Hospice Wage Index, the Final Rule, and the Signals CMS Is Sending | Part One

The hospice moratorium may eventually end—but CMS scrutiny of hospice is likely here to stay.In Part Two of The Hospice Moratorium: What CMS Is Really Signaling About the Future, Chris Comeaux and Cordt Kassner continue their conversation with Dr. Jennifer Kennedy, Vice President for Quality, Standards and Compliance at CHAP, about what hospice leaders should expect when the moratorium is lifted—and how organizations should prepare now.The conversation explores increased CMS enrollment scrutiny, changes of ownership, audits, SSVI, compliance programs, and the growing role of data and AI in identifying fraud and abuse.  Jennifer emphasizes that quality and compliance must work hand-in-hand and that hospices should begin treating audits and regulatory readiness as part of the cost of doing business. But greater regulation raises an important question: Can CMS become precise enough to eliminate bad actors without penalizing high-quality providers? The discussion examines how better data and AI could help regulators target fraud more effectively while protecting access, innovation, and legitimate hospice organizations. Most importantly, Jennifer reminds leaders that compliance cannot overshadow the mission.  Even in a more regulated future, hospice must remain centered on compassionate, patient-centered care and what matters most to the patient. In this episode:What could happen when the hospice moratorium endsWhy CMS scrutiny is likely to increaseBuilding a culture of compliance and qualityWhy hospices should budget for more auditsSSVI and the future of hospice oversightUsing AI and data to better identify fraud and abuseProtecting legitimate providers from regulatory overreachKeeping compassion at the center of hospice care🎧 Subscribe to TCNtalks | Anatomy of Leadership for conversations helping healthcare and hospice leaders navigate what’s next.Guest: Dr. Jennifer Kennedy, Vice President, Quality, Compliance and Standards with CHAPCo-Host: Cordt Kassner, PHD, Publisher, Hospice & Palliative Care TodayHost: Chris Comeaux, President / CEO of Teleios, author of The Anatomy of LeadershipTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

The hospice moratorium may be temporary—but the changes it signals for hospice oversight could be permanent.In Part One of The Hospice Moratorium: What CMS Is Really Signaling About the Future, Chris Comeaux and Cordt Kassner, PhD, are joined by Dr. Jennifer Kennedy, Vice President for Quality, Standards and Compliance at CHAP, to unpack why CMS implemented the hospice moratorium and what it could mean for the future of the Medicare hospice benefit.The conversation explores the growing federal focus on fraud and abuse, rapid hospice market expansion, Medicare enrollment, accreditation oversight, and increasingly sophisticated screening of providers.  Jennifer also explains why she believes the moratorium could be extended—and why CMS scrutiny is unlikely to disappear when the moratorium eventually ends. But there’s another side to the crackdown: legitimate hospice providers can get caught in the same regulatory net designed to stop bad actors.  What happens when high-quality organizations want to expand into rural or underserved communities but can’t? And can CMS become precise enough to protect access while aggressively pursuing fraud? In this episode:What the CMS hospice moratorium actually meansWhy fraud and rapid market expansion triggered increased scrutinyWhether the moratorium could be extendedThe role of accreditation and enrollment screeningHow legitimate hospice providers may be unintentionally affectedWhy quality and compliance will define the next era of hospice oversight Guest: Dr. Jennifer Kennedy,Co-Host: Cordt Kassner, PHD, Publisher, Hospice & Palliative Care TodayHost: Chris Comeaux, President / CEO of Teleios, author of The Anatomy of LeadershipTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

