CMS: Concurrent Hospice Care Improves Quality, Reduces Costs

Hospice News | By Jim Parker

Allowing patients to receive concurrent hospice and curative care reduces health care costs and improves quality.

The U.S. Centers for Medicare & Medicaid Services (CMS) has released its fifth and final report on the Medicare Care Choices Model (MCCM), which studied the effects of allowing individuals to receive hospice care without foregoing other treatments. 

The agency launched the MCCM in 2016. Initially slated to complete in 2020, CMS later extended it until December 2021. Throughout that period, the model hit every one of its targets — reducing costs, improving quality and family satisfaction, and keeping patients in their homes.

MCCM yielded positive results for every population subgroup that the demonstration examined, according to Keith Kranker, principal researcher for Mathematica and lead author of the CMS evaluation report.

“This model basically worked for everyone we’ve looked at. We really didn’t find subgroups that were not benefiting from the model,” Kranker told Hospice News. “We looked across these different diseases that made people eligible for the model, and for all the diseases finding these kinds of quality improvements and cost savings.”

The model’s 7,263 enrollees were Medicare fee-for-service beneficiaries with a six-month terminal prognosis due to cancer, congestive heart failure, chronic obstructive pulmonary disease, or HIV/AIDS.

These patients had also received a referral to one of the program’s participating hospices, met eligibility criteria for the demonstration and made the choice to enroll in MCCM.

Among patients who had died before the demonstration ended, MCCM reduced Medicare expenditures by $7,604 per enrollee, about a 13% reduction compared to a control group. Hospital admissions dropped 26% and emergency department visits fell by 12%.

Enrolled patients were also more likely to transition to the traditional Medicare Hospice Benefit. MCCM enrollees were 18% more likely to elect the benefit, and their average length of stay reached 42 days compared to 19 for a control group. These patients were also able to stay in their homes longer than non-participants, 183 days compared to 178.

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