lunes, 20 de julio de 2015

CMS NEWS: Medicare Care Choices Model Awards

Centers for Medicare & Medicaid Services


July 20, 2015

Contact: CMS Media Relations
(202) 690-6145 | CMS Media Inquiries

Medicare Care Choices Model awards
As part of a larger effort at the Department of Health and Human Services 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 to keep them healthy, the Centers for Medicare & Medicaid Services today announced the participants in a new model that empowers beneficiaries, their families, and clinicians by providing them with greater flexibility in deciding between hospice care and curative treatment when faced with life limiting illness. The Medicare Care Choices 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, while continuing to receive curative services.

Hospice care is covered by both the Medicare and Medicaid programs. When hospice care is chosen, a beneficiary is no longer eligible to receive curative care. According to March 2015 Medicare Payment Policy Report to the Congress, only 47.3 percent of Medicare and 42 percent of dually eligible beneficiaries used hospice care and most only for a short period of time. This data reflects the struggle in having to choose between palliative and curative care during these difficult times.

Background Information
The Medicare Care Choice Model is designed to evaluate whether eligible Medicare and dually eligible beneficiaries would elect to receive supportive care services typically provided by hospice if they could also continue to receive curative services and whether providing both palliative and curative care concurrently impacts quality of care, as well as patient and family satisfaction. Under the model, participating hospices will provide services 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. These services include nursing, social work, hospice aide, hospice homemaker, volunteer, chaplain, bereavement, nutritional support, and respite care services.

Services under this model will be available to Medicare beneficiaries that elect to participate in the model, 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. Providers and suppliers furnishing curative services will bill Medicare for the reasonable and necessary services furnished to beneficiaries who elect to participate in the model. These services include physical or occupational therapy, speech language pathology services, drugs for the management of pain or other symptoms from the terminal illness or related conditions, medical equipment and supplies, any other service that is specified in the patient's plan of care for which payment may otherwise be made under Medicare (for example, ambulance transports), short-term inpatient care for pain or symptom management that cannot be managed in the home environment, and physician services.

CMS originally anticipated selecting at least 30 Medicare-certified hospices to participate in the model and enrolling up to 30,000 beneficiaries throughout a 3-year period. Due to robust interest, CMS has invited over 140 Medicare-certified hospices to participate in the model and expanded the duration of the model to 5 years. This will enable up to 150,000 eligible Medicare and dually eligible beneficiaries to participate.

To participate in the model, beneficiaries must fall into certain categories:

