Video Testimonial: Raymond Gonzales

While at the Advocacy Intensive, I had the opportunity to interview Raymond Gonzales, RN and MSW student about his experience at the event.

Ray mentioned empowering his patients, clients, and their families as advocates. How do you use the knowledge you have an as advocate to educate and empower your clients, patients and families?

Thanks for joining us at the Intensive, Ray! We hope to see you again next year!


Eminem, Hospice Advocate?

Well not exactly. Wednesday night on the #HPM tweet-chat, the group was discussing a new video from ZDoggMD, physician turned comedian/medical commentator. The video, a parody (though it is not funny in nature) is set to the tune of popular song “Love the Way you Lie,” by rapper Eminem, featuring Rihanna. I had seen the video circulating on social media, but I took a break from the chat to watch it myself. I was stunned.

Watch the video, and then scroll down for my thoughts.



I’ll wait.





Now tell me that didn’t hit you in the feels? I think this could be an incredible tool for getting people, especially young people, to think about Advanced Care Planning and end-of-life conversations. Yes it is a little edgy, but maybe we need to try something like that to reach more people. Curious to hear what you all think about this video: Do you like it? Does it work? How would you use it? Should the #HPM community try to use different methods to spread awareness? Let us know!

Roberts/Warner Letter Results are…

On a hot July day, not too long ago, nearly 300 Hospice Advocates blanketed Capitol Hill. They were joined by fellow Hospice Advocates across the country, who joined the fight and called Congressional offices from home. These Advocates requested that their Senators join Senator Pat Roberts (KS) and Senator Mark Warner (VA) in a letter asking CMS to test proposed changes to hospice payment methodology. Yesterday afternoon, the final letter was sent to CMS Acting Administrator Slavitt. Who joined Senators Roberts and Warner?

27 Senators (including Roberts and Warner)
14 Republicans
13 Democrats
11 Members of the Senate Finance Committee, which has jurisdiction over hospice issues in the Senate

The complete list of signatories is below.

This is a great show of support from the Senate! Thank you for all of the hard work you put in–the calls made, the steps around Capitol Hill, follow-up emails. These results would not have been possible without your work! But don’t get too comfortable, Advocates! There is more work to be done… Stay tuned!

John Boozman (R)
Tom Cotton (R)

Michael Bennet (D)
Cory Gardner (R)

Christopher Coons (D)

Mazie Hirono (D)

Chuck Grassley (R)

Pat Roberts (R)*

David Vitter (R)

Susan collins (R)

Debbie Stabenow (D)

Al Franken (D)
Amy Klobuchar (D)

Jon Tester (D)

New Hampshire
Kelly Ayotte (R)
Jeanne Shaheen (D)

New York
Charles Schumer (D)

North Carolina
Richard Burr (R)

Sherrod Brown (D)
Rob Portman (R)

Robert Casey (D)

South Carolina
Tim Scott (R)

Lamar Alexander (R)

Tim Kaine (D)
Mark Warner (D)*

West Virginia
Shelley Moore Capito (R)

Tammy Baldwin (D)

CMS Announces MCCM Awards

After much deliberating by CMS and waiting from the hospice community, CMS announced the Medicare Care Choices Model (MCCM) awards last week.

What is the Medicare Care Choices Model, and why were hospices so anxious about this announcement? Glad you asked!

The Medicare Care Choice Model is designed to evaluate whether eligible Medicare and dually eligible beneficiaries would elect to receive supportive care services typically provided by hospice if they could also continue to receive curative services. Beneficiaries who qualify for coverage under the Medicare hospice benefit and dually eligible beneficiaries who qualify for the Medicaid hospice benefit but have not yet elected the hospice benefit, have the option to elect to receive supportive care services typically provided by hospice, while continuing to receive curative services. Other eligibility criteria include:

  • Only beneficiaries with specific diagnoses are eligible:
    • advanced cancers
    • chronic obstructive pulmonary disease
    • congestive heart failure
    • human immunodeficiency virus/acquired immune deficiency syndrome;
  • Must meet hospice eligibility requirements under the Medicare or Medicaid hospice benefit;
  • Must not have elected the Medicare or Medicaid hospice benefit within the last 30 days prior to their participation in the Medicare Care Choices Model;
  • Must receive services from a hospice that is participating in the model; and
  • Must have satisfied model’s other eligibility criteria.

Under the model, participating hospices will provide services that are currently available under the Medicare hospice benefit for routine home care and respite levels of care, but cannot be separately billed under Medicare Parts A, B, and D. These services include nursing, social work, hospice aide, hospice homemaker, volunteer, chaplain, bereavement, nutritional support, and respite care services. CMS will pay a per beneficiary per month fee ranging from $200 to $400 to participating hospices when delivering these services under the model.

Providers and suppliers furnishing curative services will bill Medicare for the reasonable and necessary services furnished to beneficiaries who elect to participate in the model. These services include:

  • physical or occupational therapy
  • speech language pathology services
  • drugs for the management of pain or other symptoms from the terminal illness or related conditions
  • medical equipment and supplies
  • any other service that is specified in the patient’s plan of care for which payment may otherwise be made under Medicare (for example, ambulance transports)
  • short-term inpatient care for pain or symptom management that cannot be managed in the home environment
  • physician services

CMS originally anticipated selecting at least 30 Medicare-certified hospices to participate in the model and enrolling up to 30,000 beneficiaries throughout a 3-year period. Due to robust interest, CMS has invited over 140 Medicare-certified hospices to participate in the model and expanded the duration of the model to 5 years. This will enable up to 150,000 eligible Medicare and dually eligible beneficiaries to participate.  Approximately half of the participating hospices will begin providing services under the model on January 1, 2016 for a five year period. The remaining participant hospices will provide services under the model starting January 1, 2018 for a three year period. This model is slated to end on December 31, 2020.

“This initiative represents a fundamental change in the way health care is delivered. Patients and their families should have every choice available to them when faced with life-threatening illness. Allowing Medicare coverage to continue while under hospice care means that patients no longer have to make a false choice between hospice and curative care.” – Senator Ron Wyden, March 2014

NHPCO members can click here for MCCM resources.