Home Health & Hospice Week

MCCM phase 2 training coming up, CMS promised.

Hospices chosen to take part in Medicare’s concurrent care demonstration may see a better result thanks to new eligibility changes.

Since the program’s launch in January 2016, MCCM hospices have complained that the criteria for beneficiaries to participate in the program were overly restrictive and discouraged its use. At last year’s National Association for Home Care & Hospice March on Washington conference, one attendee told the Centers for Medicare & Medicaid Services’ Sean Cavanaugh that finding an eligible MCCM patient was like “finding a unicorn” (see Eli’s HCW, Vol. XXV, No. 15).

Now CMS appears to be taking action on the matter before Phase 2 of the program launches in January 2018. Four of the program’s more restrictive eligibility criteria have been relaxed “due to lower than expected participation and stakeholder feedback,” a CMS official said in the Feb. 8 Open Door Forum for home health and hospice providers.

CMS already had changed the two-hospitalization requirement to one hospital encounter of any type, NAHC notes in its newsletter. Those hospital encounters can include observation stays or emergency room visits with no admissions, for example, the CMS representative said in the forum. The model also no longer required participation in Part D.

As of Jan. 1, the program now only requires 12 months of previous Medicare enrollment (down from 24 months) and three physician visits for any reason (as opposed to related to the terminal diagnosis),

the CMS official told forum attendees. Twelve months of data will be sufficient for evaluation and will create additional opportunity for enrollment, she elaborated.

CMS hasn’t issued written information on the changes yet, but is working to get the revisions up on the MCCM website, the CMS source said in a response to a question.

Meanwhile: Hospices taking part in the next stage of MCCM can expect training to ramp up this summer, in advance of the January 2018 start date. When it launched the program, CMS said 141 hospices would participate in each phase of the five-year project.