Monday, January 21, 2019

NHPCO Comments on CMS Announcement Regarding Medicare Advantage Demonstration and Hospice


The Centers for Medicare and Medicaid Services issued a press release on 01/18/19 announcing a new demonstration involving Medicare Part D and updates to the existing model for Medicare Advantage. This includes the ability for MA plans to test offering hospice care services beginning in 2021. 

National Hospice and Palliative Care Organization offers some comments regarding this announcement from CMS. First and foremost, NHPCO is concerned about any changes that could adversely impact patient and family access to care.

“To the extent that this expansion of the Value-Based Insurance Design (VBID) demonstration is about enhanced access and a potential opportunity to ensure that more beneficiaries will get high-quality interdisciplinary care when it is most appropriate, we are encouraged,” said NHPCO President and CEO Edo Banach, JD. “If this demonstration restricts choice and access, we will take appropriate action. We will also assure that Congress is engaged on this issue and provides appropriate oversight.”

NHPCO and the hospice community has known that the Administration has prioritized expansion of MA. For this reason, NHPCO has been focused on the issues that will impact the hospice provider community and has engaged with policymakers.

In October 2018, NHPCO hosted the first in a series of convenings on hospice and MA in collaboration with the Better Medicare Alliance, supported by Cambia Health Foundation. 

Added Banach, “I can say that we are heartened that CMS noted in its public statement that patients should not have a decision forced upon them and that this new model is voluntary.”

NHPCO will be building upon existing relationship with plans and plan associations to assure that the model will test a variety of geographic variation, plan size, and hospice contracting so any change involving hospice enhances access to quality hospice care.

Tuesday, January 8, 2019

Q&A with New President of Hospice Medical Director Certification Board


Since its inception, the independent, nonprofit, HospiceMedical Director Certification Board (HMDCB) has worked to meet its mission of “helping to relieve suffering and improve quality of life by promoting the excellence and professional competency of hospice physicians.” That work has allowed nearly 950 hospice physicians and medical directors, spanning all 50 states, to become certified in the first five years since its creation.

Following the organization’s Fall 2018 Board of Directors meeting, Brian Murphy, MD MBA FAAHPM HMDC, a hospice physician at Orange Regional Medical Center in New York, took over as HMDCB’s president. His two-year term will see the organization’s first certificants navigate its Continuing Certification Program (CCP), launched earlier in 2018. Upon assuming the role, Murphy answered several questions about his excitement, the organization, the value of certification for hospice leaders, and the new Continuing Certification Program.

As you take over as president of the Hospice Medical Director Certification Board (HMDCB), what are your hopes for the organization as it moves into its sixth year of offering certification to hospice physicians?

To continue to raise awareness about the certification by sharing the message to more and more hospice physicians. I also would like to allow opportunities for hospice CEOs to discover why certification means the hospice employs a true leader, someone with the skills and knowledge to elevate patient care, to avoid documentation traps, to ensure regulatory compliance, to excel.

Being that the organization has certified nearly 950 hospice physicians in its first five years of existence, what has made it so popular to physicians and their hospices’ leaders in such a short time?

Hospice physicians are a certain breed, taking extra pride in their work and in their field. Our work isn’t easy, it takes extra time, extra knowledge. Verifying that effort and knowledge and establishing it through this credential is then seen not only as worthwhile but essential.

There has been some confusion in the field about whether this certification is strictly for those in the Hospice Medical Director role or not. Can you help clarify who is HMDCB certification is intended for?

The certification is actually intended for any and all hospice physicians, inclusive of full-time and part-time, who meet the eligibility requirements (below*). If you’re a physician seeing hospice patients, this certification is for you.

In your discussions with hospice CEOs, what have been their responses about why they have encouraged their physicians to become HMDCB-certified?

Universally positive. “My physicians must do this!” The CEOs know they have great hospice physicians. They want to be able to brag about them. They want their hospice to stand apart from the rest.