What if the frustration, anger, and resistance showing up in your organization aren't signs of disengagement—but signals that your people still deeply care?In Part Two of From Zombies to Zealots: Cultivating Passion and Purpose in Healthcare Leadership, host Chris Comeaux continues his thought-provoking conversation with DJ Mitsch, author, master coach, and founder of the Healthcare Coaching Institute, and Tasha Walsh, CEO and Executive Director of ConnectionsPlus Healthcare + Hospice.Healthcare and hospice professionals often enter the field because they feel called to the work.  But regulations, audits, documentation requirements, productivity pressures, and constant organizational change can gradually disconnect people from that deeper sense of purpose.  DJ challenges leaders to recognize what happens when meaningful, purpose-driven work becomes dominated by the language of compliance rather than creation. Using the real-world example of hospice audits and documentation pressure, the conversation explores how fear of financial clawbacks and increased scrutiny can ripple through an organization and contribute to caregiver burnout. Rather than ignoring those emotions, DJ and Tasha encourage leaders to acknowledge them—and use anger, fear, frustration, and even pushback as valuable information.As DJ explains, anger can become fuel for change.  Tasha takes that idea further: what lies beneath someone's frustration may be a deep commitment to patients, coworkers, or the mission.  Effective leaders learn to uncover that meaning, transform emotional energy into courage, and create space for difficult but necessary conversations. In This Episode, You'll Discover:Why purpose-driven healthcare professionals can become disconnected from their callingHow leaders can shift the organizational conversation from compliance to creationWhy anger, fear, frustration, and resistance shouldn't automatically be labeled “negative”How to use emotion as information—and transform it into constructive actionWhy taking a breath and really listening can change the direction of a difficult interactionHow leaders can create cultures where people feel safe bringing their authentic selves to workWhy organizational culture is shaped by what leaders repeatedly tolerate, encourage, and createHow healthcare leaders can become change agents rather than passive participants in a dysfunctional systemOne of the most powerful ideas from the conversation is that naming what people are experiencing can reduce its hold over them.  By giving language to fear, anger, and frustration, leaders can help their teams redirect that energy toward something more productive.And ultimately, the goal isn't simply to build a more “resilient” workforce.It's to create an environment where people are excited to come to life fully every day.What is the culture you're creating helping your people become—zombies or zealots?Guest:Tasha Walsh, LCSW, PCC CEO/ED of Connections Plus Healthcare + Hospice Darelyn DJ Mitsch, Author, Master Coach, and Chief Energy Officer, The Pyramid Resource Group, Home of the Healthcare Coaching Institute and Team Advantage Team Coaching Host:Chris Comeaux, President / CEO of TELEIOS, author of The Anatomy of LeadershipIf this conversation resonates with you, like, subscribe, and share this episode with another healthcare, hospice, or business leader who is working to create a more engaged, purpose-driven culture.Teleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

What turns a passionate healthcare professional into a “zombie” at work—and what can leaders do to help reignite that sense of purpose?In Part One of From Zombies to Zealots: Cultivating Passion and Purpose in Healthcare Leadership, host Chris Comeaux is joined by DJ Mitsch, author, master coach, and founder of the Healthcare Coaching Institute, and Tasha Walsh, CEO and Executive Director of ConnectionsPlus Healthcare + Hospice, for a thought-provoking conversation about burnout, workplace culture, leadership energy, and reconnecting healthcare professionals to their calling.Healthcare professionals often enter the field with a deep sense of mission. But regulatory pressure, productivity expectations, audits, quality metrics, and constant organizational change can gradually disconnect people from the heart of why they chose this work. As DJ explains, when organizations focus primarily on mandates, productivity, and profitability rather than the human beings doing the work, healthcare can become transactional rather than transformational. DJ and Tasha explore why language is one of the most powerful indicators of organizational culture. Leaders can learn a great deal by listening not only to what employees say, but also to the emotional currents beneath words such as “pushback,” resistance, and disengagement. The goal isn't simply greater compliance—it's creating language and leadership practices that empower, clarify, and reconnect people to purpose. In This Episode, You'll Discover:Why passionate healthcare professionals can gradually become “zombified”How productivity and compliance can overshadow purposeWhy leaders should pay close attention to the language of their organizationThe difference between a workplace “zombie” and a purpose-driven “zealot”How leadership energy influences employees—and ultimately patient careWhy connection and belonging are essential to sustaining passionHow leaders can help employees reconnect with the mission that brought them into healthcareWhy changing workplace culture begins with how leaders listen, communicate, and show upA “zealot,” as DJ describes it, is someone who stays connected to purpose even when organizations change, leaders leave, or circumstances become chaotic. They remember that they belong to something bigger than themselves. For hospice leaders, healthcare executives, nonprofit leaders, and anyone responsible for organizational culture, this conversation offers a different way of thinking about burnout and workforce engagement: perhaps the answer isn't another program or initiative, but helping people rediscover the meaning, connection, and purpose already embedded in the work.Subscribe and don't miss Part Two of this conversation, as Chris, DJ, and Tasha continue exploring how leaders can transform healthcare cultures from burnout and disengagement toward greater passion, connection, and purpose.Guest:Tasha Walsh, LCSW, PCC CEO/ED of Connections Plus Healthcare + Hospice Darelyn DJ Mitsch, Author, Master Coach, and Chief Energy Officer, The Pyramid Resource Group, Home of the Healthcare Coaching Institute and Team Advantage Team Coaching Host:Chris Comeaux, President / CEO of TELEIOS, author of The Anatomy of LeadershipTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

