CMS to Reimburse Concurrent Hospice and Curative Care

The Centers for Medicare & Medicaid Services (CMS) is piloting a new Medicare Choices Care Model, designed to provide a new option for Medicare beneficiaries to concurrently receive palliative care services from hospice providers while also receiving services from curative care providers.

Currently, Medicare beneficiaries are required to forgo curative care in order to receive access to palliative care services offered by hospices. This model will test whether Medicare beneficiaries who qualify for coverage under the Medicare hospice benefit would elect to receive the palliative and supportive care services typically provided by a hospice if they could continue to seek services from their curative care providers.

CMS will study whether access to such services will result in improved quality of care and patient and family satisfaction, and whether there are any effects on use of curative services and the Medicare hospice benefit.

CMS will select at least 30 rural and urban Medicare certified and enrolled hospices that have demonstrated experience with an established network of providers for referrals to hospice. The program is limited to beneficiaries with advanced cancers, chronic obstructive pulmonary disease, congestive heart failure, and HIV/AIDS.

“This initiative represents a fundamental change in the way healthcare is delivered,” said US Senator Ron Wyden of Oregon, who authored the provisions that established the model. “Patients and their families should have every choice available to them when faced with life-threatening illness. Allowing Medicare coverage to continue while under hospice care means that patients no longer have to make a false choice between hospice and curative care.”

Eligible hospice organizations interested in participating in this model must submit application materials no later than June 19, 2014. For more information, visit http://innovation.cms.gov/ initiatives/Medicare-Care-Choices/.