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Hospice

Overview

Hospice

Hospice provides comprehensive and interdisciplinary health care to terminally ill patients, as well as bereavement and support services to the patients’ loved ones. Patients receiving hospice care forgo curative treatments. Hospice care is provided through certified hospice programs, and may be delivered in any patient care setting, but is most often provided in the patient's home.

CHA provides state and federal representation and advocacy in the legislative and regulatory arenas to improve access to quality, cost-effective hospice health care services.
 

Hospice provides comprehensive and interdisciplinary health care to terminally ill patients, as well as bereavement and support services to the patients’ loved ones. Patients receiving hospice care forgo curative treatments. Hospice care is provided through certified hospice programs, and may be delivered in any patient care setting, but is most often provided in the patient’s home.

CHA provides state and federal representation and advocacy in the legislative and regulatory arenas to improve access to quality, cost-effective hospice health care services.
 

CHA News Article

CMS Proposes Updates to Payment Rates and Wage Index for Hospices

Patricia Blaisdell, FACHE Alyssa Keefe

On April 27, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update federal fiscal year (FFY) 2019 payment rates and the wage index for hospices.

Under the proposal, CMS estimates payments to hospices would increase by 1.8 percent, or $340 million, compared to FFY 2018. The 1.8 percent update is the result of an estimated 2.9 percent inpatient hospital update, reduced by a 0.8 percent productivity adjustment and a 0.3 percent adjustment mandated by the Affordable Care Act.    

In addition to payment changes, CMS also proposes updates to the Hospice Quality Reporting Program and makes technical changes to regulatory text. Additionally, CMS issues a request for information to solicit comments on ways to achieve interoperability or improved data sharing. 

CHA will provide members with a more detailed summary of the proposed rule in the coming weeks. Comments on the proposed rule are due June 26 by 2 p.m. (PT). A CMS fact sheet is attached.  

CHA News Article

CMS Provides Updates for Post-Acute Care Quality Reporting

Patricia Blaisdell, FACHE

The Centers for Medicare & Medicaid Services (CMS) regularly provides important updates about post-acute care quality reporting programs, including training opportunities, public reporting details and reminders of data submission and review deadlines. Following are the recent updates for inpatient rehabilitation facilities, long-term care hospitals and hospice providers:

Inpatient Rehabilitation Facilities
Provider Preview Reports
Provider preview reports are now available for inpatient rehabilitation facilities (IRFs). IRFs have until April 5, 2018, to review their performance on quality measures based on data from quarter 3 of 2016 to quarter 2 of 2017, prior to their posting to the IRF Compare website in June 2018. Access instructions for the provider reports are available online. Corrections to the underlying data will not be permitted during this time. However, providers can request review by CMS during the preview period if they believe their data are inaccurate. 

Education event For Members

Productive Partners: Hospitals and the Continuum of Care Webinar Series
Using post-acute services to achieve clinical and financial success

Webinar 3: May 29, 2018
10:00 – 11:30 a.m., Pacific Time

Increasingly, providers are looking for continuing care solutions beyond acute care hospital walls. These “post-acute” services support a patient’s continued recovery from illness and play a crucial role in patient care and recovery.  Additionally, as the health care delivery system continues to shift toward population health management, acute care providers will benefit from a better understanding of post-acute care’s role in the health care delivery system. 

CHA News Article

New Law Allows Hospice Providers to Offer Palliative Care to Patients Without Terminal Diagnosis

Patricia Blaisdell, FACHE

The California Department of Public Health has released All Facilities Letter 18-03, notifying providers that a new law established a pilot program that allows licensed hospice providers to provide palliative care to non-terminally but seriously ill patients. Under Senate Bill 294 (Chapter 31, Statutes of 2017), which took effect Jan. 1, providers must notify the department at least 45 days prior to providing palliative care under the pilot program, and must submit required information. At the end of the pilot period, the department will conduct a stakeholder meeting to discuss the results of the reported information and determine the effectiveness of including hospice providers as a means of expanding palliative care for seriously ill patients. More details, including notice and reporting requirements, are available in the attached letter.

CHA News Article

Updates Available on Post-Acute Care Quality Reporting

Patricia Blaisdell, FACHE

The Centers for Medicare & Medicaid Services (CMS) has released important updates on post-acute care quality reporting programs, including training opportunities, public reporting and reminders about data submission and review deadlines. 

Inpatient Rehabilitation Facility/Long-Term Care Hospital Updates

Inpatient rehabilitation facilities and long-term care hospitals may preview performance data on each quality measure based on the second quarter of 2016 through first quarter of 2017. For more information:

CHA News Article

CMS Provides Guides for Post-Acute Care and Hospice Quality Reporting

Patricia Blaisdell, FACHE Alyssa Keefe

The Centers for Medicare & Medicaid Services (CMS) has posted quality reporting program quick reference guides for several post-acute care settings, including long-term care hospitals, inpatient rehabilitation facilities, home health agencies and hospice. The guides include frequently asked questions, information on help desks and links to additional resources. 

CHA News Article

DHCS Releases Guidance to Medi-Cal Managed Care Plans on Providing Palliative Care

Amber Kemp Patricia Blaisdell, FACHE

The California Department of Health Care Services (DHCS) has released the attached All Plan Letter (APL) informing Medi-Cal managed care health plans (MCPs) of their obligation to provide palliative care to Medi-Cal members, pursuant to Senate Bill (SB) 1004 (Chapter 574, Statutes of 2014).To fulfill the bill’s requirement that DHCS establish standards and provide technical assistance to MCPs for the delivery of palliative care, the department outlines its Palliative Care Policy specifying the minimum types of palliative care services MCPs must authorize when medically necessary for a Medi-Cal member who meets eligibility criteria. This APL advises MCPs that, effective Jan. 1, 2018, when a Medi-Cal member meets the minimum eligibility criteria for palliative care, MCPs must authorize palliative care without regard to age.

At a minimum, palliative care must include advance care planning, palliative care assessment and consultation, plan of care, palliative care team, care coordination, pain and symptom management, and mental health and medical social services. The APL further advises MCPs that they must have a process to determine the type of palliative care that is medically necessary or reasonable for eligible beneficiaries, and must have a large enough network of palliative care providers to meet their Medi-Cal members’ needs.

CHA News Article

MedPAC Issues June 2017 Report to Congress

Alyssa Keefe

The Medicare Payment Advisory Commission (MedPAC) released its June 2017 Report to the Congress: Medicare and the Health Care Delivery System. The document includes 10 chapters covering key issues facing the Medicare program and offers solutions to ensure the program’s continued viability. 

In its June report the commission continues its work, required by the Improving Medicare Post-Acute Care Transformation (IMPACT) Act, evaluating the feasibility of a unified prospective payment system (PPS) spanning post-acute care (PAC) settings (e.g., skilled-nursing facility, inpatient rehabilitation facility, long-term care hospital and home health agency). After determining a unified PPS is feasible in its 2016 report, the commission studied three implementation issues: a transition period with blended setting-specific and unified PPS rates, appropriate levels of aggregate PAC payments, and ways to address ongoing refinements to the system after implementation. MedPAC recommends that a unified PAC PPS be implemented beginning in 2021 with a three-year transition, and that aggregate payments should be reduced by 5 percent.

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