Billing Differences: Home Health, Hospice & Palliative Care

Delaine Henry, CEO of Advanced Revenue Cycle Management, discusses the differences in payment models for palliative care, home health and hospice services under Medicare and Medicare Advantage plans. Palliative care follows a familiar visit-based revenue model akin to standard physician practices, with patients covering a co-pay. Contrarily, both home health and hospice fall under Medicare Part A benefits, exempt from deductibles or copays with straight Medicare. 

However, payment structures diverge here; hospice reimbursement relies on a percentage of Medicare reimbursement, while home health payment fluctuates based on contractual agreements, often on a per-visit basis. Medicare Advantage plans introduce further variability, as payments are contingent on contracts and scoring mechanisms. Particularly, navigating contracts for home health services can present significant complexity.