b'| ELITEHEALTH GUIDEthe legislation.CMS RELEASES FINAL RULE ON HOSPICEtion of a physician,Additionally, incentive awards forWAGE INDEX services of a home health aide who has non-physician health clinicians who commitThe Centers for Medicare & Medicaidsuccessfully completed an approved to practicing and teaching palliative care, asServices (CMS) has issued a final rule thattraining program,well as funding for training centers to pro- updates the Medicare hospice wage index,homemaker services,vide short-term, intensive training to buildpayment rates, and cap amount for fiscal yearmedical supplies (including drugs and clinical and educational skills in caring for2020. The rule also rebases the continuousbiologicals), and the use of medical people with serious illnesses, are expectedhome care, general inpatient care, and inpa- appliances, while under such a plan,to be other important considerations withintient respite care per diem payment rates inphysicians services,the act that researchers believe could help toa budget-neutral manner to more accuratelyshort-term inpatient care (including lessen the negative workforce impacts.align Medicare payments with the costs ofboth respite care and procedures nec-The researchers have also offered otherproviding care, according to CMS officials.essary for pain control and acute and recommendations as part of their study,CMS has also finalized a proposal to usechronic symptom management) in including allocating funds for advancedthe current years hospital wage index data toan approved inpatient facility, if such training in palliative care and the expan- establish the hospice wage index, modifyingrespite care is provided on an intermit-sion of Medicare graduate medical educationthe election statement content requirementstent, non-routine, and occasional basis funding for palliative medicine physicianto include additional information aimed atthat is not provided consecutively over fellowships, support for additional researchincreasing coverage transparency for patientmore than five days,into the workforce capacity. and growth ofunder a hospice election, officials said.counseling (including dietary counsel-non-physician palliative care specialists, pay- Hospices will reportedly see an estimated 2.6ing), andment models for specialty palliative care thatpercent ($520 million) increase in Medicareany other item or service that is speci-are more focused on providing adequate sup- payments for 2020. Finally, this rule finalizesfied in the plan and for which payment port for a fully interdisciplinary team andchanges to the Hospice Quality Reportingmay otherwise be made under this title.that continue to be less reliant on the servicesProgram. 6These regulations became effec-of physicians and advanced practice profes- tive Oct. 1, 2019. The full language of theCREIGHTON UNIVERSITY TAKES NEW sionals who are eligible to bill under fee-for- final rule is available online for reference. 7 APPROACH TO PALLIATIVE CARE service Medicare, and policies that preventEDUCATIONthe worsening of the burnout rate.REVIEW OF HOSPICE ELIGIBILITYA new educational course being offered at GUIDELINES Creighton University is intended to prepare TERMINAL PATIENTS WANT TO DIE ATAlthough not accurate in predicting whenstudents from various academic backgrounds HOME, BUT MANY DONT death will occur, officials with the Centersincluding medicine, nursing, pharmacy, Despite the trend of the United States grow- for Medicare and Medicaid Services haveand social work to make better collabora-ing aging population that requires medicalestablished guidelines for regulating hos- tive treatment decisions for patients in the care for more comorbid serious illnessespice admissions related to most majorhospice and palliative care populations. The later in life, a minority of dying patients areterminal illnesses. Patients who do notcourse, Interprofessional Palliative Care, is referred to specialty hospice care before themeet the criteria may not be accepteddescribed as a cross-disciplinary course that last 3-4 weeks of their life. According to pal- into a federally funded hospice pro- teaches strategies that are founded on the liative care experts with Stanford School ofgram or be eligible for reimbursement.schools Ignatian tradition of discernment, Medicine, 80% of Americans would prefer toAccording to Title 18 of the Social Securityproblem-solving, and caring for the whole die at home, if possible, but 60% of people dieAct, 8the term hospice care means the fol- person. in acute care hospitals while 20% die in nurs- lowing items and services provided to a ter- According to Mandy Kirkpatrick, PhD, ing homesleaving only 20% of the popula- minally ill individual by, or by others underBSN, an assistant professor in Creightons tion dying at home.arrangements made by, a hospice programCollege of Nursing who helped to develop Dying at home is not for everyone, however.under a written plan established and period- the program, a collaborative of the College People of certain cultures prefer not to die atically reviewed by the individuals attendingof Nursing, School of Pharmacy and Health home. Others may wish to die somewhere otherphysician and by the medical director: Professions, and CHI Health, a nonprofit, than their home due to concerns related to thenursing care provided by or under thefaith-based organization headquartered stress on their family. While more research issupervision of a registered professionalin Omaha, NE, the program captures the needed to better understand how different cul- nurse, essence of palliative care because it is meant tures approach death, there are resources thatphysical or occupational therapy, orto begin well in advance of end-of-life care. 9exist to help healthcare providers attain a betterspeech-language pathology services, According to university officials, appreciation for differences that may exist. 3-5 medical social services under the direc- Creighton offers one of the nations first-es-20 ELITEHEALTH GUIDE|2019| www.elitecme.com'