The Centers for Medicare and Medicaid Services’ Primary Care First (PCF) model will start in 2021, including the Seriously Ill Population (SIP) model. The SIP program is designed to improve care for high-need, high-risk patients who currently receive fragmented or inadequate care. To do this, CMS will assign SIP patients to participating hospice programs, paying the providers to coordinate their care and avoid unnecessary hospitalizations.
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Health care technology firm Acclivity Health Solutions has designed a program to help hospice and palliative care providers prepare themselves for participation in the Primary Care First Serious Illness Population (SIP) payment model.
Technology helps with increasing efficiency, defining a patient’s needs, and gathering information before the appointment.
Palliative care physicians know that patients often have a number of questions for their doctors during their first appointment: What does my care plan look like now? How do you collaborate with my existing medical team? Can you help me achieve my quality-of-life goals? Without easily digestible, educational resources widely available, patients may have questions for weeks in between appointments until they are able to visit with their physician again. PCforMe is an online tool, available through the Acclivity Health platform, that uses interactive videos to educate patients and their caregivers about how palliative care works, its benefits, and clearly define their care plan goals. PCforMe’s palliative care questionnaires can be sent to new patients in advance of their appointments to help them collect their thoughts, which will often involve discussions that are stressful and potentially lifechanging. They can bring their completed conversation guide to their appointment, and their responses can be shared ahead of time with their physician, so all parties start the appointment on the same page. Knowing a patient’s goals and concerns in advance helps providers be more efficient with their time, and ensures the patient is able to fully participate in decision making.
Read morePCforMe simplifies palliative care, empowers patients, and increases satisfaction.
Historically, patients researching palliative care for the first time haven’t had the most helpful resources. Educational webpages tend to use medical terms, and often don’t explain the differences between palliative care and hospice. PCforMe’s interactivity seeks to personalize the education to the patient, and make their research relevant to them.
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Acclivity Health’s educational webinars cover application tips and planning for long-term success.
Acclivity Health recently partnered with NHPCO to present a two-part webinar series:Current and Emerging CMS Payment Models: Intersection between Hospice, Palliative and Primary Care. The team at Acclivity has experience with CPC+, ACOs, and other payment models similar to CMS’ forthcoming model, Primary Care First. If you couldn’t attend these online sessions, we’re providing overviews of what you missed, what you need to know, and how to prepare for Primary Care First.
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Setting you up for application acceptance and ongoing success
The Centers for Medicare & Medicaid Services’ Primary Care First (PCF) model is rolling out in 2020, and applications will be available in the coming weeks. The Seriously Ill Population (SIP) model under PCF is designed to improve care for high-need, high-risk patients who currently receive fragmented or inadequate care. To do this, CMS will assign SIP patients to participating hospice programs, paying the providers to coordinate their care and avoid unnecessary hospitalizations.
Read moreThe Centers for Medicare & Medicaid Services recently unveiled their Primary Care First (PCF) model to improve the quality of care for Medicare patients while reducing costs. PCF consists of two different payment model options and is based on the Comprehensive Primary Care Plus program. This new model will be offered in 26 states and regions beginning January 1, 2020, and may roll out to additional regions as early as 2021.
The Seriously Ill Population (SIP) model under PCF is designed for high-need, high-risk patients who are receiving fragmented or inadequate care. CMS seeks to better coordinate their care and avoid costly hospitalizations. To achieve this, CMS will be assigning SIP patients to participating organizations, and paying the providers a per beneficiary, per month fee to coordinate their care and keep them out of the hospital. Additional reimbursement is available for face-to-face visits and for achieving quality targets. Here are four reasons hospices should seriously consider participating in the SIP model:
Read moreAcclivity Health’s Chief Innovation and Advocacy Officer explains why patients and families shouldn’t hesitate to seek hospice care.
As seriously ill patients near the end of life, it is often suggested that hospice care become part of their health care plan. Unfortunately, patients often enroll in these services too late to reap the full benefits. Dianne Gray, Chief Innovation and Advocacy Officer at Acclivity Health, says this is often due to a stigma that surrounds hospice care.
Read moreAcclivity Health’s CEO weighs in on industry-changing Primary Care First model.
The Centers for Medicare & Medicaid Services recently announced a new primary care payment model that will provide an alternative to Comprehensive Primary Care Plus. This new model, called Primary Care First, will be offered in 26 states and regions beginning Jan. 1, 2020. Department of Health and Human Services Secretary Alex Azar predicts that the models will enroll 25 percent of traditional Medicare beneficiaries and providers, who must apply to take part, and the program may roll out to all states after five years pending its success.
Here’s what CMS has released so far about their new initiative.
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Over half of all hospice referrals today come from hospitals that often wait too long to refer a patient into hospice care. Whether they believe a referral suggests they are abandoning the patient or they anticipate higher profits from an extended stay, too often hospitals prevent patients from receiving hospice care in time to make it meaningful.
Independent physicians and specialists often don’t have the time or experience to handle hospice care coordination efficiently. However, when physician groups align with hospice organizations in a formal community structure called a Connected Care Community, these doctors can remain on the front line of their patients’ care.
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