The National Coalition for Cancer Survivorship (NCCS) applauds the recent decision by Health and Human Services Secretary Kathleen Sebelius to initiate the Medicare Care Choices Model, a project to evaluate the impact of permitting Medicare patients to receive ongoing curative care while also receiving hospice care.

“NCCS has focused its policy efforts on ensuring cancer patients access to quality care that responds to their personal needs and allows them to make informed choices about their care,” said NCCS CEO Shelley Fuld Nasso.  “By launching the Medicare Care Choices Model, HHS and its Center for Medicare & Medicaid Innovation (CMMI) are removing barriers that previously prevented cancer patients from receiving hospice care while continuing curative treatment.  We commend HHS for advancing this important Medicare pilot.”

“The Medicare Care Choices Model follows the example of some private payers that have eliminated the requirement that patients forgo curative treatment if they want to receive hospice care,” said Fuld Nasso.  “There is growing evidence that multi-disciplinary care that integrates treatment and symptom management is in the best interest of patients and the Medicare program, and we are pleased Medicare is undertaking a significant test to evaluate the effects of choices regarding care made by terminally ill individuals.”

Almost a decade ago, Representative Lois Capps (D-CA) introduced the Comprehensive Cancer Care Improvements Act (CCCIA) to reform the cancer care delivery system by improving the integration of curative care and symptom management, fostering the delivery of multi-disciplinary cancer care, and encouraging a cancer care planning process that honors patient treatment preferences.  NCCS strongly supported that legislation, which included a provision authorizing a Medicare demonstration project to test the impact of concurrent hospice care and curative care on beneficiaries and their caregivers and the Medicare program.

“This announcement is great news for Medicare patients who for too long have had to make the false choice between the assistance and comfort of hospice care and curative treatment. Now, under the new Medicare Care Choices program, seniors will have access to the kind of care that works for them, during a time when they need peace of mind. I am so pleased to see this piece of my Comprehensive Cancer Care Improvement Act put into practice,” said Congresswoman Capps. 

After a concurrent care demonstration project was authorized by Section 3021 of the Affordable Care Act, the comparable provision was dropped from the legislation championed by Representative Capps.  The revised legislation, the Planning Actively for Cancer Treatment (PACT) Act (H.R. 2477), focuses on establishing a Medicare cancer care planning service that will facilitate shared decision-making and care coordination.  The pending legislation and the concurrent care program are based on research findings that coordinating curative treatment, symptom management, and shared decision-making improves patient satisfaction and outcomes.

“Our next step in ensuring compassionate, patient-centered care is to pass my bipartisan PACT Act, which would help facilitate decision-making and care coordination by involving patients in the development of cancer care treatment plan that addresses both treatment and symptom management,” said Congresswoman Capps. “I will continue to look for ways to ensure patient engagement and choice in their important health care decisions.”

Hospice providers interested in participating in the Medicare Care Choices Model must apply to CMMI by June 19, 2014.  CMMI will choose at least 30 hospices to participate in the program and hopes to have a diverse group of hospice providers.  Over three years, up to 30,000 Medicare beneficiaries with advanced cancers, chronic obstructive pulmonary disease, congestive heart failure and HIV/AIDS will be served through the Care Choices Model.

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