Two New Senate Bills Promote Community-Based Care

WASHINGTON, D.C. (August 3, 2021)—Late on July 29, U.S. Sens. Jacky Rosen (D-Nevada) John Barrasso (R-Wyoming), Tammy Baldwin (D-Wisconsin) and Deb Fischer (R-Nebraska)—co-chairs and co-founders of the Senate Comprehensive Care Caucus—announced the introduction of the bipartisan Expanding Access to Palliative Care Act (S. 2565). Sens. Rosen, Barrasso and Baldwin also announced the introduction of their bipartisan Improving Access to Transfusion Care for Hospice Patients Act of 2021 (S. 2566)

The Expanding Access to Palliative Care Act calls on the Center for Medicare and Medicaid Innovation (CMMI) to develop and test a care and payment model to provide home and community-based palliative care and care coordination for high-risk, seriously-ill beneficiaries. Providers of all kinds with palliative care expertise would be eligible to participate, including hospices and home health agencies.

With an emphasis on co-management, model participants would be expected to work closely with a patient’s primary care and specialist providers for a holistic, team-based approach that would coordinate care across health care providers and community services. Aligning with the core principles of high-quality palliative care, the demo would aim to improve patient and family outcomes and experience of care, alleviate pain and troubling symptoms, and reduce unnecessary or unwanted emergency department visits and hospitalizations that can often be more of a burden than a benefit for people with serious illness.

“The National Association for Home Care & Hospice (NAHC) applauds Sens. Rosen, Barrasso, Baldwin and Fischer for their introduction of the Expanding Access to Palliative Care for Seniors Act,” said Bill Dombi, president of NAHC in a press release. “This legislation is an important step forward in the broader effort to more fully integrate palliative services into home and community-based settings. By testing a more sustainable method of payment, this demonstration model would help ensure that providers across the care continuum, including hospices and home health agencies, have the support they need to increase access to high-quality palliative care for the patients and families they serve.”

Another CMMI-focused bill, the Improving Access to Transfusion Care for Hospice Patients Act of 2021 calls for a demonstration to test a novel standalone payment mechanism for transfusion services delivered to patients on hospice. Studies have shown that some patients with hematological conditions, such as leukemia and lymphoma, rely on transfusions to address palliative needs related to breathlessness, bothersome bleeding, and profound fatigue. However, these services can be extremely expensive, and patients with these conditions access hospice less frequently than those with other serious illnesses. By paying for these transfusions outside of the Medicare hospice bundle, the model called for by this bill aims to test whether the additional support can increase access and timely utilization.

Last Congress, Sen. Rosen launched the bipartisan Comprehensive Care Caucus, with co-chairs Sens. Barrasso, Baldwin and Fischer. The purpose of the Comprehensive Care Caucus is to raise the public’s awareness and promote the availability and benefits of palliative care, while also finding bipartisan solutions to expand access to palliative care services, improve coordinated care, and address issues impacting caregivers.