CMS Responds to Hospice Quality Complaints: HOPE Is Coming
The concerns took center stage in November 2022, when The New Yorker ran a widely read article by Ava Kofman about hospice care providers that appear to cut spending by skimping on services for patients who are living in their own homes.
Hospice Quality Data
Medicare collects some information about the services hospice providers have delivered, based on reviews of patient admissions and discharge data, but that effort does not provide information about how well programs met patients’ needs, officials noted.
CMS wants the HOPE program to gather information about how fair the programs are to different kinds of patients and how well the programs perform on standardized quality measures, such as measures for how comfortable patients are and how quickly they get care.
An Agent Trainer’s Perspective
Ari Parker, the head advisor trainer at Chapter, a Medicare plan broker, said the firm has about 45 coverage advisors. He hears from advisors about the calls they get several times per month from clients having problems with hospice benefits.
Hospice “is one of the most difficult subjects you can discuss with someone,” Parker said.
Helping clients understand and use hospice benefits “is part of our responsibility,” he said. “It’s very much core to our mission.”
Chapter can offer some extra support, he said, because it has a homegrown system that can list every hospice provider in the United States by ZIP code, and advisors can give callers contact information for nearby hospice providers.
Parker would like to see CMS add hospice information, including quality rating information, to the Medicare.gov website Plan Finder tool.
Parker sees the lack of hospice information on the Plan Finder site as one of the many weaknesses of the site.
Like many agents and brokers in the Medicare plan market, Chapter executives have been frustrated with the state of the Plan Finder tool since it was updated in 2019, shortly before the COVID-19 pandemic came to light.
Chapter’s CEO co-wrote an article, published in November 2022, contending that the Plan Finder tool still lacks the feature consumers need to determine whether their providers are in a plan’s network, compare plans based on prescription drug coverage and comparing plan supplemental benefits, such as dental, vision and hearing benefits.
(Image: Adobe Stock)
