FACT SHEET
FOR IMMEDIATE RELEASE
July 20, 2015
Contact: CMS Media Relations
(202) 690-6145 | CMS
Media Inquiries
Medicare
Care Choices Model awards
As part of a larger effort at the
Department of Health and Human Services to transform our health care system to
deliver better care, spend our dollars in a smarter way, and put patients in
the center of their care to keep them healthy, the Centers for Medicare &
Medicaid Services today announced the participants in a new model that empowers
beneficiaries, their families, and clinicians by providing them with greater
flexibility in deciding between hospice care and curative treatment when faced
with life limiting illness. The Medicare Care Choices Model provides Medicare
beneficiaries who qualify for coverage under the Medicare hospice benefit and
dually eligible beneficiaries who qualify for the Medicaid hospice benefit the
option to elect to receive supportive care services typically provided by
hospice, while continuing to receive curative services.
Hospice care is covered by both the
Medicare and Medicaid programs. When hospice care is chosen, a beneficiary is
no longer eligible to receive curative care. According to March 2015 Medicare
Payment Policy Report to the Congress, only 47.3 percent of Medicare and 42
percent of dually eligible beneficiaries used hospice care and most only for a
short period of time. This data reflects the struggle in having to choose
between palliative and curative care during these difficult times.
Background Information
The Medicare Care Choice Model is
designed to evaluate whether eligible Medicare and dually eligible
beneficiaries would elect to receive supportive care services typically
provided by hospice if they could also continue to receive curative services
and whether providing both palliative and curative care concurrently impacts
quality of care, as well as patient and family satisfaction. Under the model,
participating hospices will provide services that are currently available under
the Medicare hospice benefit for routine home care and respite levels of care,
but cannot be separately billed under Medicare Parts A, B, and D. These
services include nursing, social work, hospice aide, hospice homemaker,
volunteer, chaplain, bereavement, nutritional support, and respite care
services.
Services under this model will be
available to Medicare beneficiaries that elect to participate in the model,
around the clock, 365 calendar days per year, and CMS will pay a per
beneficiary per month fee ranging from $200 to $400 to participating hospices
when delivering these services under the model. Providers and suppliers
furnishing curative services will bill Medicare for the reasonable and
necessary services furnished to beneficiaries who elect to participate in the
model. These services include physical or occupational therapy, speech language
pathology services, drugs for the management of pain or other symptoms from the
terminal illness or related conditions, medical equipment and supplies, any
other service that is specified in the patient's plan of care for which payment
may otherwise be made under Medicare (for example, ambulance transports),
short-term inpatient care for pain or symptom management that cannot be managed
in the home environment, and physician services.
Summary
CMS originally anticipated
selecting at least 30 Medicare-certified hospices to participate in the model
and enrolling up to 30,000 beneficiaries throughout a 3-year period. Due to
robust interest, CMS has invited over 140 Medicare-certified hospices to
participate in the model and expanded the duration of the model to 5 years.
This will enable up to 150,000 eligible Medicare and dually eligible
beneficiaries to participate.
To participate in the model,
beneficiaries must fall into certain categories:
· Must be diagnosed with certain terminal
illnesses: advanced cancers, chronic obstructive pulmonary disease, congestive
heart failure and hhuman immunodeficiency virus/acquired immune deficiency
syndrome;
· Must meet hospice eligibility requirements
under the Medicare or Medicaid hospice benefit;
· Must not have elected the Medicare or
Medicaid hospice benefit within the last 30 days prior to their participation
in the Medicare Care Choices Model;
· Must receive services from a hospice that is
participating in the model; and
· Must have satisfied model’s other
eligibility criteria.
Timeline Delivery of services under the model will be phased-in over two years. Approximately half of the participating hospices will begin providing services under the model on January 1, 2016. The remaining participant hospices will provide services under the model starting January 1, 2018. This model is slated to end on December 31, 2020. Hospices participating in the model will be randomly assigned to Phase 1 or Phase 2.
