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August 10, 2015

Local hospice to take part in Medicare model
Daily Item of Lynn

Care Dimensions has been selected to participate in the Medicare Care Choices Model.

The model provides Medicare beneficiaries who qualify for coverage under the Medicare Hospice Benefit, and dually eligible beneficiaries who qualify for the benefit, the option to elect to receive supportive care services typically provided by hospice. They would also continue to receive curative services at the same time.

This program is part of a larger effort at Health and Human Services to transform the health-care system to deliver better care, spend tax dollars in a smarter way, and put patients in the center of their care.

“We are honored to participate in the Medicare Care Choices Model,” said Care Dimensions President and CEO Diane Stringer. “We know this is an important step to allow for increased choice and improved health care for terminally ill patients.”

All eligible hospices across the country were invited to apply to participate in the model. Due to robust interest, Centers for Medicare and Medicaid Services (CMS) expanded the model from an originally anticipated 30 certified hospices to more than 140 and extended the duration of the model from three to five years.

This is expected to enable as many as 150,000 eligible Medicare beneficiaries with advanced cancers, chronic obstructive pulmonary disease, congestive heart failure, and human immunodeficiency virus/acquired immunodeficiency syndrome who receive services from participating hospices to experience this new option and flexibility.

Participating hospices will provide services under the models that are currently available under the Medicare hospice benefit for routine home care and respite levels of care. But it but cannot be separately billed under Medicare Parts A, B, and D. Services will be available 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.

Services will begin starting Jan. 1 for the first phase of participating hospices and in January 2018 for the remaining participating hospices.

Individuals who wish to receive services under the model must fall into certain categories:

— must be diagnosed with certain terminal illnesses (e.g., advanced cancers, chronic obstructive pulmonary disease, congestive heart failure and human 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.

Care Dimensions is the largest hospice provider to adults and children with advanced illness in Massachusetts. It provides comprehensive hospice, palliative care, grief support and teaching programs in more than 90 communities in Eastern Massachusetts.

 


Since 1978, Care Dimensions has provided comprehensive and compassionate care for individuals and families dealing with life-threatening illnesses. As the non-profit leader in advanced illness care, we offer services in more than 90 communities in Eastern Massachusetts.