The MCCM is an initiative developed by the Centers for Medicare & Medicaid Services (CMS) to explore ways to improve care options for beneficiaries by allowing greater flexibility and choice “in deciding between hospice care and curative treatment, when faced with life-limiting illness” (CMS, 2015).
With the intention of improving Medicare beneficiaries’ quality of care and patient and family satisfaction, the MCCM will provide a new option for beneficiaries with advanced cancers, chronic obstructive pulmonary disease, congestive heart failure, and HIV/AIDS who meet hospice eligibility requirements under the Medicare hospice benefit, to receive palliative care services from the hospice providers who have been chosen to participate in the model while concurrently receiving services provided by their curative care providers.
Currently, Medicare beneficiaries are required to forgo curative care in order to receive access to services offered by hospice. In this model, CMS will study whether access to such services will result in improved quality of care and patient and family satisfaction, and whether there are any effects on use of curative services and the Medicare hospice benefit.
CMS originally anticipated selecting 30 Medicare-certified hospices for the project but given the overwhelming interest from the US hospice community, the list of MCCM demonstration sites has grown to over 140, many of which are members of the National Hospice and Palliative Care Organization. This will enable the model to provide care for up to 150,000 Medicare or dually eligible beneficiaries over the five year period.
CMS sought out a diverse group of hospices representative of various geographic areas, both urban and rural, and hospices of varying sizes. These hospices were required to be able to demonstrate experience providing coordination services and/or case management, as well as shared decision-making to beneficiaries prior to electing the Medicare hospice benefit in conjunction with their referring providers/suppliers. The list of participating hospices is available on the CMS website.
“The Medicare Care Choices Model empowers clinicians and patients with choices. Specifically, clinicians, family members and caregivers in this model will no longer need to choose between hospice services and curative care,” said Patrick Conway, M.D., deputy administrator for innovation and quality, and CMS chief medical officer.
Upon announcing the MCCM in March 2014, U.S. Senator Ron Wyden (D-OR) – who has long supported the provisions that established this model – said: “This initiative represents a fundamental change in the way health care is delivered. Patients and their families should have every choice available to them when faced with life-threatening illness. Allowing Medicare coverage to continue while under hospice care means that patients no longer have to make a false choice between hospice and curative care.”