Hospice of Saddleback Valley Selected to Participate in the Medicare Care Choices Model

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Model aims to increase choice and quality by enabling individuals to receive palliative and curative care concurrently

Many seniors, disabled Americans, and family members of individuals who suffer from life limiting illnesses must choose between the support services provided through hospice care or curative treatment. Fewer than half of eligible Medicare beneficiaries use hospice care and most only for a short period of time. Under current Medicare payment rules, individuals are not able to receive both palliative and curative treatment concurrently.

On July 20, 2015, Health and Human Services Secretary, Sylvia M. Burwell, announced that Hospice of Saddleback Valley was one of the 140 Medicare-certified hospices nationwide selected to participate in the Care Choice Demonstration project. This five year project, through the Centers for Medicare and Medicaid, will help assist those wanting that extra layer of support for symptom management, emotional and spiritual support and making decisions about care options. It’s a new model that 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.

End of life care is different for everyone. A terminal or serious illness can be a time in a family’s life that is unsettling; hard decisions need to be made and often times families struggle with all of the uncertainty. Families are dealing with personal fears as well as the fears of their loved ones. Understanding palliative care can lead to better decisions about care. When symptoms are under control, people can focus on what’s important to them.

Participating hospices will provide services under the model 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. Services will be available around the clock, 365 calendar days per year and will begin starting January 1, 2016 for the first phase of participating hospices.

Individuals who wish to receive services under the model must fall into certain categories:

  • Must be diagnosed with certain terminal illnesses (e.g., advanced cancers, chronic obstructive pulmonary disease, congestive heart failure and 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.

For more information about Hospice of Saddleback Valley at Saddleback Memorial, please call 949-452-3000 or visit our Hospice of Saddleback Valley page.