Actuary also project that health care expenditures will represent 19.6% The report, published today in Health Affairs , did not contain hospice-specific data. and Medicaid by 3.2%.
Guaranteed’s New SVP of Growth, Strategy Tech-enabled hospice startup Guaranteed has named Ryan Malone as its new senior vice president of growth and strategy. Previously, he was head of growth at Mavencare, and served in sales manager and director roles at Hometeam from 2013 to 2016. The funding follows a $6.5
Greater transparency in staff evaluation processes and increased education will be keys to navigating a range of hospice compliance challenges in a post-pandemic landscape. Transparency around hospice staffing and ownership is a large focus of program integrity efforts among regulators, Piland stated. On Wednesday, the U.S.
John Mulder, chief consultant for hospice and palliative care medicine for Michigan’s Faith Hospice, was drawn to the field after witnessing his father’s difficult end-of-life experience. Having begun his practice 40 years ago in family medicine, he came to hospice in 1983 when he was asked to serve on the board of a local provider.
Among the challenges is a general lack of awareness of palliative care and its distinctions from hospice among the public, clinicians in other settings and payers. Jennifer Blechman, palliative care medicaldirector at the Oregon-based nonprofit Partners in Care said at the Hospice News Virtual Staffing Summit.
In this Voices interview, Hospice News sits down with Dr. Khai Nguyen , National MedicalDirector, Geriatrician for CHAP, to talk about the age-friendly care movement. Hospice News: What career experiences do you most draw from in your role today? That roundtable approach is key in hospice as it is at CHAP.
But moving away from fee-for-service towards value-based payment could make a difference when it comes to hiring and retention, according to Dr. Jennifer Blechman, palliative care medicaldirector at the Oregon-based nonprofit Partners in Care. Palliative care is also part of the hospice component of the U.S.
Joe Rotella, chief medical officer of the American Academy of Hospice and Palliative Medicine (AAHPM), calls on hospices to maintain their core principles amid a churning sea of regulatory and economic changes. It has just seen so much growth in hospice and palliative care. Now, Rotella will soon retire from AAHPM.
Program integrity and an onslaught of audits are top of mind for many hospice providers in 2024. Centers for Medicare & Medicaid Services (CMS). We look forward to continuing our work with CMS and Congress to ensure an equitable and effective enforcement system that preserves access to nonprofit, mission driven hospice care.”
In this Voices interview, Hospice News sits down with Deanna Heath, VP of Hospice, KanTime, to talk about the potential impact of the Value-based Insurance Design (VBID) model on today’s hospice landscape. Hospice News: What career experiences do you most draw from, in your role today?
Hospices often lack the financial and staffing resources needed to fully support bereaved families. Gross is also a medicaldirector at ANX Hospice Care. Gross is also a medicaldirector at ANX Hospice Care. Hospices are not reimbursed enough to support grief care teams,” Gross told Hospice News.
The 2025 proposed hospice rule is raising some questions along with payment rates. Centers for Medicare & Medicaid Services (CMS) proposed a 2.6% increase in hospice per diems for 2025. We know that hospice care has demonstrated $3.5 We know that hospice care has demonstrated $3.5
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. A hospice’s track record on these measures is likewise important when working with. Medicare Advantage plans.
Contessa is a subsidiary of Amedisys (NASDAQ: AMED), which the home health and hospice provider acquired in 2021 for $250 million. Since at least 2022, Contessa has been pursuing palliative care reimbursement through Medicare Advantage. Palliative care has always kind of sat in the shadows of hospice.
District Judge Debra Brown has sentenced a Mississippi hospice physician to five years in prison for taking $16 million in fraudulent Medicare claims. Dr. Scott Nelson of Clevland, Mississippi was convicted last April of certifying patients for hospice who were not terminally ill. billion in the fiscal year ending Sept.
Centers for Medicare & Medicaid Services (CMS) ramped up auditing activity in the space while also sunsetting the hospice component of its value-based insurance design (VBID) model demonstration ahead of its initial expiration. There were just some of the themes percolating among the most-read Hospice News coverage of 2024.
Hospice licensing should remain under the authority of state governments rather than federal agencies, though lawmakers “haven’t ruled anything out” when it comes to program integrity, according Rep. Centers for Medicare & Medicaid Services (CMS) on reported instances of hospice fraud in several states.
Payers, including Medicare, like to see providers reduce the costs of care. As we’re looking to value-based care, ultimately, everyone is tasked with providing improved outcomes and in doing so at a reduced price point,” Ladabaum told Hospice News. “If Historically, the U.S.
Arizona-based Stoneridge Hospice launched services in 2020 with an aim to address a swelling aging population’s growing need for end-of-life care. Stoneridge Hospice provides home-based hospice and also contracts with other providers to offer facility-based services. Stoneridge Hospice launched in 2020.
Expanding palliative care relationships and joint venture partnerships is a priority for 2024, the Louisiana-based home health and hospice provider indicated in a filing with the U.S. In addition to these types of partnerships, Contessa also contracts directly with some payers, primarily Medicare Advantage plans. “We
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