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July 21, 2015

What you need to know about Medicare's new hospice pilot program

Daily Briefing

CMS will expand a pilot project that allows terminally ill patients to continue receiving curative treatments while also qualifying for hospice coverage through Medicare, the agency announced on Monday.

The project, called the Medicare Care Choices Model, was established under the Affordable Care Act. According to a CMS fact sheet on the pilot, it will allow "greater beneficiary access to comfort and rehabilitative care in Medicare and Medicaid."

Outside of the initiative, Medicare beneficiaries are required to forgo curative treatments if they choose hospice care.

Death isn't failure: Teaching physicians to prescribe hospice

According to CMS, about 44% of Medicare beneficiaries elect to receive hospice care, with most using the services for a short period of time. However, experts have argued that providing both curative and hospice care improves patients' quality of life. In addition, experts say that offering both services concurrently would not raise health care costs because more patients and their families would choose hospice care if they do not have to give up opportunities for potential life-saving treatments.

Under the pilot, CMS will pay qualifying hospice centers a certain amount per beneficiary per month. Participating suppliers and providers still will "be able to continue to bill Medicare for the reasonable and necessary services they furnish," the agency says.

CMS will use the initiative to judge whether the program's expanded benefits will lead more patients to enter hospice care, improves patient satisfaction, and lowers costs.

According to the Wall Street Journal, CMS originally announced a smaller pilot project that would include 30 hospices, but the agency had not yet begun implementing the initiative (Armour, Wall Street Journal, 7/20; CMS release, 7/20; Evans, Modern Healthcare, 7/20).

Learn how your organization can develop concurrent care programs

Explore five models to expanding concurrent care services to improve access, lengthen hospice stay, and increase patient and family satisfaction with end-of-life care.


The characteristics of effective palliative care programs

The best palliative care programs don't just provide a better experience for terminally ill patients—they also yield longer survival rates, lower costs, and improved quality.


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  1. Current ArticleWhat you need to know about Medicare's new hospice pilot program

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