Literature Review

Hosparus Health ranked fourth in nation for overall quality The News-Enterprise; 10/5/24 Hosparus Health has been ranked fourth in the nation for Overall Quality among the 50 largest hospices, according to a study published in the American Journal of Hospice & Palliative Medicine. This ranking was determined based on key metrics: Consumer Assessment of Healthcare Providers and Systems caregiver survey scores, employee satisfaction ratings from Glassdoor and sentiment scores from Google reviews. David W. Cook, president and CEO of Hosparus Health, expressed his pride in the organization’s staff. “Your care, your compassion, it’s those on the front line of our care,” Cook said. “It’s thrilling to see the recognition of what you do here celebrated nationally.” Since 1978, Hosparus Health has been at the forefront of hospice and palliative care services, caring for thousands of patients across Kentucky and Indiana, the release said. Today, the nonprofit organization, which has offices in Elizabethtown, continues to provide expert care and holistic support to more than 14,000 patients and families annually, ensuring that each individual receives compassionate, high-quality care during life’s most challenging times.

The road ahead: 2 pressures framing the future of hospice care Hospice News; by Jim Parker; 10/1/24 The workforce shortage and value-based care will shape the future of hospice, according to some providers. The health care reimbursement environment is moving towards significant change. The U.S. Centers for Medicare & Medicaid Services (CMS) has signaled its intention to align every Medicare beneficiary with a value-based payment system by 2030. To keep pace, hospice providers must start preparing now, according to Phil Ward, president and CEO of Community Hospice of Northeast Florida. We’re implementing quality movement projects now. So that when these changes come we’re not taken by surprise,” Ward said at the National Hospice and Palliative Care Organization (NHPCO) Annual Leadership Conference. ... The second major force that could mold the industry’s future is the staffing shortage, Leigh Anderson, medical director for Our Hospice of Indiana, said during the NHPCO conference. This includes issues like turnover, nurse-to-patient ratios and health care worker burnout, she said.

BREAKING NEWS 10/1/2024, 12:30pm - Medicare Program; FY 2025 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, and Hospice Quality Reporting Program Requirements; Correction Federal Register - The Daily Journal of the United States Government; Centers for Medicare & Medicaid Services  (CMS), Department of Health and Human Services (HHS); 10/1/24 This document corrects technical and typographical errors in the final rule that appeared in the August 6, 2024 Federal Register titled “Medicare Program; FY 2025 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, and Hospice Quality Reporting Program Requirements”.I. Background: In FR Doc. 2024-16910 of August 6, 2024 (89 FR 64202), there were a number of technical and typographical errors that are identified and corrected in this correcting document. The provisions in this correction document are effective as if they had been included in the final rule that appeared in the August 6, 2024 Federal Register . Accordingly, the corrections are effective October 1, 2024.II. Summary of Errors: ...Given these errors, we are republishing the FY 2025 Hospice Wage Index file accordingly on the CMS website at: https://www.cms.gov/​medicare/​payment/​fee-for-service-providers/​hospice/​hospice-wage-index effective October 1, 2024.

Alliance sees Hospice CARE Act as opportunity to advance hospice benefit discussionNHCPO / National Alliance for Care at Home; Press Release; 9/26/24 The National Alliance for Care at Home (the Alliance), a new national organization formed by the integration of the National Association for Home Care & Hospice (NAHC) and the National Hospice and Palliative Care Organization (NHPCO) recognizes the introduction of the Hospice Care Accountability, Reform, and Enforcement (CARE) Act, by Congressman Earl Blumenauer (OR-3).  The Alliance shares Rep. Blumenauer’s desire to update the Medicare hospice benefit to address the evolving needs of our country’s aging population while ensuring the sustainability and integrity of the hospice program. As a long-standing champion of hospice care, Rep. Blumenauer has consistently demonstrated a commitment to ensuring that hospice services remain accessible, compassionate, and of the highest quality for patients and their families. The Alliance appreciates Rep. Blumenauer’s commitment to involving a diverse group of stakeholders in developing this legislation and will continue to work closely with congressional leaders on the finer points of the proposed bill to ensure that the final legislation supports the needs of patients, families, and providers alike. 

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. 

‘Think like a reviewer’: How hospices can use communication, documentation to boost quality McKnights Home Care; by Adam Healy; 9/24/24 Regulators are tightening their scrutiny of the hospice industry, so providers must prioritize the documentation and communication practices that help them obtain higher quality scores. That’s according to hospice industry experts who spoke during an educational session at the National Hospice and Palliative Care Organization’s annual meeting in Denver. “They’re looking closely at the hospice industry,” Angela Huff, senior managing consultant at Forvis Mazars, said last week during the conference. “They have increasing concerns about fraud, waste and abuse in this space. … Don’t think this is going to stop.” ... A key part of hospice quality assurance is communication, Gallarneau said. Providers should support open, friendly channels of communication. This helps staff and clients feel comfortable raising concerns, making quality issues easier to tackle quickly and effectively. Also, prioritizing accuracy in documentation will help providers stay ready for any surveys or audits, Gallarneau noted. Hospices should ensure patient consent and election of benefit forms are properly filled out, signed and dated, and staff should all be trained to do so accordingly. 

