Spectrum Health Hospice Chosen for Medicare Care Choices Model

Spectrum Health Hospice has been selected by the Centers for Medicare and Medicaid Services (CMS) to participate in a new model that allows for different kinds of services.

The “Medicare Care Choices Model” will let beneficiaries who are struggling with a life-limiting illness to receive the kind of supportive-care services typically provided by hospice as well as continuing with “curative” treatments such as chemotherapy, radiation, physical therapy and medications.

Spectrum Health Hospice is one of approximately 140 programs in the U.S. chosen for this pilot. There are 10 agencies in Michigan participating.

CMS recently said this model “empowers beneficiaries, their families and clinicians by providing them with greater flexibility in deciding between hospice care and curative treatment when faced with life-limiting illness.”

“Spectrum Health Hospice is excited to participate in providing therapeutic care to those undergoing treatment for debilitating diseases like cancer, HIV, and congestive heart failure,” said Chad Tuttle, president, Spectrum Health Continuing Care. “This model will allow appropriate medical services to alleviate severe symptoms and allow people to enjoy a higher quality of life, while undergoing curative treatments.”

Under the current hospice benefit, a patient cannot receive curative care after choosing to start hospice, which provides physical comfort and symptom management as well as emotional support and very tangible help for the patients caregivers and families,

The CMS announcement noted in its March 2015 Medicare Payment Policy Report to the Congress, only 47.3 percent of Medicare and 42 percent of dually eligible [Medicaid and Medicare] beneficiaries used hospice care and most only for a short period of time. “This data reflects the struggle in having to choose between palliative and curative care during these difficult times,” the report said. “It can be a difficult decision for patients and families to choose between receiving treatment and getting the support and help one needs to stay at home in comfort. This is a tremendous opportunity to provide the care patients want and need in a more timely manner,” added Lisa VanderWel, Senior Administrator, Spectrum Health Hospice.

Spectrum Health Hospice will provide services for patients and families in their home — such as nursing, social work, homemaker services, on-call assistance, bereavement and respite.

The Centers for Medicare and Medicaid Services said it invited more than 140 Medicare-certified hospices to participate in the model for five years, covering a total of about 150,000 Medicare and dual Medicare-and-Medicaid eligible patients.

The patients included in the program are diagnosed with the following terminal illnesses: advanced cancers, chronic obstructive pulmonary disease, congestive heart failure and/or HIV/AIDS.

The program will be phased-in over two years, with about half of participating hospices starting to offer services under the model on Jan. 1, 2016, and the rest starting Jan. 1, 2018.