What is CMS really signaling about the future of hospice?In Part Two, Chris Comeaux continues his conversation with hospice experts Annette Kiser and Judi Lund Person about the Hospice Wage Index, the Final Rule, and what leaders should be preparing for now.They explore the larger shift toward increased CMS oversight, data-driven accountability, stronger documentation, scrutiny of non-hospice spending, and greater expectations around quality and value. From SSVI and PEPPER data to the mandatory hospice addendum, claims, and cost reports, the message is clear: hospice organizations need to understand their data and trends before CMS does.The conversation also looks ahead to the future of the Medicare Hospice Benefit, including potential payment reform, outcomes-based accountability, and the growing importance of accurate, auditable cost reports.Most importantly, Annette and Judi challenge leaders to look beyond compliance and keep patients and families at the center—using data not simply to satisfy regulators, but to identify gaps, improve care, and build stronger organizations for the future.If you lead a hospice or work in compliance, quality, operations, or finance, this is a conversation you don't want to miss.▶️ Watch Part Two and share it with your leadership team.🔔 Subscribe to TCNtalks and Anatomy of Leadership for more conversations exploring hospice, healthcare leadership, innovation, regulation, and the future of serious illness care.Guests:Annette Kiser — Chief Compliance Officer, Teleios Collaborative NetworkJudi Lund Person — Principal, Lund Person & AssociatesHost:Chris Comeaux — President/CEO of Teleios and author of The Anatomy of LeadershipTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

What is CMS really signaling through the 2027 Hospice Wage Index and Final Rule—and what should hospice leaders be doing now?In Part One, host Chris Comeaux is joined by hospice regulatory experts Annette Kiser and Judi Lund Person to unpack the 2027 Hospice Wage Index and Final Rule and look beyond reimbursement to what CMS may be signaling about the future of hospice regulation, compliance, payment, and oversight.They explore the Hospice Election Statement Addendum, the Service and Spending Variation Index (SSVI), non-hospice Medicare spending, Part B claims, telehealth reporting, and why leaders should be examining their data through a quality and compliance lens.In this episode:What the 2027 Hospice Final Rule reveals about CMS prioritiesPreparing for the October 1, 2026 Election Statement AddendumUnderstanding SSVI and non-hospice spendingWhy CMS is increasing scrutiny of unrelated servicesTelehealth, G-code reporting, and eligibilityUsing SSVI and PEPPER data to identify trends and opportunitiesCMS reported that Medicare Part A and B non-hospice spending increased 160% from 2020 to 2024, exceeding $2 billion in 2024, with hospice patients responsible for approximately $510 million in cost sharing—a major reason this issue is receiving increased attention. fileciteturn0file0L130-L148The Final Rule tells you what CMS is doing. The details may tell you what CMS is preparing to do next.▶️ Listen to Part One, share it with your hospice leadership team, and subscribe so you don’t miss Part Two.Guests:Annette Kiser — Chief Compliance Officer, Teleios Collaborative NetworkJudi Lund Person — Principal, Lund Person & AssociatesHost:Chris Comeaux — President/CEO of Teleios and author of The Anatomy of LeadershipTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

