CMS Leader Explains Hospice Fraud, Medicare Risks, and the Future of Healthcare | Part One

Hospice has always been about people, but the future of hospice will increasingly be shaped by data—and that shift is both exciting and unsettling.In Part Two of The Future of Hospice: How HOPE Will Transform Reimbursement & Care, Raianne Melton and Andrea Hale unpack how the HOPE tool could redefine hospice reimbursement, value-based care, and quality measurement across CMS, Medicare Advantage, and health systems. The conversation explores where hospice measurement may be heading—from symptom impact scoring and burdensome discharges to acuity tracking, HUV utilization, and the growing importance of consistent documentation and actionable clinical data.The episode also focuses on what hospice leaders can do now to prepare: improving point-of-care documentation, simplifying EMR workflows, leveraging real-time analytics, and exploring AI-powered ambient listening to reduce clinician burden while preserving compassionate care. Ultimately, this conversation is about helping hospice organizations prove their value with measurable outcomes while staying true to the mission that defines hospice care.This episode offers practical insights for hospice executives, nonprofit healthcare leaders, clinicians, and anyone navigating the evolving landscape of end-of-life care.Guest:Andrea Hale, CEO of Valley Hospice Raianne Melton, Director of Clinical Services of Professional Services for AxxessHost:Chris Comeaux, President / CEO of TELEIOS and author of The Anatomy of LeadershipTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

The future of hospice care is changing—and the HOPE assessment tool may redefine how providers deliver care, document outcomes, and receive reimbursement.Healthcare is entering a new era where quality outcomes, patient data, and accountability are driving the future of care delivery.  In this episode, we’re joined by Andrea Hale, CEO of Valley Hospice, and Raianne Melton, Director of Clinical Services of Professional Services for Axxess, whose expertise and frontline perspective help unpack one of the most significant shifts happening in hospice today—the implementation of the HOPE assessment tool. Their insight provides valuable guidance for hospice leaders, clinicians, and organizations preparing for the future of reimbursement and patient-centered care.In Part One of this important conversation, we explore how the Hospice Outcomes & Patient Evaluation (HOPE) tool is poised to transform the hospice landscape.  From evolving CMS expectations to the growing emphasis on quality metrics and patient-centered outcomes, this episode breaks down what hospice leaders, clinicians, and healthcare organizations need to understand now.Join us as we discuss: • What the HOPE tool is and why it matters • How reimbursement models are shifting in hospice care • The operational and compliance challenges providers may face • Why documentation and quality reporting are becoming more critical than ever • How organizations can proactively prepare for the future of end-of-life careWhether you’re a hospice professional, nonprofit executive, healthcare leader, or business decision-maker, this episode provides timely insight into the changing future of compassionate care delivery.Our Guest:Andrea Hale, CEO of Valley HospiceRaianne Melton, Director of Clinical Services of Professional Services for AxxessHost:Chris Comeaux, President / CEO of TELEIOS and author of The Anatomy of Leadership🎧 Subscribe for more conversations on healthcare leadership, hospice innovation, and mission-driven care.Teleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

In Part Two of this powerful TCNtalks / Anatomy of Leadership conversation, Kim Brandt, Chief Operating Officer and Deputy Administrator at CMS joins Chris Comeaux to discuss hospice fraud, Medicare risk, AI-driven fraud detection, and the future of healthcare policy.  Kim provides a rare behind-the-scenes look at how CMS is fighting organized healthcare fraud, protecting Medicare beneficiaries, and preparing hospice providers for a more data-driven future.The conversation explores lessons learned from the Medicare Advantage VBID hospice carve-in, the challenges facing legitimate hospice providers, and how AI and machine learning are helping CMS detect fraudulent activity in real time.  Kim also shares her vision for what compassionate, dignified hospice care should look like over the next 15 years.Whether you are a hospice professional, healthcare executive, nonprofit leader, policymaker, or business leader, this episode delivers critical insights into the future of end-of-life care, healthcare leadership, and Medicare reform.Highlights:✔️ CMS reveals how billions in fraudulent Medicare payments are being stopped in real time✔️ Inside the growing hospice fraud crisis impacting patients and providers nationwide✔️ Why AI and machine learning are becoming essential tools in healthcare fraud prevention✔️ Lessons learned from the Medicare Advantage VBID hospice carve-in experiment✔️ How legitimate hospice providers can protect themselves during audits and investigations✔️ The future of hospice care: data, analytics, palliative integration, and patient dignity✔️ Kim Brandt shares her vision for compassionate end-of-life care over the next 15 years✔️ A candid conversation on healthcare leadership, accountability, and reform🎧 FeaturingGuest:Kim Brandt, Chief Operating Officer and Deputy Administrator at CMSHost: Chris Comeaux, President / CEO of TELEIOS👉 Subscribe to TCNtalks / Anatomy of Leadership for more conversations with healthcare innovators, policy leaders, and changemakers shaping the future of care.Teleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

