Hospice Concurrent Care Demonstration Not Yet Implemented by CMMI
Tuesday, May 21, 2013
by: VNAA Policy Team

Section: Public Policy and Advocacy

The Center for Medicare and Medicaid Innovation (CMMI) has not yet implemented a Congressionally mandated demonstration project to test concurrent hospice services. The demo would allow beneficiaries to continue lifesaving treatments while enrolled in the hospice care to see if money can be saved at the same time that a patient’s quality of life could be improved.

As VNAA members know, many rapidly declining patients delay entry into hospice until their final days as they exhaust their treatment options. Others end up dying in hospital intensive care units, which are expensive and generally not geared to making the terminally ill as comfortable as possible.

For children, the 2010 Affordable Care Act (ACA) included a provision requiring Medicaid to pay for joint hospice and curative treatments for children. To date more than half the states have taken steps to implement this provision of the law.
The ACA also required the Secretary of Health and Human Services to select up to 15 sites to test a Medicare concurrent care (providing both curative and palliative treatments) for three years. The ACA requires that the demonstration be “cost neutral” or not spend more than might have otherwise been spent.

According to 2011 data from CMS, Medicare spent $13.8 billion on hospice, with an average per patient of $11,342. The Medicare Payment Advisory Commission (MedPAC) has indicated it is uncertain if the concurrent care demonstration would yield savings without close management of the services beneficiaries choose. 

To read a Kaiser Health News article with more information on this topic, please click here.
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