Instead of making patients suffering from life-limiting illnesses choose between hospice care and curative care, CMS will test coverage that allows individuals to receive palliative and curative treatment concurrently.
Instead of making patients suffering from life-limiting illnesses choose between hospice care and curative care, CMS will test coverage that allows individuals to receive palliative and curative treatment concurrently, according to an announcement from HHS. As it stands now, with Medicare beneficiaries required to choose one service or the other, fewer than half of eligible patients use hospice care, and often only for a short period of time.
Hospices have been selected to participate in the Medicare Care Choices Model, which provides the option for Medicare beneficiares and dually eligible beneficiaries who qualify for coverage under the Medicare and Medicaid hospice benefits to receive supportive care services provided by a hospice while undergoing curative treatment.
“This model empowers clinicians, beneficiaries and their families with choices and is part of our broader efforts to transform our health care system into one that delivers better care, makes smarter payments, and puts patients in the center of their own care,” HHS Secretary Sylvia M. Burwell said in a statement. “We want to do what we can to help families find the care that is right for their loved one.”
Originally the model was going to only include 30 Medicare-certified hospices, but due to interest the program has been expanded to 140 hospices during the duration of the model from 3 to 5 years. According to HHS, as many as 150,000 eligible beneficiaries with advanced cancers, chronic obstructive pulmonary disease, congestive heart failure, and HIV/AIDS who receive hospice care will be able to elect this new option.
The Supreme Court seems likely to reject a challenge to the abortion pill mifepristone; the FDA is inspecting far fewer pharmaceutical companies conducting clinical research; AstraZeneca has sued to block an Arkansas law that it said would unlawfully expand the 340B program to include for profit-pharmacy chains.
Read More
Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
Listen
Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
Listen
Covered Preventive Services at Risk: V-BID Summit Breaks Down the Braidwood v Becerra Case
March 20th 2024For more than a decade, certain high-value preventive care services have been covered at no cost to patients under the Affordable Care Act, but a current legal challenge has the coverage at risk.
Read More