Hospice News

OCTOBER 15, 2024

The cap is designed to prevent overuse of hospice, put controls on Medicare spending and foster greater access to care among patients. Centers for Medicare & Medicaid Services set the cap at $33,394. For one, if they have a cap liability, they will have to repay that amount to Medicare. For Fiscal Year 2024, the U.S.

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Hospice News

SEPTEMBER 22, 2022

This strategy presents a vision, along with recommendations for achieving it. Even when a caregiver is present, that person may be elderly or ill themselves, or unable to be in the home around the clock due to work or other obligations. “At some point in our lives, most of us will either be a family caregiver or need one.

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Hospice News

MARCH 29, 2024

Centers for Medicare & Medicaid Services (CMS) proposed a 2.6% billion in annual savings for Medicare, which underscores the critical importance of investing in hospice to ensure continued beneficiary access to quality end-of-life care.” Hospice care saves Medicare roughly $3.5 In a proposed rule released yesterday, the U.S.

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Hospice News

APRIL 7, 2023

Justice Department, Angel Care enrolled 24 patients in hospice between 2009 through 2017 who did not meet Medicare eligibility requirements. None of these patients had been diagnosed with a terminal illness, and several are still alive several years later, according to evidence presented at trial. million in improper Medicare payments.

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Hospice News

APRIL 18, 2023

Centers for Medicare & Medicaid Services (CMS) is insufficient to support hospice patients’ care needs, a major industry group said. After a moratorium during the pandemic, full Medicare sequestration resumed on July 1, 2022. base payment rate increase recently proposed by the U.S. increase — an estimated total of $720 million.

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Hospice News

OCTOBER 23, 2024

Payment streams for palliative care, most palliative programs are relying on a combination of Medicare Part B and grants and fundraising,” Schramm said. Other reimbursement options exist via payment arrangements with Accountable Care Organizations (ACOs) and Managed Services Organizations (MSOs).

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Hospice News

JUNE 21, 2024

Dr. David Lovell, its founder and owner, launched the for-profit hospice in 2010, and the enterprise became Medicare-certified in 2012. million in improper Medicare claims. Justice Department, Angel Care enrolled 24 patients in hospice between 2009 through 2017 who did not meet Medicare eligibility requirements.

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Hospice News

MAY 12, 2023

Patients with ovarian cancer who have received palliative care had fewer hospital readmissions compared to others, according to a recent study presented at the 2023 Annual Meeting on Women’s Cancer from the Society of Gynecologic Oncology (SGO) in Tampa, Florida.

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Hospice News

OCTOBER 22, 2024

The cap is designed to prevent overuse of hospice, put controls on Medicare spending and foster greater access to care among patients. Centers for Medicare & Medicaid Services set the cap at $33,394. If a hospice has a cap liability, they will have to repay that amount to Medicare. For Fiscal Year 2024, the U.S.

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Hospice News

SEPTEMBER 22, 2023

The four largest hospice industry organizations have been working to present a united front to address widespread program integrity issues. At the same time, we are also working hard to address LeadingAge members’ concerns, which we presented to Congress in late January 2023.” Hospice care, all told, saves Medicare approximately $3.5

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Hospice News

JANUARY 11, 2023

The home health and hospice provider last summer placed a focus on expanding its Medicare Advantage (MA) business, forming a payer innovation team focused on strengthening Enhabit’s value proposition to health plans. We’ve faced challenges as a result of our previous lack of work with Medicare Advantage plans.

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Hospice News

APRIL 17, 2024

Centers for Medicare & Medicaid Services’ (CMS) review and appeals process, according to CEO Greg Hagfors. The provider recently celebrated the 45th anniversary of its founding, which preceded the establishment of the Medicare Hospice Benefit. Department of Health and Human Services (HHS) due to audit-related claims denials.

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Hospice News

OCTOBER 20, 2022

SCAN Health Plan is among the Medicare Advantage (MA) payers entering the hospice component of the value-based insurance design (VBID) payment demonstration in 2023. The four-year program — often called the Medicare Advantage hospice carve-in — launched Jan. 1, 2021, with 53 participating health plans. This number grew to 115 in 2022.

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Hospice News

FEBRUARY 6, 2023

Centers for Medicare & Medicaid Services (CMS) has offered further guidance on what rules will change when the COVID-19 public health emergency (PHE) ends on May 11. For fee-for-service programs, some of the flexibilities around provider appeals to Medicare contractors will remain in place.

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Hospice News

DECEMBER 15, 2022

Commonly known as the Medicare Advantage hospice carve-in, the Value-Based Insurance Design (VBID) model officially launched on January 1, 2021, with 53 Medicare Advantage Plans offering the benefit in 206 counties within 13 states and Puerto Rico for 4 years ending in 2025. The difference is Medicare Advantage vs Humana VBID.

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Hospice News

JULY 5, 2022

Centers for Medicare & Medicaid Services (CMS) penalizes hospitals for readmissions rates that exceed certain thresholds, but the agency does not account for the supply of post-acute providers available to patients in a providers’ service region.

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Hospice News

SEPTEMBER 25, 2024

While they offer an alternative to home-based services, they present their own unique benefits and challenges. First, the clinic-based model presents challenges in its need for physical space and the associated costs. Sincera’s palliative care clinics receive reimbursement from insurance companies as well as from Medicare and Medicaid.

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Hospice News

MARCH 14, 2024

Centers for Medicare & Medicaid Services (CMS) has developed a financial incentive to foster better performance on the measure, the service-intensity add-on. The greatest barrier to further improvement is the ever-present workforce shortage affecting the health care industry at large and hospices in particular.

