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Palliative Care, Health Equity Growing in Medicare Advantage

Hospice News

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.

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Medicare Made $190M in Improper Hospice Payments to Hospitals

Hospice News

Medicare made an estimated $190 million in improper payments to acute-care hospitals for outpatient hospice services between 2017 and 2021. Our medical reviewer found that Medicare paid acute-care hospitals for outpatient services that palliated or managed hospice enrollees’ terminal illnesses and related conditions,” the OIG report stated.

Medicare 239
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CMMI Analysis: Palliative Care Reduces Medicare Costs, Improve Patient Satisfaction

Hospice News

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 of four payment model demonstrations carried out by the Center for Medicare & Medicaid Innovation.

Medicare 317
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The Role of Medicare Advantage in Growing Palliative Care Services

Hospice News

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.

Medicare 300
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MA Enrollment to Outstrip Traditional Medicare in 2025

Hospice News

Growth in the number of Medicare Advantage beneficiaries will likely overtake that for traditional Medicare in 2025, according to new estimates from the U.S. Centers for Medicare & Medicaid Services (CMS). Researchers examined Medicare claims data for more than 1 million patients who died between 2016 and 2018.

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Dynamics of Palliative Care Delivery in a Potential Medicare Benefit

Hospice News

A moving target in palliative care delivery is whether or not these services should have a dedicated benefit in the Medicare system. Most palliative care in the United States is reimbursed through fee-for-service programs, as well as Medicare Advantage, Accountable Care Organizations (ACOs) and through Medicaid in a handful of states.

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Medicare Advantage Crackdown Could Dampen Palliative Care Growth

Hospice News

Federal regulators are cracking down on the private insurers that administer Medicare Advantage (MA) plans. Centers for Medicare & Medicaid Services (CMS) began giving plans more flexibility around the definition of “primarily health-related.” based research and consulting firm ATI Advisory.

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