The trusted source for
healthcare information and
MedPAC recommends increase for hospice
The Medicare Payment Advisory Commission (MedPAC) has recommended a 1% increase in hospice payment rates for FY 2012 along with payment reforms that reflect increased costs at end of life.
MedPAC staff predicted hospice profit margins in 2011 of 4.2%, taking into account the increased expense of implementing the face-to-face-encounter and the ongoing implementation of the Budget Neutrality Adjustment Factor.
In addition to the 1% update in the payment rates, MedPAC commissioners also recommended the following:
Reform the hospice payment system to:
increase payments per day at the beginning of the episode and reduce payments per day as the length of the episode increases;
provide an additional end-of-episode payment to reflect hospices' higher level of effort at the end of life.
Implement a budget-neutral payment change that will redistribute revenues.
Overall, revenues will increase for provider-based, nonprofit, and rural hospices and will decrease for other providers.
The secretary of Health and Human Services should direct the Office of Inspector General to investigate:
the prevalence of financial relationships between hospices and long-term care facilities such as nursing facilities and assisted living facilities that might represent a conflict of interest and influence admissions to hospice;
differences in patterns of nursing home referrals to hospice;
the appropriateness of enrollment practices for hospices with unusual utilization patterns (e.g., high frequency of very long stays, very short stays, or enrollment of patients discharged from other hospices);
the appropriateness of hospice marketing materials and other admissions practices and potential correlations between length of stay and deficiencies in marketing or admissions practices.
a. press time, these recommendations were scheduled to be presented to Congress this month.