How does having a physician with the HMDC credential positively impact a hospice?

With physicians who have a verifiable knowledge base, a hospice is then stronger. The HMDC physician has learned to avoid regulatory and documentation pitfalls, and they have leadership skills, which strengthen not just their care, but that of the whole IDT.  Having someone who has shown they have a certified knowledge base can be a differentiator for your hospice.

As a follow up, how does having a physician with the HMDC credential help the CEO or administrator specifically in their role?

The knowledgeable HMDC physician keeps the documentation aligned with regulatory issues, decreasing audit risk. And with skillful patient review, they can bring in those patients with less clear diagnoses and prognoses with minimal risk, helping to grow census — and similarly help to maintain census by keeping patients with longer length of stays on service with justifiable rationale and documentation.  Finally, an HMDC physician can help get through an audit with wins for the hospice.

How can a physician’s preparation and completion of the HMDCB certification exam impact operations at any given hospice?

For the better!! How? By enhancing patient care, staying up to date on medication and pharmacologic knowledge, and improving documentation with up to date regulatory expertise. Also, the preparation and completion of the examination strengthens communication skills not only with patients and families but also with the IDT, as well as referring physician colleagues, and administrative hospice leadership.

There are some hospices who have chosen to both support and pay for their physicians to participate in the certification program. Why is this important for hospice CEOs to do?

A hospice who supports their physicians will have a physician who supports their hospice.  This allows a CEO to say, “I support you, I want you to be and I’ll help you to be a strong expert physician. I care.” A hospice employing HMDC physicians will recruit stronger physicians.

How do physicians with the HMDC credential help differentiate a hospice from competitors in the ever-increasing competitive landscape?

The HMDC credential demonstrates to consumers, patients, and families that this hospice wants and demands their physicians to be the best. The credential is a symbol of dedication to the hospice field and quality to the care the physician provides.

How is HMDCB ensuring that there is ongoing learning and development of its certificants?

After proving their knowledge with the initial exam, the certificant establishes continuing education in hospice as a part of their work and job. We test every 6 years for a reason, because things change in hospice quickly. We require CME during those 6 years to ensure the learning continues. We offer self- evaluation too, so a physician can learn where to focus their education. There are numerous opportunities for certificants to continue developing and learning through the Continuing Certification Program.

* The eligibility requirements mentioned earlier include holding a current license to practice medicine in the US or Canada, adhering to HMDCB’s Professional Code of Conduct, and demonstrating a minimum of 400 hours of broad-based hospice activities during the previous five years. We also have three different pathways to choose from for eligibility which adhere to a wide range of practicing hospice physicians.

More hospices are making the determination that having certified hospice physicians is important enough to require it.  If you are interested in learning more about how having a certified hospice physician can positively impact your hospice, please visit HMDCB.org/CEOs

Please note that the HMDCB application cycle will open January 8 and close on April 22, 2019. Physicians interested in applying can do so at HMDCB.org/Apply


Tuesday, December 18, 2018

Integrated Care Management Train-the-Trainer Series for Palliative and Hospice Care Professionals


NHPCO and Sutter Health are partnering on an Integrated Care ManagementTrain-the-Trainer Series specifically designed for clinicians who care for the seriously ill and their families.

This new series focuses on the practices and tools needed to optimally care for the patient with an advanced illness, with an emphasis on communication, symptom management and supportive measures during palliative care and though end-of-life care. Palliative care and hospice clinicians will be equipped with the tools and competencies that facilitate meaningful relationships with their patients and families. Learn how to deliver care that engages patients, identifies their care goals, reduces unnecessary healthcare utilization and promotes high patient and caregiver satisfaction. 
 

This series is comprised of 8 live, one-hour interactive Webinars and 4 online, self-paced condition-specific modules that will solidify competencies for the successful implementation of the ICM model of care and prepare you to be a trainer within your organization. The first Webinar is January 16, 2019.

Space is limited for this special opportunity. Register by January 14, 2019