·         Must be diagnosed with certain terminal illnesses: advanced cancers, chronic obstructive pulmonary disease, congestive heart failure and hhuman immunodeficiency virus/acquired immune deficiency syndrome;
·         Must meet hospice eligibility requirements under the Medicare or Medicaid hospice benefit;
·         Must not have elected the Medicare or Medicaid hospice benefit within the last 30 days prior to their participation in the Medicare Care Choices Model;
·         Must receive services from a hospice that is participating in the model; and
·         Must have satisfied model’s other eligibility criteria.
Timeline Delivery of services under the model will be phased-in over two years. Approximately half of the participating hospices will begin providing services under the model on January 1, 2016. The remaining participant hospices will provide services under the model starting January 1, 2018. This model is slated to end on December 31, 2020. Hospices participating in the model will be randomly assigned to Phase 1 or Phase 2.
List of Awardees The hospices selected to participate in the model represent a diverse group of Medicare-certified hospices from both urban and rural geographic areas. Further, the selected hospices demonstrate experience providing coordination services and/or case management, as well as shared decision-making with beneficiaries and their families prior to electing the Medicare or Medicaid hospice benefit in conjunction with their referring providers.
Region 1 (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont)
§  Regional Hospice and Home Care of Western Connecticut (Connecticut)
§  Community Health and Counseling Services (Maine)
§  Care Dimensions, Inc. (Massachusetts)
§  HopeHealth, Inc. (Massachusetts)
§  Notre Dame Health Care, Inc. dba Notre Dame Hospice (Massachusetts)
§  North Country Home Health & Hospice Agency, Inc. (New Hampshire)
§  Addison County Home Health & Hospice Inc. (Vermont)
§  Bayada Home Health Care, Inc. dba Bayada Hospice (Vermont)
§  Caledonia Home Health Care (Vermont)
§  Central Vermont Home Health and Hospice (Vermont)
§  Franklin County Home Health & Hospice (Vermont)
§  Lamoille Home Health Agency Inc. dba Lamoille Home Health & Hospice (Vermont)
§  Orleans/Essex VNA & Hospice Inc. (Vermont)
§  Southwestern Vermont Hospice Network dba Rutland Area Visiting Nurses (Vermont)
§  Visiting Nurse Association & Hospice of Vermont and New Hampshire (Vermont)
§  VNA of Chittenden & Grand Isle Counties (Vermont)
Region 2 (New Jersey, New York, Puerto Rico, Virgin Islands)
§  Compassionate Care Hospice of Marlton dba Compassionate Care Hospice (New Jersey)
§  Meridan Home Care Services Inc. dba Meridian Hospice (New Jersey)
§  Robert Wood Johnson Visiting Nurse, Inc. (New Jersey)
§  Visiting Nurse Association of Central Jersey Hospice (New Jersey)
§  Visiting Nurse Association of Englewood Hospice (New Jersey)
§  Good Shepherd Hospice (New York)
§  M J H S Hospice and Palliative Care, Inc. (New York)
§  Comprehensive Community Hospice Program of Parker Jewish Institute (New York)
Region 3 (Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia)
§  Delaware Hospice, Inc. - Southern Division (Delaware)
§  Delaware Hospice, Inc. - Central Division (Delaware)
§  Coastal Hospice Inc. dba Coastal Hospice and Palliative Care (Maryland)
§  Hospice of the Chesapeake, Inc. (Maryland)
§  Gilchrist Hospice Care, Inc. (Maryland)
§  Hospice and Community Care (Pennsylvania)
§  Hospice of Central Pennsylvania (Pennsylvania)
§  Jewish Association on Aging dba Sivitz Jewish Hospice (Pennsylvania)
§  Neighborhood Visiting Nurse Association dba Neighborhood Health (Pennsylvania)
§  Capital Hospice dba Capital Caring (Virginia)
§  Hospice of Surry County, Inc dba Mountain Valley Hospice and Palliative Care (Virginia)
§  Carilion Medical Center dba Carilion Clinic Hospice Service of Roanoke (Virginia)
§  Carilion Franklin Memorial Hospital dba Carilion Clinic Hospice of Franklin (Virginia)
§  Carilion New River Valley Medical Center dba Carilion Clinic Hospice Service of New River Valley (Virginia)
Region 4 (Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee)
§  Catholic Hospice Inc. (Florida)
§  Covenant Hospice, Inc. (Florida)
§  Halifax Hospice Inc. dba Halifax Health Hospice (Florida)
§  North Central Florida Hospice, Inc.  dba Haven Hospice (Florida)
§  Hope Hospice and Community Services Inc. dba hope Health Care Services (Florida)
§  LifePath Hospice Inc. (Florida)
§  Community Hospice of Northeast Florida, Inc. (Florida)
§  The Hospice of the Florida Suncoast, Inc. dba Suncoast Hospice (Florida)
§  Hospice of the Treasure Coast, Inc. (Florida)
§  The Hospice of Martin & St. Lucie, Inc. dba Treasure Coast Hospice of Martin (Florida)
§  Compassionate Care Hospice of Northern GA, LLC (Georgia)
§  Hospice of the Bluegrass, Inc. (Kentucky)
§  Hospice of the Bluegrass, Inc. dba Mountain Community Hospice (Kentucky)
§  Mercy Health Partners-Lourdes Inc. dba Lourdes Hospice (Kentucky)
§  Burke Hospice and Palliative Care, Inc. (North Carolina)
§  Hospice of Cabarrus County dba Hospice and Palliative Care of Cabarrus County (North Carolina)
§  Carolina's Palliative Care and Hospice Network dba Hospice of Union County (North Carolina)
§  Hospice of Henderson County, Inc. dba Four Seasons Compassion for Life (North Carolina)