What if one of the most powerful partnerships in serious illness care is one healthcare leaders have largely overlooked?In Part Two of The Healthcare Partnership Nobody Is Talking About: Hospice + FQHCs, Chris Comeaux continues his conversation with Kyle Ahlenstorf about the opportunity for hospice and palliative care organizations to partner with Federally Qualified Health Centers (FQHCs) to create a stronger continuum of care.FQHCs bring primary and preventive care, behavioral health, care coordination, community health workers, telehealth capabilities, and deep connections within their communities.  Hospice and palliative care organizations bring expertise in serious illness and the ability to extend specialized care directly into the home. Chris and Kyle explore what could become possible when these strengths are intentionally connected. In this episode, you'll hear about:How hospice, palliative care, and FQHCs can collaborate beyond traditional referral relationshipsOpportunities to extend palliative and serious illness care into the homeThe role of care coordinators, referral specialists, and community health workersHow FQHCs integrate behavioral health, substance use disorder services, and telehealthWhat hospice leaders should understand about FQHC operations, federal funding, and the 340B Drug Pricing ProgramThe importance of EMR data sharing, quality reporting, and value-based careHow FQHCs participate in ACOs and shared-savings modelsPotential opportunities involving rural healthcare transformation grants and service co-locationWhy these partnerships could become increasingly important to the future of community-based healthcareKyle's message to hospice and palliative care leaders is simple: “Think of us as partners.”  Stronger community connections can help organizations better coordinate resources and serve patients across the continuum. If you're a hospice leader, palliative care professional, FQHC executive, healthcare executive, nonprofit leader, or anyone working in value-based and community-based care, this conversation offers a different way to think about partnership, access, and healthcare innovation.👍 Like this episode💬 Share your thoughts in the comments🔔 Subscribe to TCNtalks and Anatomy of Leadership for more conversations designed to challenge healthcare leaders, spark innovation, and inspire better leadership.Episode Topics: Hospice care, palliative care, Federally Qualified Health Centers, FQHCs, serious illness care, community health centers, healthcare partnerships, value-based care, behavioral health, 340B Drug Pricing Program, ACOs, rural healthcare, community health workers, care coordination, telehealth, preventive care, population health, healthcare leadershipGuest:Kyle Ahlenstorf, CEO of Infinity HealthHost:Chris Comeaux, President / CEO of TELEIOS, author of The Anatomy of LeadershipTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

What if one of the biggest untapped opportunities for hospice growth, access, and community impact is a partnership most healthcare leaders aren’t even considering?In Part One of The Healthcare Partnership Nobody Is Talking About: Hospice + FQHCs, Chris Comeaux sits down with Kyle Ahlenstorf, CEO of Infinity Health, to explore the powerful potential of partnerships between hospice and palliative care organizations and Federally Qualified Health Centers (FQHCs).FQHCs are built around access, equity, and serving communities where barriers to healthcare are often greatest.  Kyle explains how these community health centers work, how they’re reimbursed, the populations they serve, and why their mission has so much in common with hospice and palliative care.  The conversation also explores integrated medical, dental, behavioral health, and pharmacy services—and how FQHCs can function as an important hub for coordinated, patient-centered care.  For hospice leaders, the opportunity goes far beyond generating another referral. Kyle and Chris discuss how trusted relationships, provider education, care coordination, and warm handoffs can create a stronger continuum of care for people facing serious illness.  Kyle also offers a highly practical starting point: find out who manages referrals at your local FQHC and begin building the relationship there.  In this episode, you’ll discover:What an FQHC is and why it matters to the healthcare safety netWhy hospice and FQHC missions may be more closely aligned than leaders realizeHow FQHC reimbursement and payer mix workHow FQHCs integrate medical, dental, behavioral health, and pharmacy servicesWhy care coordination and warm handoffs matter for serious illnessCommon misconceptions hospice leaders may have about FQHC patientsHow hospice organizations can begin building relationships with local FQHCsWhy behavioral health may represent another major area for collaborationIf you lead a hospice, palliative care organization, FQHC, community health center, nonprofit, or rural healthcare organization, this is a conversation worth bringing back to your leadership team.👉 Your next step: Find the FQHCs serving your community.  Identify their referral or care coordination leader. Start a conversation about where your missions—and your patients—intersect.Subscribe and turn on notifications so you don’t miss Part Two of this important conversation.Guest:Kyle Ahlenstorf, CEO of Infinity HealthHost:Chris Comeaux, President / CEO of TELEIOS, author of The Anatomy of LeadershipTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

