General Surgery Coding Alert - 2015 Issue 17
Despite Enthusiasm, Here's Why Some Say MCCM Isn't a Bed of Roses
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Article Overview
This article examines a cautious perspective on the Medicare Care Choices Model (MCCM), focusing on how the model is discussed by a consumer advocacy organization and why its design may create confusion for providers and patients. It covers broad issues involving hospice election, continuing treatment, selected serious illness categories, and diagnoses that are discussed as excluded from the model. The piece is relevant to hospice, palliative care, and Medicare-focused audiences that need a general understanding of the policy and care-setting implications.
Why This Topic Matters
It helps readers understand why a Medicare demonstration model can affect patient communication, care planning, and expectations around hospice and ongoing treatment in serious illness settings.
Article Sections
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Overview of concerns about the Medicare Care Choices Model
Introduces the Medicare Care Choices Model and summarizes the cautionary viewpoint presented by a consumer advocacy organization. It frames the main areas of potential confusion discussed in the article.
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Confusion over the law
Discusses concerns about how hospice election and Medicare coverage are described in relation to terminal illness and other ongoing care needs. The section uses broad examples to illustrate the policy issue.
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Confusion about treatment goals
Explores concerns about language used to describe continuing treatment in the model and how that language relates to serious illness care. It also references the disease categories tied to the demonstration.
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Confusion about when curative treatments are best
Addresses concerns about the timing and appropriateness of ongoing treatment for some selected diagnoses. It also notes diagnoses discussed as not being included in the model.
What You Will Learn
- The general purpose and scope of the Medicare Care Choices Model
- Why some observers have concerns about how the model may be understood by patients and providers
- How hospice election is discussed in relation to other ongoing Medicare-covered care
- Which broad disease categories are associated with the model
- Which serious diagnoses are discussed as excluded from the model
Who Should Read This
- Hospice providers
- Palliative care teams
- Medicare billing and coding professionals
- Case managers
- Compliance staff
- Health care policy readers
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