So far, the path to make hospice part of the Medicare Advantage benefit has been a rocky one. The so-called “carve-in” failed when the Centers for Medicare & Medicaid Services halted the hospice portion of the Value-Based Insurance Design program last year. And just last month, providers were speaking out against the carve-in to lawmakers at the annual fly-in for the National Alliance for Care at Home. But the two value-based care programs — hospice and MA — are not necessarily incompatible, according to Joe Shega, MD, chief medical officer for hospice provider VITAS Healthcare. As long as all the stakeholders agree about the parameters — that benefits remain intact, that there is no delay in access — there can be a “path forward” for hospice to be part of the MA benefit, he told McKnight’s Home Care in a Newsmakers podcast.
Joe Shega, chief medical officer for VITAS Healthcare, supports the Centers for Medicare & Medicaid Services’ initiative to ensure that hospice beneficiaries have a smooth, uninterrupted, high-quality, highly coordinated hospice experience. Such an experience, he noted, could occur through traditional hospice or Medicare Advantage. But there are certain non-negotiables: There must be access to hospice care as well as safeguarding of the pillars of hospice, which include frequency of touches from multiple disciplines. He also talked about problems involving the now-halted Special Focus Program. One of the problems of the program was it conflated the issues of quality hospice care with fraud, waste and abuse. These are two unique and distinct issues. Other topics discussed included the new Hospice Outcomes and Patient Evaluation (HOPE) assessment tool, which was released on Oct. 1. It allows for real-time assessments at admission and then two times within the first 30 days, Shega said. He noted there have been challenges with the rollout as it coincided with the launch of the new Internet Quality Improvement and Evaluation System. To be successful, HOPE requires adjustments of workflow and scaling. To improve hospice uptake in minority communities, it’s important to make sure the hospice team mirrors the community being served and ensure there are individualized care plans so patients and families feel supported on their end-of-life care journeys, he said.
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Show contributors:
McKnight’s Home Care Editor Liza Berger; Joe Shega, MD, Chief Medical Officer, Vitas Healthcare