The Hospice Care Act of 2024 stands to change core aspects of how hospices run in the U.S. The Act represents new hospice care accountability reform and enforcement efforts. Hospice operators should begin to prepare now for a shift in their Medicare payment structures, reporting obligations, and patient care models in the event the Act passes.
Understanding the Hospice Care Act 2024
The Act will be the most significant update to Medicare's hospice benefit since 1982, according to Congressman Earl Blumenauer (D-OR), who introduced the bill.
The significant changes to hospice services include:
- Modifying the payment structure for routine home care.
- Increasing payments for some services like palliative radiation and chemotherapy.
- Allowing respite care to be offered at home.
- Five-year moratorium on enrollment of new hospices into Medicare.
- Increased oversight of new hospice programs.
- Increasing survey frequency for some programs.
- Requires the medical director to have an active medical license.
- Disallows the hospice's employees, owners, or financial stakeholders to certify a terminal illness.
These changes are meant to combat fraud in the hospice industry, but they stand to impact all providers. Organizations must adapt to a new payment structure, new provision of some types of patient care, and increasing levels of oversight.
Why Staying Informed Is Crucial
Hospice operations must prepare for a new billing model that makes significant changes such as incentivizing in-person clinic visits. This can have an impact on revenue streams which affect all aspects of administration and patient care.
If organizations are not prepared for billing changes, they might receive less funds from Medicare reimbursements. This can impact staffing and service levels and can have a direct impact on patient care.
By preparing early, your organization can adapt to these changes so there is no decline in the quality of patient care. WorldView Healthcare Solutions is a suite of tools that can help your organization get ready through elevated healthcare process documentation and HIPPA-compliant technology.
Key Provisions of the Hospice Care Act 2024
Let's take a closer took at the main components of the new Act and what they mean for your hospice organization.
Enhanced Regulatory Compliance
The Act would allow for the increased survey of some hospices, so that they occur once every 18 months instead of every 36 months. It would also make other changes, such as requiring a face-to-face assessment before a recertification of terminal illness.
The Medical Director of a hospice cannot be the MD of more than two hospices without special permission. They also must be licensed to practice medicine in the state. The aim is to improve patient care quality, by making sure care is still appropriate for the individual.
Changes in Documentation and Reporting
The Act prohibits payment to hospices that do not comply with Quality Data Reporting Requirements. Currently, hospices that do not submit this information receive a 4% payment penalty. Under the new legislation, there's an increasing emphasis on transparent reporting practices.
Financial Implications
The Act makes several changes that have a direct impact on financial reimbursement from Medicare. Specifically, there is a wage cap that limits the amount of wage reimbursement consistent with local area wage ratios. There are also changes to payments made for hospice services based on differences between an individual hospice's payment rates and the average rates for such care.
The new legislation can therefore impact the reimbursement it receives from Medicare for staffing and service costs, which can impact a hospice's future financial planning.
Impact on Hospice Owners and Employees
Operationally, hospice team members might have to spend less time on administrative tasks and more time on direct patient care. This can reflect the changing priorities of Medicare as to what services the agency will pay for. Hospices might therefore need to update their policies and procedures so staff devote time to the tasks that hold more value for patients.
Hospice owners can work to train staff on the new Act regulations even before they come into effect. Training programs on-site can help your team to better understand what tasks are additional priorities.
Compliance with all legal obligations, including those of Medicare, are essential. Not following Medicare regulations can result in a finding of fraud, which opens the hospice's owners up to legal ramifications. It can also result in action taken against the hospice, risking the quality of patient care.
Instead, consider learning what the new Act requires, how it applies to your hospice, and what changes you need to make before it comes into effect.
Challenges in Implementing the Hospice Care Act 2024
If the Act comes into effect, it might mean a greater administrative burden for hospices who have to report more frequently and in more detail than they have in the past. This can put a strain on existing administrative resources.
To meet the new reporting and documentation challenges, hospices might have to implement new technology solutions with systems better designed to meet these standards such as adopting electronic documents and healthcare AI. Digital hospice data can make it easier for organizations to stay in step with these changes.
If your team members are under greater regulatory scrutiny or efficiency pressures, it might lead to declining morale. Try to combat this with resources for your team to meet new efficiency requirements. That can include training on new technology solutions so they are more comfortable with their daily use.
How Automation Can Ease the Transition
New technology solutions that include automation can ease the transition to the new requirements under the Act. Technology can make it easier to adhere to regulations by automatically uploading quality control data and digitizing patient intake and referral records in moments. With automation, there's less risk of error in patient records and your health care team members save time on data entry.
With solutions that emphasize automation, staff can devote their time to interacting with patients. They can develop personal care plans with automated support tools like WorldView Physician Order Tracking.
WorldView Solutions for Navigating the Hospice Care Act
WorldView has a suite of automation tools that are relevant to hospice care and can help you to improve compliance under the provisions of the new Act. Using WorldView Referral AI, for example, supports the new Act's requirements about who is permitted to certify or re-certify a patient's terminal illness.
By using WorldView Healthcare Solutions, the results will be improved efficiency and reduction in administrative workload. With greater regulatory compliance, there's less legal and financial risk to the business.
Best Practices for Implementing Automation in Hospice Care
Here are a few tips to implement automation in hospice care in preparation for the new Act:
- Assess current processes to identify areas for improvement
- Develop a strategic implementation plan for integrating automation tools
- Invest in ongoing staff training so they are comfortable with new technology
- Monitor and evaluate outcomes based on your metrics to assess the effectiveness of automation
- Encourage continuous improvement based on feedback
Embracing Change for a Better Future
The Hospice Care Act of 2024 stands to change compliance frameworks and payment structures for hospices. By adopting automation and technology solutions designed for your industry, you can be prepared. Schedule a demo with WorldView Healthcare Solutions today.
