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Assessing and Modeling Reforms to the Medicare Hospice Prospective Payment System

Since 2011, Abt Global has conducted comprehensive analyses of Medicare Hospice Benefit utilization for the Centers for Medicare & Medicaid Services (CMS). This work helped identify vulnerabilities in the payment system, which led to Abt developing alternative hospice payment systems that better align payment with patient resource use.

Additionally, Abt has provided extensive operational and rulemaking support to CMS as they refine the payment system and implement large scale changes as mandated by the Affordable Care Act.

Abt’s work has contributed to the first major changes to the hospice payment system since the inception of the benefit in 1983. Starting in 2016, payment for Routine Home Care services will be based on the length of the beneficiary’s enrollment in hospice. Additionally, hospices have the ability to receive a service intensity adjustment if they provide certain services to their patients at the end of life.

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