A group of lawmakers have rolled out a new Senate bill that would direct the Center for Medicare & Medicaid Innovation (CMMI) to develop a palliative care-specific payment model demonstration.
The bill is dubbed the Expanding Access to Palliative Care Act. Sens. Jacky Rosen (D-Nev.), John Barrasso (R-Wy.), Tammy Baldwin (D-Wisc.) and Deb Fischer (R-Neb.) are sponsoring the legislation.
The demonstration that would allow palliative care to be covered at the same time as curative treatment. The goal is to help patients receive palliative services earlier in their care journeys.
“Palliative care has been shown to improve health outcomes and quality of life, but unfortunately, for seniors, it is only currently available to patients in hospice,” Rosen told Palliative Care News in an email. “That’s why I’m introducing bipartisan legislation to expand Medicare coverage of palliative care, making it available to seniors earlier in the diagnosis and treatment process. As a co-founder of the Senate’s Comprehensive Care Caucus, I’ll always work to improve the quality of life for patients and their families.”
Despite its proven clinical value, palliative care is a difficult space for home health providers to navigate due to a murky reimbursement landscape.
It’s not currently covered under Medicare. Oftentimes, palliative care is covered under fee-for-service arrangements, for example, under Medicare Part B. This is a hindrance that limits who is able to operate in this space.
If passed, the bill would be a step toward a dedicated community-based palliative care benefit. This could mean potential growth for the sector, and more home health providers could be enticed to offer palliative care services.
Currently, only 7% of home-based palliative care programs are operated by home health agencies.
On the flip side, 41% of home-based palliative care programs are operated by hospice agencies, 34% by hospitals, 10% by physician groups, 5% by health systems and 4% by independent organizations, according to Center to Advance Palliative Care and Palliative Care Quality Collaborative data.