List of Awardees The hospices selected to participate in the model represent a diverse group of Medicare-certified hospices from both urban and rural geographic areas. Further, the selected hospices demonstrate experience providing coordination services and/or case management, as well as shared decision-making with beneficiaries and their families prior to electing the Medicare or Medicaid hospice benefit in conjunction with their referring providers.
Region 1 (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont)
§ Regional
Hospice and Home Care of Western Connecticut (Connecticut)
§ Community
Health and Counseling Services (Maine)
§ Care
Dimensions, Inc. (Massachusetts)
§ HopeHealth,
Inc. (Massachusetts)
§ Notre
Dame Health Care, Inc. dba Notre Dame Hospice (Massachusetts)
§ North
Country Home Health & Hospice Agency, Inc. (New Hampshire)
§ Addison
County Home Health & Hospice Inc. (Vermont)
§ Bayada
Home Health Care, Inc. dba Bayada Hospice (Vermont)
§ Caledonia
Home Health Care (Vermont)
§ Central
Vermont Home Health and Hospice (Vermont)
§ Franklin
County Home Health & Hospice (Vermont)
§ Lamoille
Home Health Agency Inc. dba Lamoille Home Health & Hospice (Vermont)
§ Orleans/Essex
VNA & Hospice Inc. (Vermont)
§ Southwestern
Vermont Hospice Network dba Rutland Area Visiting Nurses (Vermont)
§ Visiting
Nurse Association & Hospice of Vermont and New Hampshire (Vermont)
§ VNA
of Chittenden & Grand Isle Counties (Vermont)
Region
2 (New Jersey, New York, Puerto Rico, Virgin Islands)
§ Compassionate
Care Hospice of Marlton dba Compassionate Care Hospice (New Jersey)
§ Meridan
Home Care Services Inc. dba Meridian Hospice (New Jersey)
§ Robert
Wood Johnson Visiting Nurse, Inc. (New Jersey)
§ Visiting
Nurse Association of Central Jersey Hospice (New Jersey)
§ Visiting
Nurse Association of Englewood Hospice (New Jersey)
§ Good
Shepherd Hospice (New York)
§ M J
H S Hospice and Palliative Care, Inc. (New York)
§ Comprehensive
Community Hospice Program of Parker Jewish Institute (New York)
Region
3 (Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West
Virginia)
§ Delaware
Hospice, Inc. - Southern Division (Delaware)
§ Delaware
Hospice, Inc. - Central Division (Delaware)
§ Coastal
Hospice Inc. dba Coastal Hospice and Palliative Care (Maryland)
§ Hospice
of the Chesapeake, Inc. (Maryland)
§ Gilchrist
Hospice Care, Inc. (Maryland)
§ Hospice
and Community Care (Pennsylvania)
§ Hospice
of Central Pennsylvania (Pennsylvania)
§ Jewish
Association on Aging dba Sivitz Jewish Hospice (Pennsylvania)
§ Neighborhood
Visiting Nurse Association dba Neighborhood Health (Pennsylvania)
§ Capital
Hospice dba Capital Caring (Virginia)
§ Hospice
of Surry County, Inc dba Mountain Valley Hospice and Palliative Care (Virginia)
§ Carilion
Medical Center dba Carilion Clinic Hospice Service of Roanoke (Virginia)
§ Carilion
Franklin Memorial Hospital dba Carilion Clinic Hospice of Franklin (Virginia)
§ Carilion
New River Valley Medical Center dba Carilion Clinic Hospice Service of New
River Valley (Virginia)
Region
4 (Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina,
Tennessee)
§ Catholic Hospice Inc. (Florida)
§ Covenant Hospice, Inc. (Florida)