§  Hospice of Iredell County dba Hospice & Palliative Care of Iredell County (North Carolina)
§  Hospice of Surry County Inc. dba Mountain Valley Hospice and Palliative Care (North Carolina)
§  Palliative Care Center & Hospice of Catawba Valley (North Carolina)
§  Hospice of Wake County Inc. dba Transitions LifeCare (North Carolina)
§  Amedisys Hospice LLC dba Amedisys Hospice of South Carolina (South Carolina)
§  Alive Hospice, Inc. (Tennessee)  
§  Hospice of Chattanooga Inc. (Tennessee)  
§  Alliance Health Services, Inc. dba Methodist Alliance Hospice (Tennessee)  
§  UTMC Home Care Services Hospice (Tennessee)  
§  University of TN Medical Center  Hospice (Tennessee)  
Region 5 (Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin)
§  Journeycare (Illinois)
§  Saint Francis Medical Center OSF Hospice (Illinois)
§  St. Joseph Medical Center OSF Hospice (Illinois)
§  Community Home Health Services, Inc. dba Community Home Health (Indiana)
§  Indiana University Health Inc. dba Indiana University Health Hospice (Indiana)
§  Visiting Nurse & Hospice Home (Indiana)
§  Spectrum Health Hospice and Palliative Care (Michigan)
§  Great Lakes Home Health Services Inc. dba Great Lakes Caring (Michigan)
§  Hospice Advantage LLC dba Home and Hospice Advantage (Michigan)
§  Hospice of Michigan dba Hospice of Northeastern Michigan (Michigan)
§  Hospice of Michigan dba Hospice of Western Michigan (Michigan)
§  Hospice of Michigan dba Hospice of Mecosta County (Michigan)
§  Hospice of Michigan dba Hospice of Saginaw County (Michigan)
§  Hospice of Michigan (Michigan)
§  Hospice of Northwest Ohio (Michigan)
§  Edward W. Sparrow Hospital Association dba Sparrow Hospice Services (Michigan)
§  Allina Health dba Allina Health Hospice & Palliative Care (Minnesota)
§  Fairview Home Care and Hospice, Inc. (Minnesota)
§  Hospice of the Twin Cities Inc. (Minnesota)
§  Hospice of Summa and Summa At Home Hospice Services (Ohio)
§  Aultman Hospital dba Aultman Hospice (Ohio)
§  Blanchard Valley Home Care Services LLC dba Bridge Home Health and Hospice (Ohio)
§  Hospice of Northwest Ohio (Ohio)
§  Hospice of the Valley, Inc. (Ohio)
§  Hospice of the Miami Valley (Ohio)
§  Hospice of Dayton (Ohio)
§  Mount Carmel Health System dba Mount Carmel Hospice (Ohio)
§  Agrace Hospice Care, Inc dba HospiceCare Inc. (Wisconsin)
§  Hospice Alliance, Inc. dba Hospice Alliance (Wisconsin)
§  Unity Limited Partnership dba Unity Hospice (Wisconsin)
§  Home Health United Hospice (Wisconsin)
Region 6 (Arkansas, Louisiana, New Mexico, Oklahoma, Texas)
§  St Joseph Hospice of Cenla, LLC (Louisiana)
§  St Joseph Hospice and Palliative Care Northshore, LLC (Louisiana)
§  St Joseph Hospice, LLC (Louisiana)
§  Cross Timbers Hospice Inc. dba Cross Timbers Hospice (Oklahoma)
§  FalconSouth  Plains Hospice LP dba Interim Hospice of West Texas (Texas)
§  Visiting Nurse Association of Texas dba VNA (Texas)
§  C & L Esperanza Home Health, Inc. dba Cuidado Casero Home Health & Hospice (Texas)
Region 7 (Iowa, Kansas, Missouri, Nebraska)
§  Cedar Valley Hospice (Iowa)
§  Sioux Valley Memorial Hospital Association dba Cherokee Regional Medical Center Hospice (Iowa)
§  Hospice of Central Iowa dba H C I Care Services (Iowa)
§  Hospice of Siouxland (Iowa)
§  Iowa City Hospice (Iowa)
§  Unity Point at Home dba Unity Point Hospice (Iowa)
§  Unity Point at Home dba Unity Point Hospice  (Iowa)
§  Unity Point at Home dba Unity Point Hospice (Iowa)
§  Genesis Health System dba Genesis Hospice (Iowa)
§  Douglas County Visiting Nurses Association dba Douglas County Visiting Nurse and Hospice (Kansas)
§  Interim Health Care of Wichita Inc. (Kansas)
§  Midland Care Connection, Inc. dba Midland Care Hospice (Kansas)
§  Mercy Hospital Jefferson dba Mercy Hospice (Missouri)
§  SSM Health Businesses dba SSM Health at Home-St. Louis (Missouri)
§  SSM Health Businesses dba SSM Health at Home-Maryville (Missouri)
§  Saint Luke's Health System Home Care and Hospice dba Saint Luke’s Home Care and Hospice (Missouri)
Region 8 (Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming)
§  HopeWest (Colorado)
§  Tru Community Care (Colorado)
§  Benefis Hospital dba Peace Hospice of Montana (Montana)
§  Kalispell Regional Medical Center dba Home Options Hospice (Montana)
§  Partners in Home Care, Inc. (Montana)
§  Compassionate Care Hospice of the Midwest LLC dba Compassionate Care Hospice (South Dakota)
§  IHC Health Services Inc. dba Intermountain Homecare Hospice (Utah)
Region 9 (Arizona, California, Hawaii, Nevada, Pacific Territories)
§  Hospice of the Valley- Central (Arizona)
§  Assisted Home Hospice (California)
§  Assisted HomeCare Inc. dba Assisted Hospice Care (California)
§  Sea Crest Hospice Services, Inc. (California)
§  CareChoices Hospice and Palliative Care Services, Inc. (California)
§  Hospice of Saddleback Valley (California)
§  Kaua'i Hospice (Hawaii)
§  Nathan Adelson Hospice dba Center for Compassionate Care and Palliative Services Institute (Nevada)
§  Procare Hospice of Nevada, LLC (Nevada)
Region 10 (Alaska, Idaho, Oregon, Washington)
  • St. Luke's Hospice (Idaho)
  • Providence Health & Services dba Providence Hospice (Oregon)
  • Hospice of Spokane (Washington)
  • Providence Health and Services-Washington dba Providence Hospice of Seattle (Washington)
  • Yakima Valley Memorial Hospital Association dba Memorial Home Care Services (Washington)


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