CMS Awards $5.5M to Develop Palliative Care Quality Measures

The American Academy of Hospice and Palliative Medicine (AAHPM), in partnership with the National Coalition for Hospice and Palliative Care and the RAND Corporation, has been awarded a three-year $5.5 million grant from Centers for Medicare & Medicaid Services (CMS) to develop patient-reported quality measures for community-based palliative care.

Filling the gaps in quality measurement of palliative care is one of the main sticking points for the three-year grant, according to AAHPM.

One of the many reasons to develop measures is because major gaps were observed in quality measurement for people with serious illness, according to a 2015 report measuring quality indictors for hospice and palliative care from AAHPM and the Hospice and Palliative Nurses Association.

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“Only a few of the quality measures currently available for reporting under the Merit-Based Incentive Payment System are meaningful for palliative care clinicians who treat a broad population of seriously ill patients, particularly in outpatient settings,” Joe Rotella, chief medical officer at AAHPM, said in an email to Home Health Care News. “The new measures under development will matter for palliative care patients and the clinicians who are accountable for the quality of their care.”

Chicago-based AAHPM is an organization for physicians specializing in hospice and palliative care medicine.

The Richmond, Virginia- based National Coalition for Hospice and Palliative Care is a network that is comprised of 10 national hospice and palliative care organizations. The organizations that make up the coalition represent 5,000 physicians, 11,000 nurses, 1,600 palliative care programs and 5,000 hospice programs.

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Santa Monica, California-based RAND Corporation is a nonprofit research organization that has a history of developing, testing and implementing quality measures across a wide range of clinical care domains.

These measures could mean big changes are on the way for how Medicare covers palliative care for patients under home health care. Medicare currently covers home visits for certain medical clinicians, but key members of the palliative care team — social workers and chaplains — are not covered.

“Earlier this year, AAHPM and the Coalition to Transform Advanced Care presented proposals to the Physician-Focused Payment Model Technical Advisory Committee (PTAC) for alternate payment models for providing palliative care in people’s homes,” Rotella said. “Both models were recommended for demonstration, and AAHPM and C-TAC have provided additional recommendations to the Center for Medicare and Medicaid Innovation. Any alternative payment model for serious illness tested by CMS would include accountability for quality. We expect that the quality measures to be developed here for MIPS would also be applicable to relevant alternative payment models.”

The partnership will utilize a technical expert patient panel to provide input for the measures during the development, testing and implementation process.

“Measure development will follow an established and well-defined process that moves from refining measure concepts to testing measure specifications and data collection approaches to harmonization with other measures,” Rotella said. “Stakeholders and subject matter experts, including patient advocates, will provide input at every stage of the process.”

Palliative care has seen an uptick in interest recently among home health companies.

Anthem, Inc. (NYSE: ANTM) bought Nashville-based Aspire Health, the nation’s largest non-hospice, community-based palliative care provider in February. The Duke Endowment also recently awarded the Medical University of South Carolina (MUSC) a $1.27 million grant to create a statewide palliative care telehealth program.

Written by Kaitlyn Mattson

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