This bill creates a new Medicare program to test community-based palliative care—medical care focused on comfort and quality of life rather than just treating disease. The program will run for five years and serve Medicare patients with serious illnesses like cancer, heart disease, dementia, ALS, and other conditions that significantly impact their health.

The program works by having specialized palliative care teams coordinate with patients' regular doctors and other healthcare providers to manage pain, symptoms, and emotional needs while still allowing patients to pursue treatments aimed at curing or controlling their illness. This is different from hospice care, which typically focuses only on comfort when curative treatment is no longer an option. Importantly, patients won't be excluded from this program just because they've used hospice care before.

Services are available 24/7 through various providers—including independent palliative care teams, home health agencies, hospitals, and hospice programs—and can be delivered at home, in a caregiver's residence, in nursing facilities, or through telehealth. The program specifically aims to reduce unnecessary emergency room visits and hospitalizations by helping patients manage their conditions better and making their wishes clear through advance care planning. The government will study how well the program works by comparing patients in the program to similar patients receiving standard care, looking at hospital usage, quality of life, and patient satisfaction.

Expanding Access to Palliative Care Act

Rosen, Jacky

Expanding Access to Palliative Care Act This bill requires the Center for Medicare and Medicaid Innovation (CMMI) to test a model that provides community-based palliative care and care coordination for high-risk Medicare beneficiaries and that may replace the Medicare Care Choices Model (which ended on December 31, 2021). Under the new model, multi-disciplinary teams must provide coordinated, palliative care that is available 24-7 for Medicare beneficiaries with serious illnesses or injuries, such as cancer. The CMMI must evaluate the model by comparing patients participating in the model with those outside of the model in relation to specified metrics, including the election and duration of hospice care.