Hospice and Palliative CareROXANNE ROTH MSN, RN

DIRECTOR OF INNOVATION

Terminology Palliative Care: “to cloak”, “alleviate symptoms of disease without curing it.

Hospice Care: team oriented approach to medical care, pain management, and emotional and spiritual support individualized to the patient’s needs and wishes at end of life.

Advanced Illness Management: team oriented approach that combines best medical approaches for disease management combined with supportive care with a caregiver focus.

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Features of the Medicare Hospice Benefit

Features Details

Patient Eligibility Prognosis of 6 months or lessCertified by 2 physiciansPart A Medicare

Benefit Periods Two 90 day periodsUnlimited 60 day periodsRecertification process

Reimbursement Per diem based on level of care

Covered Services IDT, Bereavement, Dietary, PT, OT, ST, Drugs, DME, Supplies, Labs, Diagnostics

Levels of Care Routine home careContinuous home careGeneral Inpatient careRespite inpatient care

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Curative Treatment

Palliative Care Hospice

Current Practice

Disease-Modifying Treatment

Hospice Care

Bereavement Support

Palliative Care

Terminal Phase of Illness

Death

Continuum of Care

Medicare Care Choices (MCCM)

• Advanced cancers, chronic obstructive pulmonary disease, congestive heart failure and HIV/AIDS

•Must meet Medicare hospice eligibility requirements.

•Must not have elected the Medicare hospice benefit within the last 30 days prior to participation in MCCM

•Lives in a traditional home

• Qualify for Medicare/Medicaid hospice benefit.

• Is enrolled in Medicare Part A, B and D

• Cannot be enrolled in a Medicare managed care organization, or participated in a Medicare managed care plan for at least 2 open enrollment years