NHPCO Comment on CMS Primary Care First Model Options

NHPCO President and CEO Edo Banach, released the following statement in response to the Health and Human Services announcement of the Primary Care First Model Option:

“While we look forward to gathering more details about HHS’ recently announced set of payment model proposals, we applaud the Administration’s goal of delivering better value and care for patients. NHPCO has long advocated that any serious illness alternative payment model (APM) must balance population health and value-based care goals with the imperative to respond to patients’ unique care needs. 

“Key to the success of any model will be protecting and expanding access to high-quality palliative care and hospice services, and we hope that timely access to care will be integrated as a quality metric in the evaluation of the new Primary Care First Model. An interdisciplinary team is a key component of hospice and palliative care—but is not explicitly highlighted in the information released thus far. Any successful model will have to leverage interdisciplinary, person-centered care to be successful.

As the oldest and largest membership organization representing hospice and palliative care programs and professionals in the United States, NHPCO stands ready to help with the development and implementation of an APM that meets these goals.

“NHPCO has also recently partnered with other stakeholders across our sector in expressing our ongoing excitement and support for a serious illness payment model that will increase access to palliative care services for patients and families. Together, we have a continued interest in working with CMS to inform model refinement and educate and activate the field for model implementation.”

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Bringing Together Representatives from CMS, CMMI and HHS

As part of the 2019 Leadership and Advocacy Conference, to be hosted in Washington, DC, on April 15 - 17, 2019, NHPCO has secured attendance of a number of representatives from the Centers for Medicare and Medicaid Services, the Center for Medicare and Medicaid Services Innovation, and the Administration.

• Eric D. Hargan, Deputy Secretary of the Department of Health and Human Services will be the featured plenary speaker on Wednesday, April 17.
• Hospice Assessment Instrument Listening Sessions – CMS is hosting three separate listening sessions for conference attendees to discuss the Hospice Assessment Instrument under development that will be part of the CMS Hospice Quality Reporting Program (HQRP).
• Monday’s CMS Update – Featuring CMS staff members: Cindy Massuda, Charles Padgett, Kelly Vontran, Lori Teichman, Shannon Landefeld , and Michael Plotzke of Abt Associates.
• CMS Innovation Priorities – Discussion between Amy Bassano of the CMMI and NHPCO's Edo Banach.
• MCCM and VBID –  staff members from these CMS programs will be participating in LAC activities as well.

This is a rare opportunity to hear noted leaders talk about issues that are of primary concern to our community.

It's not too late to participate in the LAC. Onsite registration at our conference hotel, the Marriott Wardman Park, is available. 

CMS Introduction to CY2021 Hospice Component in the VBID Model

(News from CMS) - The CMS Innovation Center will be hosting two webinars to support robust stakeholder engagement efforts and as a result, the seamless test of carving in the Medicare hospice benefit into Medicare Advantage, as part of the Value-Based Insurance Design (VBID) model.

The first webinar will provide an overview of the model’s main goals and guiding principles, provide a brief review of Medicare Advantage and the Medicare Hospice Benefit, introduce the key model design considerations, and provide a general timeline for the coming months.

The second webinar will delve more deeply into CMS’s key design considerations that relate to beneficiary access, quality metrics and payment. During both webinars, CMS will share next steps and engagement opportunities as well as include a live question and answer (Q&A) session.

The first webinar will be held on Tuesday, April 9, from 2:00 - 3:00 p.m. EST. Details on the time and date, including how to register, for the second webinar will be announced separately on the VBID model website.

Registration for the first webinar can be found here: https://innovation.cms.gov/resources/vbid-hospice-intervention.html.

Hospice: Leading Interdisciplinary Care

NHPCO is proud to announce the publication of Hospice: Leading Interdisciplinary Care, a policy brief outlining key aspects, goals, and benefits of hospice care. The document, which was commissioned by NHPCO and developed by Dobson|DaVanzo & Associates, is intended to serve as a comprehensive guide for policymakers and stakeholders who seek to learn more about the Medicare Hospice Benefit and understand why an integrated, person-centered care model should be adopted more broadly in America’s evolving healthcare landscape.

Through evidence-based quantitative research and extensive case-study analysis, Hospice: Leading Interdisciplinary Care illustrates the physical, emotional, spiritual and financial benefits of hospice care for patients, families, and communities throughout the country.

The paper also provides important policy considerations to expand access and availability of this critical model of care. Of utmost importance is preservation of the integrity of the Medicare Hospice Benefit during any changes to care delivery. The paper further concludes that knowledge and access to information and services should be widely available for patients and families evaluating advance care planning and treatment options. The paper recommends policymakers consider expanding palliative intervention earlier in disease progression to further ease care transitions to hospice for constituents.