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Hospice News

SEPTEMBER 6, 2023

Some organizations know how to go out and present information in a way that’s meaningful to referral sources, and others don’t. Often called the Medicare Advantage hospice carve-in , the VBID demonstration project took effect Jan. Participation in the demonstration is voluntary for both payers and providers.

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Hospice News

DECEMBER 8, 2023

Centers for Medicare & Medicaid Services to obtain any necessary amendments or waivers to implement the provisions of the bill and to secure federal funding for the program. Too often when an older person is facing an illness, they get swept up in the health care system without being presented the option of noninvasive care.

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Hospice News

APRIL 23, 2024

We were able to fund 13 junior investigators to come to Denver to present research into neuropalliative care.” Medicare covers most expenses related to palliative care, but as with other health care services, reimbursement remains low. To increase the number of specialists in the field, Daly said.

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Hospice News

JULY 25, 2022

About 10,000 people in the United States become Medicare eligible each day, according to the Kaiser Family Foundation. We can sue the Medicare program on payment rate cuts, or we can get the law changed by Congress when we don’t like the outcome of that. Workforce shortages are by far the industry’s most significant headwind.

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Hospice News

JANUARY 16, 2023

They included VA hospice encounters in the outcome but not enrollment in a home hospice program, nursing home hospice center or Medicare-paid hospice. The agency in the early 2000s also launched several initiatives to expand veterans’ access to hospice and palliative care. “As

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Hospice News

SEPTEMBER 27, 2024

In addition to these types of partnerships, Contessa also contracts directly with some payers, primarily Medicare Advantage plans. “We The insurance company provides the patient data and claims,” Black said during the presentation. “So So both the joint ventures have a contract with an insurance company.

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Hospice News

MARCH 12, 2024

The organizations earlier this year presented their findings , published today, to members of Congress and the U.S. Centers for Medicare & Medicaid Services (CMS). In addition to those my Medicare Contractors, last year the U.S. Regulatory issues topped providers’ list of concerns, the survey found. “To

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Hospice News

MARCH 29, 2023

Are you in an outlier scenario with your data that Medicare contractors are looking at? Centers for Medicare & Medicaid Services (CMS) and the U.S. In 2020, the average length of stay for Medicare patients enrolled in hospice was 97.0 according to the Medicare Payment Advisory Commission. Young told Hospice News.

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Hospice News

MARCH 7, 2023

Centers for Medicare & Medicaid Services (CMS) contracts UPICs to investigate instances of suspected fraud, waste and abuse. For example, UPIC contractors conducted “substantially more Medicare fee-for-service program integrity work” that year compared to those for state Medicaid programs. Stakes around UPICs The U.S.

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Hospice News

AUGUST 5, 2022

We contract with [the Center for Medicare & Medicaid Innovation (CMMI)] as a direct contracting entity, and our job is to coordinate a network of providers, called DCE participants, and then also preferred providers, which would be hospices, home health agencies that can help coordinate the care as the patients move into the home setting.”.

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Hospice News

MAY 24, 2023

Because of the poverty requirement, Medicaid beneficiaries present with a much more complicated picture of needs,” Silvers said. And it’s not only the social needs, there’s a stage of life difference, at least between Medicare patients and Medicaid patients. It’s a lot of complex needs.”

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Hospice News

APRIL 24, 2023

However, unlike hospice services, which have a distinct payment model supported by the Centers for Medicare and Medicaid Services (CMS), palliative care has less established infrastructure for delivery. The shift does present challenges, however. There needed to be something special and differentiated.”

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Hospice News

JULY 11, 2022

million seniors who reside in Illinois are 85 or older, and 40% of Medicare beneficiaries in the state have four or more chronic conditions, according to HCCI. Centers for Medicare & Medicaid Services (CMS) is replacing the Global and Professional Direct Contracting (GPDC) model with ACO REACH. About 12% of the 2.1

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Hospice News

DECEMBER 23, 2022

Centers for Medicare & Medicaid Services (CMS). License transactions are often favorable for smaller organizations that seek to expand, but may struggle to outbid a large strategic buyer or private equity firm. Texas markets like Houston are primed for hospice growth. Favorable demographics are driving demand for hospice in Texas.

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Hospice News

SEPTEMBER 14, 2022

However, we will maintain a nimble approach to M&A and explore all high-quality opportunities that present.”. Hospice utilization among Medicare decedents in Georgia reached 51% during 2018, which is in line with that year’s national average of 50.3%, according to the National Hospice & Palliative Care Organization (NHPCO).

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Hospice News

JULY 20, 2023

Centers for Medicare & Medicaid Services (CMS) recently expanded the hospice component through 2030. Hospices have been inching closer to value-based care, beginning with the value-based insurance design (VBID) model demonstration. Originally slated to complete next year, the U.S.

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Hospice News

FEBRUARY 10, 2023

We’ve heard from the [Medicare Payment Advisory Commission (MedPAC)] on the 20% payment cap reduction. If we look at some of the decks and slide presentations on the Medicare Advantage carve-in, going back to 2018, it’s the same information, and we’re still talking about impacting change.

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Hospice News

MAY 12, 2023

Centers for Medicare & Medicaid Services (CMS), asking for the agency to brief them on fraud and abuse within the hospice benefit. Hospice News sat down with Jingle to talk about how these concerns are presenting themselves in her markets, how regulators should respond and the benefits of engaging with policymakers.

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Hospice News

JUNE 30, 2023

Centers for Medicare & Medicaid Services (CMS). Because the unit is situated in a residential neighborhood and the original house was completely renovated, we wanted to maintain the home-like environment in our presentation of the unit.” Census Bureau. More patients elect hospice in California than in any other state.

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