in 2012, 11% of hospices were required to make cap payments. The average of those payments was $510,000 (Medpac, Report to the Congress: Medicare Payment Policy, March 2015). Cap problems disproportionately affect smaller, freestanding hospices (ABT Associates, Medicare Hospice Payment Reform: A Review of the Literature, April 2013).

 

These payment requirements can arise without warning and have a devastating financial impact to a hospice. Even worse, payment requests can be initiated several years after a cap year ends, at which time there is no choice but to make the payment, or have Medicare reimbursements suspended. Proactive analysis and planning can help your hospice avoid these catastrophic pitfalls and stay on solid financial ground.