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February 02, 2023 at 01:34 PM
What You Need to Know
- Patients have been expressing concerns about hospice care quality for years, and advisors have been hearing about it regularly.
- Once finalized, the CMS's HOPE program will gather information about different hospice programs to develop a quality rating tool.
- One Medicare advisor wants to see hospice information, including quality rating information, sent to the Medicare.gov website Plan Finder tool.
Patients are complaining that some hospice programs shortchange dying Medicare enrollees and their families.
In response, Medicare program managers are promising that a new, improved hospice program quality rating program is going through a national testing process.
The Centers for Medicare and Medicaid Services, the agency that oversees Medicare, posted an update on the Hospice Outcomes and Patient project, or HOPE project, last week.
“When finalized in future rulemaking, HOPE will be implemented in the Medicare Hospice Benefit to provide value to hospice providers, patients and families,” CMS officials said.
What It Means
Any new hospice quality rating tool could help you give better advice to some of your most vulnerable clients: People who have a life expectancy of less than six months and their families.
Advisors who are taking hospice program problems into account might want to encourage clients to consider increasing the pot of savings earmarked for health care expenses and buying recovery care insurance, or short-term care insurance.
Some advisors might want to vet and form referral relationships with elder care management and advocacy services.
The Medicare Hospice Program
Medicare is a federal program that covers health care for 65 million Americans who are over the age of 65, qualify for Social Security disability insurance or have the kind of kidney disease that leads to dialysis and organ transplants.
For people who appear to be nearing the end of life and who agree to go without the kind of care that might be provided in an effort to cure their conditions, hospice programs provide extra coverage for care that might make the patient feel more comfortable.
The extra benefits could cover home health care services, medical supplies and some services resembling long-term care services, such as homemaker services and short periods of inpatient care intended to give a family caregiver a break.
Normally, Medicare declines to pay for homemaker services and other long-term care services. Patients who need those services must pay out of their own pockets, use private insurance to pay the bills or exhaust their assets and qualify for Medicaid nursing home benefits.
The Hospice Care Controversy
Patients have been talking about concerns about hospice care quality for years.
