Dr Maen Hussein on How Changes in Medicare Hospice Coverage Impact Community Oncology Practices

March 21, 2020

"There is this mentality that hospice means the patient is going to die very soon, and that's really not true," said Maen Hussein, MD, physician director of finance at Florida Cancer Specialists.

"There is this mentality that hospice means the patient is going to die very soon, and that's really not true," said Maen Hussein, MD, physician director of finance at Florida Cancer Specialists.

Transcript:

Have you seen inprovements in the proposed Oncology Care First Model when it comes to accounting for high-cost drugs for some patients? Which proposed change do you believe is the most important?

I think it's still early to judge if the changes have an impact. I think one of the things that seemed to be promising that they had the risk assessment for each cancer so they have the risk stratification, That might help in the future to assess for each type of cancer, how much it will cost to treat those patients and that will help in the bundled payment in the future.

What will CMS's proposed change in the way Medicare Advantage pays for hospice mean for community oncology practices?

I think that hospice is being underutilized in caring for our patients. There is this mentality that hospice means that the patient is going to die very soon, that's really not true. There are more data showing that palliative care and hospice actually help improve the quality of life, and in some cases, even survivorship. I believe that the new changes will help and encourage the oncologists to bring up that topic sooner than later, and maybe help the patient accept that concept and change the culture to understand that being under hospice care, doesn't mean you're dying tomorrow. Actually, the indication for hospice, if the patient has survived, it's less than 6 months, and that actually can be extended. It doesn't mean that you're even dying within 6 months, but that's usually the period and if the patient lived to 6 months, you can even extend that. That will encourage the physicians to approach the patient sooner than later; talking about the option of hospice. I can see that culture change. I've been practicing here for almost 15 years now. It was much harder to talk about hospice before than now, especially when you explain to the patient that this is not the end you're not giving up. But it's a way to focus on your pain and uncomfort and still allow for some palliative therapies. A lot of hospice now are accepting, to pay for radiation therapy or even sometimes some forms of chemotherapy.