§ Halifax Hospice Inc. dba Halifax Health Hospice (Florida)
§ North Central Florida Hospice, Inc. dba Haven Hospice (Florida)
§ Hope Hospice and Community Services Inc. dba hope Health
Care Services (Florida)
§ LifePath Hospice Inc. (Florida)
§ Community Hospice of Northeast Florida, Inc. (Florida)
§ The Hospice of the Florida Suncoast, Inc. dba Suncoast
Hospice (Florida)
§ Hospice of the Treasure Coast, Inc. (Florida)
§ The Hospice of Martin & St. Lucie, Inc. dba Treasure
Coast Hospice of Martin (Florida)
§ Compassionate Care Hospice of Northern GA, LLC (Georgia)
§ Hospice of the Bluegrass, Inc. (Kentucky)
§ Hospice of the Bluegrass, Inc. dba Mountain Community
Hospice (Kentucky)
§ Mercy Health Partners-Lourdes Inc. dba Lourdes Hospice (Kentucky)
§ Burke Hospice and Palliative Care, Inc. (North Carolina)
§ Hospice of Cabarrus County dba Hospice and Palliative Care
of Cabarrus County (North Carolina)
§ Carolina's Palliative Care and Hospice Network dba Hospice
of Union County (North Carolina)
§ Hospice of Henderson County, Inc. dba Four Seasons
Compassion for Life (North Carolina)
§ Hospice of Iredell County dba Hospice & Palliative Care
of Iredell County (North Carolina)
§ Hospice of Surry County Inc. dba Mountain Valley Hospice and
Palliative Care (North Carolina)
§ Palliative Care Center & Hospice of Catawba Valley (North
Carolina)
§ Hospice of Wake County Inc. dba Transitions LifeCare (North
Carolina)
§ Amedisys Hospice LLC dba Amedisys Hospice of South Carolina (South
Carolina)
§ Alive Hospice, Inc. (Tennessee)
§ Hospice of Chattanooga Inc. (Tennessee)
§ Alliance Health Services, Inc. dba Methodist Alliance
Hospice (Tennessee)
§ UTMC Home Care Services Hospice (Tennessee)
§ University of TN Medical Center Hospice (Tennessee)
Region
5 (Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin)
§ Journeycare
(Illinois)
§ Saint
Francis Medical Center OSF Hospice (Illinois)
§ St.
Joseph Medical Center OSF Hospice (Illinois)
§ Community
Home Health Services, Inc. dba Community Home Health (Indiana)
§ Indiana
University Health Inc. dba Indiana University Health Hospice (Indiana)
§ Visiting
Nurse & Hospice Home (Indiana)
§ Spectrum
Health Hospice and Palliative Care (Michigan)
§ Great
Lakes Home Health Services Inc. dba Great Lakes Caring (Michigan)
§ Hospice
Advantage LLC dba Home and Hospice Advantage (Michigan)
§ Hospice
of Michigan dba Hospice of Northeastern Michigan (Michigan)
§ Hospice
of Michigan dba Hospice of Western Michigan (Michigan)
§ Hospice
of Michigan dba Hospice of Mecosta County (Michigan)
§ Hospice
of Michigan dba Hospice of Saginaw County (Michigan)
§ Hospice
of Michigan (Michigan)
§ Hospice
of Northwest Ohio (Michigan)
§ Edward
W. Sparrow Hospital Association dba Sparrow Hospice Services (Michigan)
§ Allina
Health dba Allina Health Hospice & Palliative Care (Minnesota)
§ Fairview
Home Care and Hospice, Inc. (Minnesota)
§ Hospice
of the Twin Cities Inc. (Minnesota)
§ Hospice
of Summa and Summa At Home Hospice Services (Ohio)
§ Aultman
Hospital dba Aultman Hospice (Ohio)
§ Blanchard
Valley Home Care Services LLC dba Bridge Home Health and Hospice (Ohio)
§ Hospice
of Northwest Ohio (Ohio)
§ Hospice
of the Valley, Inc. (Ohio)
§ Hospice
of the Miami Valley (Ohio)
