Mountain Valley Hospice to Administer National Model for Medicare/Medicaid “Care Choices” Program

by staff
The Center for Medicare and Medicaid Innovation has selected Mountain Valley Hospice and Palliative Care to administer its “Care Choices” demonstration model. Mountain Valley Hospice & Palliative Care provides hospice services to terminally ill patients and their families in 17 counties from 8 locations in North Carolina and Southern Virginia, including Forsyth county.

hospice
hospice

“Care Choices” studies how the quality of life can improve when individuals with a serious illness have access to care focused on comfort as they continue to aggressively treat the illness, with hope of a cure or extended life.

The Model focuses on clarifying the patient’s needs and helping with decision-making between the patient and family, his or her primary medical provider, and the Care Choices team.

The centerpiece of “Care Choices” is a plan to allow qualified patients to receive both palliative and curative care at the same time. The benefits of “Care Choices” include pain and symptom management, care coordination with medical providers, case management by the Care Choices team, emotional and spiritual support, completing Advanced Directives, and education on disease and treatment options. The plan will provide care in-home, with costs covered by Medicare.

coverage area
coverage area

Those eligible for “Care Choices” include individuals diagnosed with:

  • Advanced Cancer
  • Advanced COPD (Chronic Obstructive Pulmonary Disease)
  • Advanced CHF (Congestive Heart Failure)
  • End Stage HIV/AIDS

In order to participate in “Care Choices”, candidates mus also meet the following requirements:

  • The candidate must be enrolled in Medicare Parts A and B.
  • The doctor or provider must state in writing that the individual has a life expectancy of 6 months or less.
  • Participants must have been to the hospital once (ED visit, hospitalization, or admitted for observation) within the last 12 months, and had three doctor visits within the last twelve months related to the diagnosis.
  • At the time of enrollment, the patient must reside in a traditional house, rather than a nursing home, or assisted living facility.

“Care Choices” professionals can assist patients with this eligibility screening process, and can answer questions for family members and loved ones.

The patient’s Medicare Benefit will pay for the Care Choices team. Medications, equipment, therapies and visits to primary physicians and specialist providers are billed to Medicare as before, and established co-pays will apply.

mtn valley logoFor more information call (336)789-2922, or visit mtnvalleyhospice.org