National Hospice and Palliative Care Organization

Some hospice advocates and providers are concerned that too few Medicare beneficiaries will qualify for a CMS experimental program that lets terminally ill patients continue curative treatment after starting hospice care, Modern Healthcare reports.

Medicare patients now must forgo curative services when they enroll in a hospice program to receive palliative care during the dying process. “But studies have found that providing both forms of care concurrently improves quality of life and reduces costs since those patients tend to not make frequent hospital visits,” the publication reports.

Under a demonstration run by the CMS Innovation Center, Medicare is paying some hospices $400 per beneficiary per month for palliative services while also letting providers and suppliers of curative services  bill Medicare.

But“ {u}nfortunately, the early indication from the first group of 71 hospice awardees is that this demonstration has been constructed too narrowly, and that CMS has so tightly managed it that few patients’ are able to participate,” Don Schumacher, CEO of the National Hospice and Palliative Care Organization, told Patrick Conway,  M.D., the CMS’s deputy administrator for innovation and quality. The trade group  comprises not-for-profit hospice and palliative-care programs.

Modern Healthcare reports that patients must meet 14 requirements before they can can be enrolled in the demonstration. The demonstration program is only open to individuals with late-stage cancer, chronic obstructive pulmonary disease, HIV or congestive heart failure who are otherwise hospice-eligible. The most recent Medicare hospice data indicates that only a third of hospice-eligible beneficiaries have one of these diagnoses.