Empassion Health CEO Says MA Model Could Curb Hospice Fraud
In a Hospice News interview, Empassion Health CEO Robin Heffernan argues that bringing hospice fully into Medicare Advantage, similar to how MA absorbed the home health benefit in the late 1990s, could reduce fraud, waste and abuse while improving program integrity. Heffernan draws parallels between hospice's current growth-driven scrutiny problems and home health's history, when MA utilization management and plan-level financial accountability cut home health spend roughly in half while reducing hospitalizations. She contends CMS's hospice value-based insurance design demonstration had the right intent but failed because plans could not build provider networks or apply utilization management, unlike in Accountable Care Organizations where hospice accountability already exists. Heffernan says Empassion, which serves original Medicare, MA, and Special Needs Plan populations across 45 states, sees earlier hospice identification and network-based care coordination as key levers.