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Palliative Care, Health Equity Growing in Medicare Advantage

Hospice News

Reimbursement for community-based palliative care is gaining ground in the Medicare Advantage realm. Palliative care is among the wide range of supplemental benefits that exist within the Medicare Advantage payment landscape. This is a rise from 180 MA plans in 2023 offering palliative services and 64 MA plans in 2020.

Medicare 241
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CMMI Analysis: Palliative Care Reduces Medicare Costs, Improve Patient Satisfaction

Hospice News

Despite this potential, existing programs hit barriers created by misconceptions about palliative care among referring physicians, as well as health equity concerns, among others, according to an analysts of four payment model demonstrations carried out by the Center for Medicare & Medicaid Innovation.

Medicare 317
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‘Upgrading’ the Medicare Hospice Benefit

Hospice News

The Medicare Hospice Benefit could use an “upgrade” to ensure greater flexibility that may be necessary to fully support patients’ needs. Centers for Medicare & Medicaid Services (CMS) should consider is retiring the six-month terminal prognosis requirement and allowing for some concurrent care, Wallace and Wladkowski indicated.

Medicare 278
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The Role of Medicare Advantage in Growing Palliative Care Services

Hospice News

For the time being, Medicare Advantage may be providers’ best bet for palliative care reimbursement. Centers for Medicare & Medicaid Services (CMS) also allows Medicare Advantage plans to cover palliative care as a supplemental benefit.

Medicare 305
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Dynamics of Palliative Care Delivery in a Potential Medicare Benefit

Hospice News

A moving target in palliative care delivery is whether or not these services should have a dedicated benefit in the Medicare system. Most palliative care in the United States is reimbursed through fee-for-service programs, as well as Medicare Advantage, Accountable Care Organizations (ACOs) and through Medicaid in a handful of states.

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Medicare Advantage Crackdown Could Dampen Palliative Care Growth

Hospice News

Federal regulators are cracking down on the private insurers that administer Medicare Advantage (MA) plans. Centers for Medicare & Medicaid Services (CMS) began giving plans more flexibility around the definition of “primarily health-related.” based research and consulting firm ATI Advisory.

Medicare 246
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Medicare Home Health Cuts Could Have Ripple Effect on Hospice, Palliative Care

Hospice News

Margin pressures from the proposed cuts to Medicare home health rates could impact palliative care and hospice. Centers for Medicare & Medicaid Services (CMS) in June released its proposed home health reimbursement rule for 2023, which included a 4.2% reduction in aggregate payments totaling an estimated $810 million.

Medicare 317