Cigna to cut Medicare Advantage plans in several statesModern Healthcare; by Lauren Berryman; 9/19/24Cigna Group's health insurance unit is scaling back Medicare Advantage offerings in eight states next year, according to a notice to third-party marketers published by the insurance brokerage Pinnacle Financial Services. Members in 36 health plans will be affected by Cigna Healthcare’s cuts and service area reductions in Colorado, Florida, Illinois, Missouri, North Carolina, Tennessee, Texas and Utah. Most people will have another Cigna Medicare Advantage plan available in their counties. The company's Medicare Advantage business is fully exiting at least three counties: two in Missouri and one in North Carolina, the notice said.

New red flags emerge in hospice UPIC auditing Hospice News; by Holly Vossel; 9/20/24 Unified Program Integrity Contractor (UPIC) auditors are taking a sharper look at nursing home room-and-board for hospice patients. Hospices have increasingly faced more regulatory scrutiny in recent years amid rising program integrity concerns, including ramped up UPIC audits, among various others. These audits are designed to instill oversight measures aimed at safeguarding against bad actors in the hospice industry. Regulators have been zeroing in around hospices’ data when it comes to patient interviews and Medicaid skilled nursing room-and-board payments, among other aspects of care delivery. These data could give UPIC auditors clues as to potential malfeasance. However, auditors’ data extrapolation methodology is flawed and poses risks for quality hospice providers, according to Bryan Nowicki, partner at the law firm Husch Blackwell.

What are the Medicare respite care guidelines? Medical News Today; by Amy McLean; 9/18/24 Medicare Part A and Medicare Advantage may cover respite care as part of hospice care coverage. A person will usually need to pay 5% of the Medicare-approved amount for respite care. Respite care allows the carer to take a short amount of time off from caring for an individual. If the Medicare beneficiary spends this time in a medical facility, Medicare will likely cover the cost of the stay. [Click on the title's link to read on] ... to learn more about Medicare coverage for respite care, including what it means and what costs may be involved.

CMS updates guidance for rural emergency hospitals: 16 things to know Becker's Hospital CFO Report; by Alan Condon; 9/17/24 CMS has updated guidance for hospitals interested in converting to a rural emergency hospital, a Medicare designation that was made available Jan. 1, 2023. REHs are a provider type established by the Consolidated Appropriations Act, 2021, to address concerns over rural hospital closures and provide rural facilities a potential alternative to closure.  Since 2005, 106 rural hospitals have shut down, with another 86 facilities no longer providing inpatient services, according to data compiled by the University of North Carolina's Cecil G. Sheps Center for Health Services Research. Of those, 37 closures have occurred since 2020. Here are 16 things to know about REHs, including designation requirements, qualifying facilities, conditions of participation and how many hospitals have converted to REHs.  

CMS submits 75,000 pages to federal court to justify nursing home staffing mandate McKnights Long-Term Care News; by Kimberly Marselas; 9/15/24 The Department of Health and Human Services filed more than 75,000 pages of rule-making records with a federal court Friday, beginning its formal defense of its controversial nursing home staffing mandate. The submission of the administrative record is the first significant advance in the case since the American Health Care Association brought its challenge to the minimum staffing standard in late May. The Texas Health Care Association, three Texas providers and LeadingAge are also part of the case. In another development, District Court for the Northern District of Texas Judge Matthew Kacsmaryk on Sept. 10 agreed to fold in a separate federal challenge against the staffing mandate filed by the state of Texas. He noted that the two cases “share common questions of law or fact, consist of similar parties, the same claims, and [have] the same relief sought.”

More home health providers sunset relationships with largest Medicare Advantage players Home Health Care News; by Andrew Donlan; 9/13/24 Essentia Health--a regional nonprofit health system with a substantial home health arm--announced this week that it will no longer serve as an in-network provider for UnitedHealth Group. ... Dr. Cathy Cantor, Essentia’s chief medical officer for population health, said in a statement ... “The frequent denials and associated delays negatively impact our ability to provide the timely and appropriate care our patients deserve. This is the right thing to do for the people we are honored to serve.” Headquartered in Duluth [MN], Essentia Health provides care across Minnesota, Wisconsin and North Dakota. Its network includes about 15,000 employees, 14 hospitals, 78 clinics, six long-term care facilities, six assisted living and independent living facilities, and much more. It also has a robust home health and hospice business. The company has informed patients that it will no longer serve as an in-network provider for the above-mentioned MA payers beginning Jan. 1. ... Sanford Health, a health system based in Sioux Falls, South Dakota, announced a similar plan this week. 

CMS teases new cybersecurity policies for third-party vendors Modern Healthcare; by Bridget Early; 9/13/24 The Centers for Medicare and Medicaid Services is planning oversight of third-party healthcare vendors in the wake of the Change Healthcare cyberattack, said Jonathan Blum, the agency's principal deputy administrator. Blum, who also serves as chief operating officer for CMS, said at Modern Healthcare's Leadership Symposium Thursday that the agency is working to determine what levers it can pull to ensure severe disruptions in care like those linked to the cyberattack on the UnitedHealth Group subsidiary aren’t repeated. ... Almost 133 million individuals were affected by healthcare data breaches last year, more than double the number of those affected in 2022 and a number equivalent to about 40% of the U.S. population.