Because Medicare plays such a major role in the healthcare system, accounting for 20% of total national health spending in 2014, containing Medicare costs is a priority for policymakers.

For Medicare patients who meet hospice eligibility requirements, government pays up to 100% of costs for hospice staff, medical supplies and medications relating to pain and comfort management for patients. Understandably, the hospice industry feels the pressure to control costs.

Recently the Centers for Medicare and Medicaid Services (CMS) released data comparing hospice providers’ ability to be effective stewards of Medicare spending.

Tulsa, OK-based Crossroads Hospice & Palliative Care topped the list.

According to CMS data on Medicare Overcharges, Crossroads Hospice‘s results were 77.5 percent below the industry average.  Against national nonprofit hospices, Crossroads scored 78.6 percent lower. 

The findings contradict a popular belief that nonprofits are better at providing high quality, cost-effective care, said Perry Farmer, President and CEO of Tulsa, OK-based Crossroads Hospice.

 The report is based on data compiled from approximately 4,000 hospice sites nationwide. Under the Patient Protection and Affordable Care Act (ACA), CMS in 2014 began reporting on various quality measures to provide greater transparency and insights for consumers about how well hospices perform.

“We strive to be effective stewards of our patients’ – and Medicare’s – spending,” said Farmer. “Our goal is to provide the highest level of care in the most appropriate setting and in the most cost-effective way possible.”

Medicare pays a per diem rate to providers delivering hospice care at home, or in a nursing home, hospital or inpatient unit if pain or symptoms become too difficult to manage at home. Typically, the rate is higher for services provided outside the home. Total payments to a hospice are limited by an annual statutory cap. Payments in excess of the cap are considered overcharges.

The Medicare hospice benefit covers palliative and support services (medical, social and counseling services and prescription drugs) for terminally ill patients with a life expectancy of six months or less if the illness runs its normal course.

Making such determinations isn’t an exact science says Farmer. But Crossroads works closely with medical professionals to ensure patients’ conditions and needs are recognized and addressed correctly and efficiently. Providing effective palliative care and prescription drug management in the proper setting helps reduce down costs by minimizing hospital readmissions and other expensive procedures. 

“We were thrilled by this analysis of Crossroads and its peers,” said Farmer. ”We believe it is a tribute to the commitment of our professional staff, as well as Crossroads’ highly patient-centric approach.”

“We welcome the development of an impartial, transparent system to help consumers evaluate hospice providers,” Farmer said. “While we recognize this is still evolving, we are very happy and proud of these early results.”

  Visit www.crossroadshospice.com for more information.