Model Aims to Increase Choice and Quality by Enabling Individuals to Receive Palliative and Curative Care Concurrently
Detroit, August 24, 2015 – Hospice of Michigan has been selected to participate in the Medicare Care Choices Model announced today by Health and Human Services Secretary Sylvia M. Burwell.
The model provides Medicare beneficiaries the option to elect to receive supportive care services typically provided by hospice and continue to receive curative services at the same time. The announcement is part of a larger effort to transform America’s health care system to deliver better care, spending dollars in a smarter way and putting patients in the center of their care.
Hospice of Michigan, the state’s original – and largest – provider of hospice and palliative care services, is one of more than 140 hospice organizations selected to participate in the national Medicare Care Choices model. All eligible hospices across the country were invited to apply to participate in the model.
Due to robust interest, the Centers for Medicare & Medicaid Services, or CMS, expanded the model from an originally anticipated 30 Medicare-certified hospices to more than 140 Medicare-certified hospices and extended the duration of the model from three to five 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 or acquired immunodeficiency syndrome to experience this new option and flexibility.
Patients who qualify for Medicare or Medicaid hospice benefits can elect to receive supportive care services while continuing to receive curative services at the same time. 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.
Hospice of Michigan will participate in the first and second phases of the program, expanding on the framework currently used in its At Home Choices program to provide more robust care options. Launched in 2013, At Home Choices is community-based palliative care program that currently serves more than 280 patients statewide.
“We are incredibly pleased to have been selected by CMS to participate in this national Medicare Care Choices model,” said Robert Cahill, president and CEO of Hospice of Michigan. “At Home Choices aligns perfectly with the CMS goals of improving care coordination, case management and quality of care while reducing expenses.
“Medicare has provided hospice care as a benefit since 1983, allowing organizations like ours to provide compassionate end-of-life care. This model program could be the first step in expanding that benefit to provide expanded care options for families struggling to care for loved ones struggling with a serious illness.”
Developed by the Hospice of Michigan Institute, At Home Choices assigns a dedicated nurse case manager to assist patients and their families with care planning and the palliative needs associated with a serious illness. Patients receive an in-person needs assessment by an At Home Choices clinical staff member to develop an individual scope of treatment plan.
The nurse case manager collaborates with the patient’s current medical team to optimize medical treatment and pain and other symptom control. If needed, the manager can bring in additional resources such as a social worker or spiritual care advisor.
“We have achieved tremendous results with At Home Choices, which closes an existing gap in care as it encourages patient-centered choices,” Cahill said. “Families no longer are forced to make the difficult decision between receiving supportive care or continuing to seek active treatment; this program allows them to do both.
“At Home Choices is one of a several innovative programs we have developed to complement our traditional hospice services and provide a true continuum of care. Through innovative partnerships and testing of new care payment and delivery models, Hospice of Michigan has gained valuable insight into health care challenges. We look forward to sharing our knowledge and expertise with other hospice providers and with CMS through this model.”
Developed by the Hospice of Michigan Institute, At Home Choices used evidenced-based tools for risk screening in its care planning, evaluation of health outcomes and measurement. Clinicians screen patients for symptom burden, hospital risk and functional needs, along with ongoing assessments of spiritual and culture needs.
The quality framework includes measures for lowering per-capita costs centered on the impact of improved coordination and improved outcomes associated with transitions and end-of-life measures. We propose that along with cost analysis methods, end-of-life transitions (specifically, the proportion of patients who do not transition to hospice), and assessment of emergency room and ICU use in the last weeks and month of life through claims data analysis should be considered in the overall MCCM analysis.
For additional information on the model, visit: https://innovation.cms.gov/initiatives/Medicare-Care-Choices/
About Hospice of Michigan
A nationally recognized leader in end-of-life care, Hospice of Michigan is the original – and largest – hospice in the state. The nonprofit cares for more than 1,700 patients each day, raising more than $4 million each year to cover the cost of care for the uninsured and underinsured. HOM offers a broad range of services to enhance the quality of life at the end of life, including At Home Support™, our advanced illness management program, community-based palliative care and pediatric care programs. HOM provides grief support and counseling, caregiver education and support, and education programs for physicians and health care professionals through its research, training and education arm, the Hospice of Michigan Institute. For more information, call 888.247.5701 or visit www.hom.org.
About the Hospice of Michigan Institute
The Hospice of Michigan Institute is the premier hub for research, education and community outreach initiatives aimed at improving care for people who are seriously ill and providing support for their caregivers. As the only research and innovation center in Michigan focused on end-of-life care, the Institute provides a place where palliative care experts can exchange ideas on enhancing the care of the seriously ill and dying, and where health care providers can learn new ways to improve the care they provide their patients in the last phase of life.