Medicare Compliance & Reimbursement
Fast Facts -- Medicare Hospice Payments
Providers shouldn't be surprised if new Medicare hospice payment policies are soon afoot.
The Medicare Payment Advisory Commission is eyeing the hospice payment system for possible changes (see related story, this issue). Here's the crucial data the influential advisory body to Congress is considering in making its recommendations:
• Medicare expects to spend $9.8 billion on hospice services in 2006. Hospice payments will increase approximately 9 percent per year through 2015.
• Medicare pays for 88 percent of hospice care.
• Routine hospice days are the most common hospice service by far at a 93-percent billing rate in 2003.
• The ratio of fee-for-service Medicare beneficiaries electing hospice increased from 22 percent in 2000 to 31 percent in 2004.
• From 2000 to 2004, the number of hospice users grew 50 percent, the number of billed hospice days doubled, and payments grew 130 percent.
• While the median length of stay held steady at about two weeks from 2000 to 2004, the mean LOS increased from 51 to 67 days. "The mean length of enrollment was driven up by the upper end of the distribution having increasingly longer lengths of stay before they died," explains MedPAC staffer Kathryn Linehan in the Commission's recent meeting.
• In 2003, more than half of hospice patients had a non-cancer terminal diagnosis. Patients with non-cancer diagnoses have longer lengths of stay on average.
• Forty-seven percent of hospices are freestanding for-profits in 2006, up from 31 percent in 2001.
• MedPAC staff cited research pegging hospice profit margins at 10 percent (Government Accountability Office), 11 to 19 percent (National Hospice and Palliative Care Organization) and 2 percent for non-profits versus 18 percent for for-profits (Journal for Palliative Medicine).
Medicare Compliance & Reimbursement
- EHRs:
Lacking Audit Trails Could Render EHRs Moot In Court
Most EHR systems fail to track revisions' sources, study shows. Electronic health records need more [...] - Medicare:
Hospices May Get Higher Payments At Beginning, End Of Stays
MedPAC looks to shake up hospice pay--but don't count on a case mix adjuster.
After more [...] - Hospices:
Fast Facts -- Medicare Hospice Payments
Non-cancer diagnoses growing for hospice patients, along with lengths of stay.
Providers shouldn't be surprised if [...] - Suppliers:
4-Step Program Positions Suppliers For DRA Fallout
Suppliers should get proactive about budget changes, experts advise
Suppliers shouldn't let the looming Deficit Reduction [...] - Budget:
Senate Proposes To Preserve Home Care Spending
But physician fix threatens home care reimbursement anyway.
After a double whammy from President Bush and [...] - Billing:
CMS Transmittal Clarifies Proper E/M Claims Filing
Warning: Providers may be making crucial mistakes in E/M billing.
A recent transmittal from the Centers [...] - Nursing Homes:
'Shelter In Place' Emergency Management Plans May Be Insufficient
Upcoming GAO report could make a push for emergency SNF evacuations.
Skilled nursing facilities that assume [...] - CMS:
'Medically Unbelievable' Edits Go Beyond CMS Mission
PPAC wants CMS to withdraw MUEs.
The Centers for Medicare & Medicaid Services seemed to have [...] - Physicians:
Medicare Needs More Up-To-Date Data On Practice Expenses
MedPAC also wants to coordinate care for patients with chronic conditions.
The Centers for Medicare & [...]
