Recent Changes in Medicare and Medicaid Hospice Coverage in Cleveland, Ohio: What You Need to Know


As healthcare evolves, so too does the landscape of Medicare and Medicaid hospice coverage, especially in areas like Cleveland, Ohio. Understanding these changes is crucial for individuals and families considering hospice care. This article delves into the recent adjustments made to these programs and what they mean for residents of Cleveland.

Understanding Hospice Care and Insurance Coverage in Cleveland, OH

Hospice care, focused on providing comfort and quality of life for terminally ill patients, is often covered under Medicare and Medicaid. Understanding the nuances of these coverages is key for those seeking hospice care in Cleveland.

2023 Medicare and Medicaid Payment Rate Updates for Hospice Care in Cleveland, Ohio.

In fiscal year 2023, Medicare hospice payments witnessed a 3.8% increase, amounting to an estimated $825 million rise from the previous year. This change, inclusive of a market basket update reduced by a productivity adjustment, also introduced a new annual payment cap per patient of $32,486.92. These updates directly impact the funding and services available for hospice care in Cleveland.

Improving Care Quality: Recent Enhancements to Cleveland’s Hospice Quality Reporting Program.

The Hospice Quality Reporting Program (HQRP) saw significant enhancements, including the introduction of the Hospice Outcomes and Patient Evaluation (HOPE) tool. These updates aim to bolster the quality of care provided by hospices, ensuring that Cleveland’s residents receive top-tier end-of-life care.

New 36-Month Ownership Rule for Hospices: How It Affects Medicare Coverage in Cleveland.

A major shift came with the extension of the 36-month rule to Medicare-enrolled hospices. This rule aims to provide stability in hospice operations by prohibiting changes in majority ownership within 36 months of initial Medicare enrollment or the most recent change in ownership. This rule’s impact on the hospice landscape in Cleveland is significant, affecting both providers and patients.

Enhanced Oversight of Hospice Providers in Cleveland Under Medicare and Medicaid.

CMS has heightened its oversight of hospice providers. Facilities in the bottom 10% based on specific performance metrics face increased scrutiny. This enhanced oversight is set to improve the quality of hospice care available in Cleveland, ensuring higher standards and better patient outcomes.

Navigating High-Risk Designation and Deactivation Period Changes for Cleveland Hospices.

Newly enrolling hospices are now classified as “high-risk” under Medicare, requiring rigorous screening processes, including criminal background checks. Moreover, the period for deactivation of Medicare billing privileges for non-billing was reduced from 12 to six months, affecting hospice operations and billing practices in Cleveland.

What Cleveland Residents Need to Know About Recent Medicare and Medicaid Hospice Changes.

For Cleveland residents, these changes mean a more regulated hospice environment. While this could translate to higher quality care, it also requires individuals to be more diligent when choosing a hospice care provider. Understanding these changes is crucial in making informed decisions.


The recent changes in Medicare and Medicaid hospice coverage are pivotal for residents of Cleveland, Ohio. Staying informed about these updates is crucial for those navigating hospice care choices in this region.

We encourage Cleveland residents to consult healthcare providers and insurance experts for personalized advice. Additionally, reaching out to Hospice Cleveland for more information can provide further guidance in understanding these changes.

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