Literature Review

Blumenauer proposes overhaul to Hospice Benefit: If enacted, the legislation would be the single most significant update to the hospice benefit and payment structure since its inception in 1982.U.S. Congressman Earl Blumenauer, Washington, DC; Press Release; 9/26/24Today, Congressman Earl Blumenauer (D-OR), a senior member of the Ways and Means Committee, introduced the Hospice Care Accountability, Reform and Enforcement Act (Hospice CARE Act) to modernize Medicare’s hospice benefit, which has remained largely unchanged since its inception in 1982. The proposal comes as egregious reportsof fraud and abuse within the benefit persist, despite action from Centers for Medicare & Medicaid Services (CMS). The legislation is the product of years of collaboration between stakeholders, lawmakers, and industry leaders. It builds on Blumenauer’s decades-long commitment to ensure the federal government supports families at a time of great stress and vulnerability: the end of life. 

BREAKING NEWS: 9/27/2024 11:45 am - Blumenauer proposes overhaul to Hospice Benefit: If enacted, the legislation would be the single most significant update to the hospice benefit and payment structure since its inception in 1982.

The ROI of interoperability in home health Home Health Care News; by Elizabeth Ecker; 9/16/24 Today’s home-based care organizations know there is value in interoperability among their technology vendors. Allowing for seamless data integration as well as ease-of-use for staff and clinical professionals, interoperability is an important consideration for technology decisions in today’s operating environment. But what is the true value of interoperability, and how can home-based care agencies measure their return on investment? Several leading professionals share their perspectives on how they approach ROI calculations in their organizations.

Bayada Home Health Care settled nurses’ wages class action lawsuit for $13.5 million Head Topics - Daily Botique; 9/13/24 The settlement, if approved by a judge, will cover nearly 11,000 Bayada nurses in Pennsylvania. Bayada Home Health Care Inc., one of the nation’s largest home care providers, agreed to settle a class-action lawsuit in Philadelphia alleging the company failed to pay nurses for time spent updating the incoming nurse or caregiver on a patient’s condition and for time spent in mandatory training sessions the $13.5 million Philadelphia Court of Common Pleas settlement.Editor's note: Additional information is behind a paywall at the Philadelphia Inquirer.

2024 NHPCO Facts and Figures Report now available National Alliance for Care at Home, Alexandria, VA and Washington, DC; Press Release; 9/10/242022 Data Show First Increase in Hospice Utilization Rates Since COVID The National Alliance for Care at Home (the Alliance) published the 2024 edition of National Hospice and Palliative Care Organization (NHPCO) Facts and Figures, an annual report on key data points related to the delivery of hospice care, including information on patient characteristics, location and level of care, Medicare hospice spending, and hospice providers. Facts and Figures – the leading resource for hospice providers and others interested in understanding the work of the community – has been published annually for over two decades by NHPCO. ... The findings in this report reflect patients who received care in Calendar Year (CY) 2022, or Fiscal Year (FY) 2022, provided by hospices certified by the Centers for Medicare and Medicaid Services (CMS) and reimbursed under the Medicare Hospice Benefit. This year COVID-19 continued to impact patient care as COVID-19 waivers were still in place through May 2023. These waivers included increased telehealth services. With 49.1% of all Medicare decedents in 2022 choosing hospice care, utilization of hospice increased in 2022 for the first time since 2019. The increase hints at a normalization of the utilization rates back to pre-COVID data. Hospice utilization rates increased across all race and ethnicity groups, with the largest increase among Hispanic Medicare beneficiaries seeing. The total number of beneficiaries enrolled in hospice care in 2022 was 1.72 million. Due to the unique impact of COVID-19 on 2020 data, those data are not included in many of the charts this year.

A wave of change is coming for healthcare benefits — are hospitals ready? Becker's Hospital CFO Report; by Jakob Emerson; 9/3/24Surveys of employers are making one thing clear: Healthcare costs are rising faster than they did before the pandemic, and those costs are being driven by inflation, the increasing use of weight loss medications, and higher overall medical expenses.  ... As financial pressures mount, many employers are exploring or expanding alternative payment and coverage models, a trend that could significantly alter hospital's revenue streams. ...  The average cost of employer-sponsored coverage is expected to jump 9% from 2024 to 2025, according to estimates from Aon published in August. Healthcare costs per employee are projected to surpass $16,000 per employee in 2025, driven by rising employment levels, inflation and rising pharmaceutical costs. In 2024, employers budgeted an average of $14,823 per employee for healthcare costs. These costs have risen by more than 20% over the past five years and by 43% over the past decade.

Seven-year-old finishes 145-mile charity challenge BBC News, Northamptonshire, United Kingdom; by Brian Farmer; 9/2/24 A seven-year-old boy has raised more than £600 for charity after walking, cycling and scooting 145 miles over four months. Isaac Yates, from King's Cliffe, Northamptonshire, got into the habit of exercising on 1 May and completed his 145-mile (233km) challenge, in aid of the Sue Ryder Thorpe Hall Hospice in Peterborough, on 1 September. He has helped walk family dogs Poppy and Summer, ridden his bike, and scooted his scooter until the mileage totted up to his 145 target. The youngster added to the fun by logging his trips on an online Lord of the Rings game - which enabled him to take a virtual 145-mile journey through writer J. R. R. Tolkien's fictional Middle Earth with two Hobbits.Editor's Note: Pair this with today's article, Crisis in care for dying people says Marie Curie as survey shows suffering. 

