New Hospice Payment Program Will Admit More Of Us With Advanced Illness, Chronic Conditions To Reduce Costs

Ron Panzer

Hospice Patients Alliance Newsletter


We have mentioned the "Advanced Illness Programs" under which hospices in some areas have been able to admit non-terminal, but seriously ill patients into hospice. What happens once they're admitted is supposed to be supportive care that helps these patients, but the experience of many families is that hospice staff find ways of reducing the length of the patients' lives by one method or another.

Of course, hospice cultists will disagree, but it is obvious that when the goal of these programs is admittedly (see below) to reduce re-admission to the hospital for treatments that could save the patient, the result is that the patient doesn't get those treatments and then dies. Obviously!

The entire intent has to do with reducing costs for "the system." People ask us, "Is this program or that program worthy of being trusted?" Or, "Is this tainted palliative care/hospice?"

All of us must realize that today, all healthcare is managed care. This means that the physicians are controlled by the government-run (MCare/MCaid/MCal) or private insurance companies that reimburse the hospitals or physicians' offices for services they bill for. Options for treatment are absolutely not offered or even mentioned in many cases if they docs know they can't get reimbursed for it.

If "Medicare for All" is ever implemented, it will be rationed care for all and those who are thought to be unworthy of care -- the elderly and disabled or those with multiple chronic conditions -- won't get it. "Medicare for All" goes hand-in-hand with coerced euthanasia/medical killing. There is no doubt about that. Think about it.

"They" promise everything but can't pay for it, so what do they do? Kill the expensive rather than caring for those who need care. In that way, their "Medicare for All" becomes provide minimal mostly preventive care for the many while denying care for the few who are desperate.

That is openly admitted by the designers of the most recent health care reforms. While they said that their "system" guaranteed all basic services to the people, they revealed that the elderly were not guaranteed those same services (see the Stealth Euthanasia book for details).

Of course, outside "the system," those who are "cash pay" physicians, who are paid directly by the patients and refuse government or insurance payments, will be able to openly discuss all the options that have been made available through medical advances in the field.

Executive Director of the Association of American Physicians & Surgeons, Jane Orient, MD spoke about the challenges in getting authentic and life-affirming care in "the system" due to the coercive effect of the managed care that permeates "the system." You can listen to her recent interview conducted by HPA Board member, Marsha Joiner:

Now, the Centers for Medicare & Medicaid Services is initiating changes that will even more coercively force patients into hospice, even if they are non-terminal. Of course, there are patients who have multiple chronic conditions who are cared for by their physicians and stabilized after often having an acute episode of a condition. Really supportive care is being provided by many, but the push from the "elite stakeholders" is to make sure more and more of us don't get acute hospital care.

Financial incentives will reward hospitals and hospices that follow the new program that will be implemented in just over a year.

"Hospice News" reports the following that explains the expansion of the financial incentives that will make it even harder to avoid hospice. They think it's a great thing:


[article from "Hospice News" begins:]

CMS: Hospices Can Now Apply to Primary Care First

By Jim Parker | October 25, 2019

The U.S. Centers for Medicare & Medicaid Services (CMS) has opened the online application period for the Primary Care First payment models.

The agency announced the program in April and will implement the models in phases beginning in January 2021, initially in 26 regions throughout the United States. Hospices and palliative care organizations are eligible to participate in the payment models provided they meet the program’s criteria. The program is designed to control costs, reduce avoidable hospitalizations and improve care coordination.

Eligible providers can choose to participate in one or both of two payment options under the program: A general payment option and a Seriously Ill Population payment option designed to serve patients with complex, chronic needs, through which providers focused on caring for that population would receive increased payments.

“The goal of this model is to provide coordination for patients upstream of the hospice benefit–patients with serious and advanced illness,” Mollie Gurian, former chief strategy officer for the National Partnership for Hospice Innovation told Hospice News in April. “Part of good serious illness care is planning and counseling about appropriate transitions including to hospice.”

Gurian is now director of Hospice, Palliative Care and Home Health for Leading Age.

Hospices and palliative care practitioners will be able to receive payments through Primary Care First’s general payment option if they meet the programs eligibility requirements. They can also participate exclusively in the Seriously Ill Population payment option, either directly as an organization or by partnering with a primary care practice.

Participating health care providers would also receive a bonus for reducing avoidable hospitalizations, an area in which community-based hospice and palliative care providers have a strong track record. A growing body of research indicates that hospice and palliative care reduces hospitalizations as well as hospital readmissions.

“That’s where I think the opportunity lies,” Brad Stuart, the chief medical officer at the Coalition to Transform Advanced Care (C-TAC), and co-author of a Health Affairs study that helped inform the new payment models, told Hospice News in June. “You can really score a large increase if you achieve certain metrics that CMS has already specified. There is only one metric in year one, and that is you have to reduce avoidable hospitalizations.”

Development of the models was informed by research and proposals by a number of health care stakeholders, including the American Academy of Hospice, C-TAC, and Sacramento, Calif.-based health system Sutter Health, who received a $13 million grant to study clinical and financial systems for serious illness care through a program called the Advanced Illness Management Model (AIM). The three organizations made proposals to CMS’ Center for Medicare & Medicaid Innovation (CMMI) for new payment models.

A key goal of the models is to create a “spectrum of models” to support patients suffering from serious illness from diagnosis through end of life. In addition to these government programs, the agency foresees that health care providers — including hospice and palliative care organizations — will work with payers to develop similar programs in the private sector, CMMI’s Chief Strategy Officer Gary Bacher told the attendees of the C-TAC National Summit on Advanced Illness Care in Minneapolis.

Bacher made the comments in response to a question from coalition co-founder Tom Koutsoumpas.

Companies featured in this article: Coalition to Transform Advanced Care, LeadingAge, National Partnership for Hospice Innovation, Sutter Health

[end of article from "Hospice News"]


Spread the word about what is going on! The major media, conservative media, as well as both federal and state government officials are all utterly censoring this epidemic of medical killing. They will not admit what is going on and in fact, deny the reality!

For that reason, we have the Stealth Euthanasia book online and available to everyone to read for free (It can also be downloaded or bought as a hardcover printed book). If each of you tell 10 others, and they tell 10 others who also tell 10 others, etc. everyone in the country would know the truth before their family member is in danger!

Getting the word out is really very possible -- actually certain -- all you have to do is make this small effort. This is the first step to stopping the killing!

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All healthcare must be pro-life, otherwise it is not healthcare!

Ron Panzer
for Hospice Patients Alliance

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