A landmark legislation may be changing the face of hospice care. This past June, Rhode Island Senator Sheldon Whitehouse introduced a bill that will improve access to home health and hospice care for Medicare beneficiaries.
Whitehouse said the bill is an effort to “break down barriers between patients and the care they need.” The bill, aptly named the Removing Barriers to Person-Centered Care Act, proposes a pilot program that will promote better coordination of care between providers by assessing the needs of Medicare beneficiaries, then providing education on how to better communicate – and ultimately facilitate – the treatment preferences of those with advanced illnesses.
It would also create two new Medicare hospice benefit coverage options for patients with terminal illnesses, including:
- Payment for room and board at nursing facilities for patients who elect routine-level hospice care
- Payment for short-term, home-based respite care as an alternative to inpatient care
The Act Revamps Regulations That Are Common Obstacles to Receiving Care
Notably, the program will waive some of the existing regulations that make it difficult for Medicare beneficiaries to receive home health and hospice care:
- Rather than being forced to choose one method of treatment, patients will be able to receive curative and hospice treatment simultaneously
- Offering the option of home health services to patients who have a “normal inability to leave home” rather than denying them treatment because they aren’t fully homebound
- Signing and certifying home health and hospice care plans won’t be limited to doctors; nurse practitioners will also have the authority to do so
With an estimated 90 million Americans suffering from advanced illnesses like cancer, heart disease, and Alzheimer’s disease — and another 90 million expected to be diagnosed in the next 25 years — the need for home health and hospice care will continue to accelerate. Making services more accessible will lay the groundwork for a more seamless transition to home health and hospice care for patients, as well as provide care organizations with the flexibility to offer better treatments and improve the patient experience.
The Quality Measures Trend Carries Over to the Removing Barriers Act
The Removing Barriers Act follows suit with PQRS, Meaningful Use, and now MACRA, calling for the “specification, development, and/or testing of new quality measures.”
The proposed quality measures will focus on ensuring that care is consistent with patients’ documented care preferences, evaluating care experiences for patients and their family members, and improving access to medical and supportive services, including timely referral to hospice.
Care organizations have been quick to support the Removing Barriers Act and its related quality measures. The American Academy of Hospice and Palliative Medicine noted the ongoing need for quality measures not only as a means of improving the quality of care but also as a vehicle for ensuring that palliative clinicians participate in value-based reimbursement.
The Removing Barriers Act Is Good News for Home Health and Hospice Organizations
What does the bill mean for hospice organizations? “This legislation allows for important innovations in care delivery and removes obstacles to support patients throughout the care continuum,” says Tom Koutsoumpas, Co-Chair of the Board of Directors of C-TAC (Coalition to Transform Advanced Care). Other industry leaders are equally optimistic.
The changes proposed in the Removing Barriers Act – such as allowing nurse practitioners to sign off on care plans – will relieve some of the burden put on doctors, eliminate delays to treatment, and improve the care experience for patients. This bill could provide the much-needed stepping stone to relieving the ongoing burdens faced by both patients and their care providers in home health and hospice services.
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