Hospice’s post-VBID value-based outlook Hospice News; by Holly Vossel; 8/15/24 The post-Medicare Advantage hospice carve-in landscape could include wider value-based reimbursement avenues in the hospice space, leading providers to pivot into MA payer relationships. The forthcoming end of the hospice component of the value-based insurance design (VBID) demonstrative takes effect Dec. 31. Launched in 2021, the carve-in was designed to test coverage of hospice care through Medicare Advantage, as well as coverage of palliative and transitional care. Hospices will need a strong value-based payment negotiation strategy to prepare for the unknowns that lie ahead, according to Melinda Gaboury, co-owner and CEO of Healthcare Provider Solutions Inc., a hospice and home care consulting company. 

Biden administration says Medicare negotiated price discounts on 10 prescription drugs USA Today; by Ken Alltucker; 8/15/24 ... The Biden administration announced Thursday that Medicare had negotiated discounts with pharmaceutical companies on 10 drugs prescribed to treat blood clots, cancer, heart disease and diabetes. The drugs are Eliquis, Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, and the insulins Fiasp and NovoLog. The discounts will range from 38% to 79% when the negotiated prices take effect in 2026. The bargaining will save Medicare $6 billion when the price cuts are implemented in two years, according to U.S. Department of Health and Human Services estimates. 

The tangled web of pediatric palliative care payment and policy Hospice News; by Holly Vossel; 8/13/24 A complex web of state regulations and reimbursement systems can challenge pediatric palliative care access for seriously ill children and their families. The nation’s fragmented health care system lacks clear guidance when it comes to navigating chronic, complex conditions in children, adolescents and young adults, according to Jonathan Cottor, CEO and founder of the National Center for Pediatric Palliative Care Homes. Much of the current state palliative regulations and reimbursement pathways focus on adult patient populations, representing a significant barrier to improved quality and support in the pediatric realm, Cottor said.

Letter: Closing Cottage of the Meadow [Hospice House] is a loss for allYakima Herald-Republic, Yakima, WA; by Lee Murdock; 8/13/24, with news post from 8/5/24 [Letter] To the editor — I was devastated to learn that Cottage in the Meadow, our local hospice facility, is ending hospice care. Both of my parents were fortunate enough to spend their final days in this serene and caring environment. The difference between the overrun hospital setting with its short staffing and the compassionate, individualized care at Cottage in the Meadow was stark. This facility provided invaluable support not only to those at the end of life but also to their families. As our population ages, the need for such services will only increase. Studies have shown that hospice care can reduce healthcare costs by up to 30% compared to traditional hospital care (Journal of Palliative Medicine). Additionally, hospice care significantly reduces hospital readmissions and emergency room visits, further reducing healthcare costs (JAMA). In a healthcare system with ample profit margins, ensuring access to hospice care is the least we can do. ...Editor's Note: This letter to the editor was in response to Yakima Herald-Republic's 8/5/24 article, "Yakima's Cottage in the Meadow will close its hospice house. It will reopen as a skilled nursing facility."

Hospices face ‘hard roads’ in budgeting for sustainable growthHospice News; by Holly Vossel; 8/9/24Hospice budgeting practices hinge on several factors, according to Matt Chadwick, CFO of Well Care Health. Building a sustainable financial structure for end-of-life care delivery can be a challenging feat when navigating the impacts of patient care and staffing needs, referral streams, operational expenses, billing claim cycles and compliance factors, Chadwick said... Quality and compliance are also important pieces of a hospices’ budget and growth potential as providers experience. Case in point, hospices that fail to comply with new quality reporting requirements set forth in the 2025 payment rule face a 4% penalty... “The budget should not just be solely 100% of the financial person’s responsibility,” Rachael Feeback, revenue cycle senior product manager of home and hospice at MatrixCare by ResMed, said. “It should be a conversation with the clinical side, the operational side, so that you’re understanding your different measurements for hospice and how that translates to the budget and not solely focused on the pure dollars behind it.”

[CMS Fact Sheet] Fiscal Year (FY) 2025 Hospice Payment Rate Update Final Rule (CMS-1810-F) CMS Fact Sheet - Final Rule (CMS-1810-F); 7/30/24 On July 30, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a final rule (CMS-1810-F) updating Medicare hospice payment rates and the aggregate cap amount, for fiscal year (FY) 2025, in accordance with existing statutory and regulatory requirements. This rule also finalizes the proposal to adopt the most recent Office of Management and Budget (OMB) statistical area delineations, which impacts the hospice wage index and clarifies current policy related to the hospice “election statement” and the “notice of election” (NOE), as well as adds clarifying language regarding hospice admission and certification of terminal illness. The final rule summarizes public comments received related to the request for information regarding implementing a separate payment mechanism to account for high-intensity palliative care services. Editor's Note: Click here for the full Final Rule.