Specifically, the paper offers the following action items as opportunities for advancing the hospice value proposition:

•  Preserve the integrity of the hospice benefit as Medicare Advantage (MA) plans, ACOs and other organizational delivery forms as they expand in coming years
• Concurrently coordinate the hospice benefit with medical and behavioral care under all Medicare payment model
•  Expand timely access to hospice and palliative care based on the individual’s unique care needs
• Ensure high-quality supply of hospice care providers and professionals who are poised to address the rapidly aging population seeking hospice and palliative care

“We hope this document will serve as a resource for policymakers and others who want to learn more about hospice, and will highlight the value of hospice as an example of a successful coordinated care model,” said NHPCO President and CEO Edo Banach. “Hospice exemplifies the principles of quality, compassionate, personalized care that works for beneficiaries, payers and policymakers.”

A link to the full policy brief is available here.

What Matters

Spring is a time for renewal, for growth, and for change. I am often reminded of this when I see the first daffodils shoot up in March or April. I live in the country and call myself a “gentleman farmer.” I enjoy planting seeds and seeing them grow. But there’s something special about a perennial that comes back each year with simple nurturing and a little love.

As loyal NHPCO blog readers know, I can take Moana or Physics and apply it to Hospice. But this time, my analogy is not a stretch! You see, perennials adapt and live from one year to the next through a form of vegetative reproduction (which sounds racier than it is) rather than seeding. Perennials bounce back when the conditions are again suitable—and they do it because they have adapted to the environment.

So it is with hospice. We planted the seeds long ago and have evolved and adapted to changing needs of our country ever since. HIV and AIDS, dementia, disasters, opioids…we have seen and done it all. And now, while everybody else is planting the seeds of person centered, interdisciplinary, coordinated/managed/integrated care, our community’s already there— ready to show folks how it is done. We don’t survive because we stay still, but because we have continually adapted to change. So let’s keep moving.

As you will see at this year’s Leadership and Advocacy Conference (April 15-17), we are leading person-centered care. We have been managing care for over 40 years. We do provide person centered, interdisciplinary care, and we are experts. We welcome the annuals to our garden. Heaven knows, there is so much need for this kind of care – and so many people who might benefit from the skills we have mastered.

As a field, we will continue to evolve, but the bedrock will always be the perennial hospice and palliative care providers that have been doing this and coming back for over 40 years.

Happy Spring. See you at this year’s conference.

Edo Banach, JD
President and CEO
NHPCO

This year's Leadership and Advocacy Conference is at the Marriott Wardman Park in Washington, DC, the grounds are pictured above. Online registration is available thru March 29. Onsite registration is also available.

A Busy Day in Washington for the HPM Community

On a cold March morning at NHPCO headquarters in Alexandria, Virginia, ten hospice and palliative care CEOs from across the country gathered with NHPCO leadership to meet with officials from the Department of Health and Human Services in Washington D.C.  On the agenda – reinforcing the message that hospice is the original care coordination model and plays an integral role in our healthcare system.

L to R: Edo Banach; Melinda Gruber, Caring Circle; Reggie Bodner, Carroll Hospice, Greg Wood, Hospice of the Ozarks, Ann Mitchell, Montgomery Hospice; Dame Cicely in bronze; Norman McRae, Caris HealthCare; Susan Lloyd, Delaware Hospice; Ben Marcantonio, Hospice of the Chesapeake; and Rafael Sciullo, Empath Health/Suncoast Hospice.

Provider members had the opportunity to share patient and family stories to demonstrate how hospice not only provides services to eligible beneficiaries at the end of life, but in many other meaningful ways.  Several examples were cited of how hospices have filled the gap in times of crisis by offering grief support and other services for not only victims of the opioid crisis, mass shootings, community tragedies, and natural disasters but also their families.

“We appreciate how the administration welcomed us and were truly engaged in the conversation,” says NHPCO President and CEO Edo Banach. “They connected with how our work directly supports the Secretary’s four top priorities – particularly around the opioids crisis and value-based healthcare.”

At the Department of Health and Human Services in Washington, DC.

Edo continues, “Sometimes face-to-face conversations are needed to really help focus everybody on what is important.  Instead of bickering, we spent yesterday focusing on expanding minds and connecting on how hospices and palliative care programs are integrally involved in helping people live their best life.”

“The topics were not uplifting:  Disaster relief, grief counseling, opioid addiction, serious illness and death.  However, connecting on ways that we are helping communities and people get through these issues, was uplifting.  I think we melted some hearts on a cold day in March, and I am so grateful for the members and board members that accompanied us.”

The meeting was a success and HHS officials were left with a positive impression of hospice, our providers, and acknowledged that they learned something new about the care we provide.

After the meeting at HHS, Edo and Darren and Brian Bertram of Infinity Hospice, traveled to Capitol Hill to meet with Senator Jacky Rosen.  It was another successful meeting and opportunity to talk about the importance of hospice care. Senator Rosen is a founding member of the bipartisan Palliative Care Task Force in the House and is committed to continuing to find ways to improve care for those with serious illness.

L to R: Darren Bertram, Edo Banach, Senator Rosen, Brian Bertram.

At NHPCO, we are proud to take the lead on shaping what the future of hospice and palliative care could look like, and we are proud to partner with our provider members to make those recommendations. It is vital that we, as one community, rally together to carry our message to the regulators and policymakers who have the control to change the care we provide to patients and families every day. 

Want to be looped in to our community's advocacy efforts, connect with the My Hospice Campaign.