Have you seen the NewsBriefs report on the U.S Department of Health & Human Services Office of Inspector General’s review of Medicare Part D claims? Are you curious what it means?
Come talk to the OnePoint Patient Care hospice pharmacy experts during the NHPCO Management and Leadership Conference. Find us at booth #423.
When Compliance Means Change
Managing a successful hospice program means also managing the rigmarole of regulatory compliance. While keeping up with paperwork and potential change in the compliance climate can be cumbersome, being prepared can help avoid burdening your resources when issues arise—such as when prescription payment claims may be under review.
As you may have seen in the National Hospice and Palliative Care Organization (NHPCO) NewsBriefs this week, the Office of the Inspector General (OIG) is reviewing a sample of Medicare Part D prescriptions filled during hospice claim dates in 2016. The aim is to determine whether some of the prescription drugs covered by Medicare Part D should have been covered by hospice organizations instead.
While the OIG has stated that it’s not expecting to reprocess those claims, this review serves as a good reminder to always be prepared, from maintaining good records to building adaptability into your business model.
With the potential for revisions to drug payment requirements on the horizon, now is the time to ask: How is your hospice positioning itself for the future?
Take Charge of What You Can Control
In the healthcare industry, we are accustomed to identifying all available options and making the best choice based on knowledge—the best treatment plan, the best resource allocation and so on.
Preparing for the unknown in regulations and compliance is no different. To scope out a future plan, consider your available options so that you’ll be ready to choose the best one for your hospice program when changes happen.
To do this, take charge of the aspects of hospice management that you can control and build in some flexibility. Medication cost management is an excellent place to start. For example, in what ways can you lower the burden of prescription drug coverage for your hospice without compromising your high standards of patient care?
One hot topic worth examining closely is deprescribing. With our focus on providing hospice partners with the best patient outcomes, OnePoint Patient Care continuously researches this important subject. As with all healthcare decisions at end-of-life, medication management requires carefully weighing the necessity of different drugs against their expected benefits.
When done responsibly, deprescribing is not analogous to simply eliminating prescription medications. Instead it is part of a holistic plan of care. Ultimately, deprescribing should be a positive, patient-centered intervention that results in better patient care—a mutually favorable outcome for the patient and the hospice alike.
Similarly, providing therapeutic alternatives for managing pain and symptoms associated with a patient’s terminal illness can be an important component of an overall treatment plan. When appropriate, these options can provide comfort and value to the patient, while also potentially generating cost savings.
Of course, implementing a plan for deprescribing and alternative treatment options into overall medication management can be a challenge, as with any systemic change.
To help with future-proofing your hospice, OnePoint Patient Care has 50 expert pharmacists who can discuss the details of creating a cohesive vision for your hospice, and help address the specific challenges you may face in navigating the changing landscape of hospice care.
In addition, our dedicated Service Delivery Directors can help you create a culture of preparedness and adaptability—from providing medication reports which identify possible deprescribing opportunities to keeping you on track with in-person quarterly reviews.
Stay One Step Ahead
While the future of Medicare regulations may be unclear, we can speculate that the Centers for Medicare & Medicaid Services (CMS) is likely to use their recent auditing to effect change in medication reimbursement requirements under the Part D benefit.
What is clear, however, is that your hospice program has the option be prepared.
As the nation’s leading provider of hospice pharmacy benefits management (PBM) and mail order and local pharmacy services, OnePoint Patient Care is committed to staying one step ahead so that we’re always prepared to support our hospice partners, now and in the future. Let us help you stay one step ahead as well.
Visit us at NHPCO MLC in booth #423 to discuss the potential changes to medication payment requirements for hospice. We look forward to meeting you there.