Revenue Cycle – Hospice

Effective management of the hospice revenue cycle is an ongoing challenge, as cash flow optimization efforts must always be balanced against potential compliance threats and the evolving hospice payment landscape. Office of Inspector General reports continue to suggest the possibility of increased scrutiny of the hospice benefit, which often comes in the form of increased program integrity activity, impacting the revenue cycle. Individual states continue to adopt Medicaid managed care, significantly complicating the hospice revenue cycle, and the hospice benefit continues to draw interest from program integrity contractors. The second year of the hospice benefit component of the Value-Based Insurance Design (VBID) Model offers new challenges in managing the revenue cycle, as more Medicare Advantage plans participate and expand the reach of this demonstration project. Resumption of the Medicare Targeted Probe and Educate (TPE) process increases the consequences of poor revenue cycle and documentation management practices.