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The 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:

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Acclivity 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.

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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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Today’s doctors are trained to keep patients alive, but not always to prepare them for death. From developing a care plan to delivering the news to supporting their patients’ medical, emotional and spiritual needs, most doctors are uncomfortable starting the conversations required to develop the most appropriate end-of-life care plans.

As Baby Boomers retire and age, we have an older generation that has grown up expecting continuing gains to their longevity. But longevity doesn’t mean everyone who lives longer lives in good health. In fact, according to the National Centers for Disease Control and Prevention, about 60 percent of adult Americans have a chronic disease, and 40 percent have more than one1. Our medical community needs to ensure that the sickest and most vulnerable in this generation will receive comprehensive, high-quality, person- and family-centered care that honors their dignity and choices and is consistent with their goals and values.

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Less than 40 years ago, when you went to the Emergency Room at your local hospital, you had no idea what kind of doctor you’d see. Staff physicians in the hospital took shifts in the ER, so you might have an obstetrician casting your broken wrist or a psychiatrist treating your heart palpitations. Beginning in 1979, Emergency Medicine was recognized by the American Board of Specialties. Over the next decades, EM specialists became thoroughly integrated into the continuum of care, so that today, patients coming into to the ER can expect treatment and a proper diagnosis from the right physician. 

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Eighty percent. That’s how many Americans would like to die at home. But despite the fact that 70 percent of Americans die from chronic illnesses1, giving them time to anticipate their deaths, over 50 percent still die in hospitals or nursing homes.2  Of the Medicare patients who died in 2016, only 48% received hospice services at the time of death3, even though every patient was eligible for six months of hospice care.

Prior to 1950, the majority of Americans did die at home. At that time, many chronic and advanced illnesses were untreatable, and all physicians could offer was palliative care. Over the next few decades, innovations in medicine enabled doctors to prolong life with medical and surgical interventions and for hospitals to treat patients with ventilators and IV anesthesia. As seriously ill patients lived longer, medical institutions recognized advanced illness management as an effective way to maximize their profits.

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