§ Hospice
of Dayton (Ohio)
§ Mount
Carmel Health System dba Mount Carmel Hospice (Ohio)
§ Agrace
Hospice Care, Inc dba HospiceCare Inc. (Wisconsin)
§ Hospice
Alliance, Inc. dba Hospice Alliance (Wisconsin)
§ Unity
Limited Partnership dba Unity Hospice (Wisconsin)
§ Home
Health United Hospice (Wisconsin)
Region
6 (Arkansas, Louisiana, New Mexico, Oklahoma, Texas)
§ St
Joseph Hospice of Cenla, LLC (Louisiana)
§ St
Joseph Hospice and Palliative Care Northshore, LLC (Louisiana)
§ St
Joseph Hospice, LLC (Louisiana)
§ Cross
Timbers Hospice Inc. dba Cross Timbers Hospice (Oklahoma)
§ FalconSouth
Plains Hospice LP dba Interim Hospice of West Texas (Texas)
§ Visiting
Nurse Association of Texas dba VNA (Texas)
§ C
& L Esperanza Home Health, Inc. dba Cuidado Casero Home Health &
Hospice (Texas)
Region
7 (Iowa, Kansas, Missouri, Nebraska)
§ Cedar
Valley Hospice (Iowa)
§ Sioux
Valley Memorial Hospital Association dba Cherokee Regional Medical Center
Hospice (Iowa)
§ Hospice
of Central Iowa dba H C I Care Services (Iowa)
§ Hospice
of Siouxland (Iowa)
§ Iowa
City Hospice (Iowa)
§ Unity
Point at Home dba Unity Point Hospice (Iowa)
§ Unity
Point at Home dba Unity Point Hospice (Iowa)
§ Unity
Point at Home dba Unity Point Hospice (Iowa)
§ Genesis
Health System dba Genesis Hospice (Iowa)
§ Douglas
County Visiting Nurses Association dba Douglas County Visiting Nurse and
Hospice (Kansas)
§ Interim
Health Care of Wichita Inc. (Kansas)
§ Midland
Care Connection, Inc. dba Midland Care Hospice (Kansas)
§ Mercy
Hospital Jefferson dba Mercy Hospice (Missouri)
§ SSM
Health Businesses dba SSM Health at Home-St. Louis (Missouri)
§ SSM
Health Businesses dba SSM Health at Home-Maryville (Missouri)
§ Saint
Luke's Health System Home Care and Hospice dba Saint Luke’s Home Care and
Hospice (Missouri)
Region
8 (Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming)
§ HopeWest (Colorado)
§ Tru Community Care (Colorado)
§ Benefis Hospital dba Peace Hospice of Montana (Montana)
§ Kalispell Regional Medical Center dba Home Options Hospice (Montana)
§ Partners in Home Care, Inc. (Montana)
§ Compassionate Care Hospice of the Midwest LLC dba
Compassionate Care Hospice (South Dakota)
§ IHC Health Services Inc. dba Intermountain Homecare Hospice (Utah)
Region
9 (Arizona, California, Hawaii, Nevada, Pacific Territories)
§ Hospice
of the Valley- Central (Arizona)
§ Assisted
Home Hospice (California)
§ Assisted
HomeCare Inc. dba Assisted Hospice Care (California)
§ Sea
Crest Hospice Services, Inc. (California)
§ CareChoices
Hospice and Palliative Care Services, Inc. (California)
§ Hospice
of Saddleback Valley (California)
§ Kaua'i
Hospice (Hawaii)
§ Nathan
Adelson Hospice dba Center for Compassionate Care and Palliative Services
Institute (Nevada)
§ Procare
Hospice of Nevada, LLC (Nevada)
Region
10 (Alaska, Idaho, Oregon, Washington)
- St. Luke's Hospice (Idaho)
- Providence Health &
Services dba Providence Hospice (Oregon)
- Hospice of Spokane (Washington)
- Providence Health and
Services-Washington dba Providence Hospice of Seattle (Washington)
- Yakima Valley Memorial
Hospital Association dba Memorial Home Care Services (Washington)
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