FutureFocus February 21, 2018: Reforms Ahead: Hospital Discharges, Telehealth, Hospice, and Payment Systems

Lisa Remington

In this week’s FutureFocus, we discuss four reforms coming to your organization. Key topics will impact home health payment reform, hospice, a new hospital discharge penalty, and the expansion of telehealth. We provide insights to each reform.

Lisa Remington, President, Remington Health Strategy Group

The Bipartisan Budget Act (PL115-123) will allow physician assistants to serve as the attending physician to hospice patients, incorporating policies found in the Medicare Patient Access to Hospice Act (HR1284), sponsored by Sens. Mike Enzi (R-WY) and Tom Carper (D-DE) and Reps. Lynn Jenkins (R-KS) and Mike Thompson (D-CA).

 Effective January 1, 2019, PAs will be able to serve as the attending physician to hospice patients and perform other functions that are otherwise consistent with their scope of practice. Specifically, the law’s language inserts “or a physician assistant” after “a nurse practitioner”.

"Currently, Medicare only allows physicians and nurse practitioners to serve as the hospice attending physician"

“For years, the number of primary care physicians has been declining in more remote areas and this bill would help combat the problem so that some of the most vulnerabl Americans get the healthcare they deserve,” said Rep. Jenkins. National Hospice and Palliative Care Organization (NHPCO) President and CEO Edo Banach said: “This common sense, bipartisan legislation will go a long way to ensuring that patients can have their preferred care team at the end of life.”

Currently, Medicare only allows physicians and nurse practitioners to serve as the hospice attending physician, despite the fact that there is a shortage of hospice providers in rural and underserved communities. Often, people in these communities receive primary care from a PA prio to their hospice election and must give up that provider when they elect hospice.