What if the biggest breakthrough in hospice care isn't a new technology—but a better way of focusing on what matters most?In Part Two of this special conversation, host Chris Comeaux continues his discussion with Kelly McCutcheon Adams and Margherita Labson about how the Four M's Framework—What Matters, Medication, Mentation, and Mobility—is transforming hospice and palliative care into a more reliable, person-centered model. Together, they explore why exceptional hospice care goes far beyond symptom management to preserve dignity, independence, emotional well-being, and meaningful moments for patients and families. The conversation dives into practical questions every hospice leader and clinician should be asking:How can we better address delirium, depression, and cognition at the end of life?Why should mobility be viewed as preserving independence instead of simply preventing falls?Is it time to add a fifth "M" to the framework?What would healthcare look like if every decision truly began with what matters most?Kelly and Margherita also paint a compelling vision for the future of hospice—one where earlier conversations, better continuity of care, and reliable systems lead to fewer late hospice admissions, better patient experiences, and stronger healthcare organizations. Their message to leaders is both practical and inspiring: hospice is not something to apologize for—it's one of healthcare's greatest expressions of compassion. Whether you're a hospice executive, palliative care professional, healthcare leader, clinician, nonprofit executive, or someone passionate about improving the patient experience, this episode offers actionable insights that can reshape the way you think about quality care.In This Episode:✅ Why Mentation deserves greater attention in hospice care✅ Looking beyond fall prevention to meaningful Mobility✅ The debate over adding a Fifth M to Age-Friendly Care✅ Why earlier hospice conversations improve patient outcomes✅ Practical leadership advice for creating reliable, person-centered care systems✅ Resources available through the Institute for Healthcare Improvement (IHI)Guest: Kelly McCutcheon Adams, Senior Director at the Institute for Healthcare Improvement (IHI)Margherita Labson, President and CEO, MCLabson Consultation and Education ServicesHost:Chris Comeaux, President / CEO of TELEIOS, author of The Anatomy of LeadershipLearn More➡️ Institute for Healthcare Improvement (IHI): https://www.ihi.org➡️ Learn more about Teleios Collaborative Network: https://www.teleioscn.org🎙️ Subscribe to TCNtalks / Anatomy of Leadership for conversations with healthcare innovators, nonprofit leaders, and industry experts who are shaping the future of leadership and care.👍 If you found this episode valuable—Like this videoShare it with your colleagues—Leave a comment: How can healthcare better focus on what matters most?Teleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

How can hospice and palliative care become more person-centered while also becoming more reliable?In Part One of this Anatomy of Leadership conversation, host Chris Comeaux sits down with Kelly McCutcheon Adams, Senior Director at the Institute for Healthcare Improvement (IHI), and Margherita Labson, President and CEO of McLabson Consultation & Education Services, to explore the groundbreaking 4 M's Framework and its growing impact on hospice and palliative care. Originally developed through the Age-Friendly Health Systems Initiative, the 4 M's—What Matters, Medication, Mentation, and Mobility—provide a practical, evidence-based framework for helping healthcare teams consistently deliver individualized care that aligns with each patient's goals while improving reliability across the care continuum. During this conversation, you'll discover:Why the 4 M's are a framework—not another quality measureHow "What Matters" transforms goal-concordant hospice careWhy reliability and individualized care are not mutually exclusiveHow medication decisions should be guided by patient goals—not habitsWhat hospice leaders can learn from the science of quality improvementWhether you're a hospice executive, palliative care clinician, healthcare leader, or quality improvement professional, this episode offers practical insights for building care systems that are both compassionate and consistently excellent. Don't miss Part Two, where we continue the discussion by exploring the remaining 4Ms and practical strategies for implementing this framework within hospice organizations.Chapters00:00 Introduction00:22 Meet Kelly McCutcheon Adams & Margherita Labson04:14 What is the 4Ms Framework?06:58 How IHI is Bringing the 4Ms to Hospice Care09:43 The Mission of the Institute for Healthcare Improvement (IHI)11:46 Why the 4Ms Work Across Every Care Setting15:17 Framework vs. Traditional Quality Measures17:24 What "What Matters" Really Means in Hospice21:08 Reliable Systems for Individualized Care26:57 Medication Decisions Guided by Patient Goals32:12 Hospice, Opioids, and Changing the Conversation34:37 Coming Up in Part Two🎙️ Learn more about TCNtalks /Anatomy of Leadership and by subscribing and following Teleios Collaborative Network (www.teleioscn.org) for more conversations on leadership, hospice, healthcare innovation, and purpose-driven organizations.Teleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast