Providence Hospice selected to participate in the Medicare Care Choices Model

August 11, 2015

Providence Hospice has been selected to participate in the Medicare Care Choices Model. The model provides Medicare beneficiaries who qualify for coverage under the Medicare Hospice Benefit and dually eligible beneficiaries who qualify for the Medicaid Hospice Benefit the option to elect to receive supportive care services typically provided by hospice and continue to receive curative services at the same time. The model is part of a larger effort across the nation to transform our health care system to deliver better care, spend our dollars in a smarter way, and put patients in the center of their care.

Under current payment rules, Medicare patients with serious life limiting illnesses must stop receiving any curative treatments for their disease in order to receive the palliative care benefits of a hospice program. This is often an extremely difficult choice for the patient and his or her loved ones. Now, thanks to the Medicare Care Choices Model, launched by the Center for Medicare & Medicaid Services (CMS), that decision will no longer be necessary.

“The comforts and expertise of palliative care in a hospice program aim to maximize quality of life,” says Jane Brandes, Director of Hospice with Providence Home Services in Oregon. “This program means that patients will no longer face an ‘either-or’ decision to end medical treatments in order to ease the pain and stress of managing their illness.”

Providence Hospice is the only hospice in Oregon selected for the model. CMS expanded the model from an originally anticipated 30 Medicare-certified hospices to over 140 Medicare-certified hospices and extended the duration of the model from 3 to 5 years. This is expected to enable as many as 150,000 eligible Medicare beneficiaries with advanced cancers, chronic obstructive pulmonary disease, congestive heart failure, human immunodeficiency virus/acquired immunodeficiency syndrome who receive services from participating hospices to experience this new option and flexibility.

Participating hospices will provide services under the model that are currently available under the Medicare hospice benefit for routine home care and respite levels of care, but cannot be separately billed under Medicare Parts A, B, and D. Services will be available around the clock, 365 calendar days per year and CMS will pay a per beneficiary per month fee ranging from $200 to $400 to participating hospices when delivering these services under the model. Services will begin starting January 1, 2016 for the first phase of participating hospices, which includes Providence Hospice in Oregon, and in January 2018 for the remaining participating hospices.

Learn more about the Medicare Care Choices Model ›