In this compelling first installment, CMS Chief Operating Officer and Deputy Administrator Kim Brandt joins Chris Comeaux for a candid conversation about the growing hospice fraud crisis, the financial future of Medicare, and the urgent transformation happening across American healthcare. Drawing from her leadership role at CMS and firsthand experiences with hospice care in her own family, Brandt shares why hospice remains a critical pillar of compassionate care — while also exposing the alarming abuse threatening the integrity of the system.  The discussion dives deep into the pressures facing Medicare as the nation approaches the “silver tsunami,” with 10,000 new beneficiaries entering Medicare every day through 2030. Brandt explains how CMS is thinking about value-based care, the role of technology and AI in improving patient outcomes, and why hospice and palliative care may increasingly blend together in the future. From home-based care expansion to quality-driven reimbursement models, this episode offers healthcare leaders a rare inside look at the policy conversations shaping the next decade of healthcare delivery.  Key TakeawaysCMS views hospice as an essential part of the Medicare ecosystem and is committed to protecting legitimate providers while aggressively combating fraud.Medicare faces mounting financial pressure as 10,000 baby boomers enroll daily, accelerating the need for healthcare reform and value-based care models.Kim Brandt predicts hospice and palliative care will increasingly integrate, allowing patients to receive supportive care earlier in their illness journey.Home-based healthcare, telehealth, AI, and remote monitoring are expected to play a major role in the future of hospice care delivery.CMS is shifting its focus from enrollment volume toward aligning incentives with quality outcomes and patient-centered care.If you’re passionate about the future of healthcare, hospice innovation, and leadership that drives meaningful change, this is an episode you cannot miss. Subscribe to our podcast and  share this conversation with your team, and stay tuned for Part Two as we continue exploring the future of Medicare, hospice reform, and value-based care.  Guest:Kim Brandt: Chief Operating Officer and Deputy Administrator at CMS Host:Chris Comeaux, President / CEO of Teleios, author of The Anatomy of LeadershipTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

What does the future of hospice care really look like—and who’s shaping it?In Part Two of this compelling conversation, healthcare leaders Tom Koutsoumpas, Founder & CEO of NPHI and Carole Fisher, President of NPHI, join Chris Comeaux and Cordt Kassner to discuss the future of hospice reform, Medicare modernization, quality care standards, and the challenges facing nonprofit hospice providers across America.From fraud prevention and workforce shortages to Medicare Advantage and innovative disease-specific care models, this episode delivers an inside look at the policy, leadership, and operational decisions shaping the future of end-of-life care.Whether you’re a healthcare executive, hospice professional, nonprofit leader, policymaker, or business leader, this discussion provides valuable insight into how hospice organizations can remain relevant, sustainable, and mission-driven in a rapidly evolving healthcare environment.⸻Episode Highlights✔️ Why hospice quality reporting and transparency matter more than ever✔️ The growing impact of Medicare Advantage on hospice care✔️ Challenges facing nonprofit hospice organizations✔️ Innovation in palliative care and disease-specific support models✔️ How NPHI is advocating for hospice reform and accountability✔️ The workforce and financial pressures affecting hospice providers✔️ The truth about the hospice carve-in debate and what the data shows✔️ Why leadership and mission remain critical in end-of-life care⸻Key Quote From The Episode“The future of hospice and palliative care is making sure we are staying relevant, necessary, and sustainable.” — Carole Fisher⸻About This EpisodeThis episode explores the intersection of healthcare leadership, hospice advocacy, Medicare reform, patient-centered care, and operational sustainability. The conversation emphasizes the importance of preserving the mission of hospice while adapting to changing healthcare systems and patient expectations.  Featured Guests🔹 Tom Koutsoumpas — National Partnership for Healthcare and Hospice Innovation (NPHI)🔹 Carole Fisher — President, NPHI🎙️ Hosted by Chris Comeaux, President / CEO of TELEIOS     Co-Hosted by Cordt Kassner,  PhD, Publisher of Hospice & Palliative Care     Today & CEO and Founder of Hospice Analytics ⸻Subscribe & Connect👉 Subscribe for more conversations on leadership, healthcare innovation, hospice care, and nonprofit strategy.👉 Share this episode with healthcare professionals, executives, clinicians, and industry leaders.👉 Learn more about TCNtalks /Anatomy of Leadership, and NPHI in the links below.TCNtalkshttps://www.teleioscn.org/tcntalkspodcastNPHIhttps://www.nphihealth.org/People Over Profitshttps://www.nphihealth.org/peopleoverprofits/Inside View Podcasthttps://www.nphihealth.org/podcast/Teleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

In Part One of Healthcare Leaders Break Down Hospice Reform, Medicare & Quality Care, Chris Comeaux sits down with nationally respected healthcare leaders Tom Koutsoumpas, Founder & CEO of NPHI  and Carole Fisher, President of NPHI to explore the evolving future of hospice, palliative care, Medicare oversight, and the growing demand for quality-driven, compassionate healthcare leadership. Together, they unpack the growing challenges facing end-of-life care — from fraud and benefit manipulation to the urgent need for quality transparency and authentic patient-centered care.  Drawing on decades of leadership experience, the guests explore how nonprofit hospice organizations are redefining quality while advocating for compassion, integrity, and trust across the healthcare continuum.  The discussion also dives into the emotional and cultural barriers surrounding hospice conversations, the importance of introducing palliative care earlier in serious illness, and why communication remains one of the most powerful tools in healthcare leadership. Through personal stories, policy insights, and candid reflections, Tom and Carole reveal how mission-driven organizations are creating calm and clarity for patients and families during life’s most vulnerable moments.  This episode offers healthcare leaders, hospice professionals, and nonprofit executives a timely and inspiring look at where serious illness care is headed — and what it will take to protect its future.  Key TakeawaysHospice leaders are pushing back against fraud, abuse, and “benefit manipulation” that prioritize profits over patient care.  Earlier integration of palliative care can build trust with patients and families before hospice services are needed.  One of hospice care’s greatest challenges remains overcoming public fear and misunderstanding surrounding death and end-of-life conversations.  Nonprofit hospice organizations continue to lead in quality outcomes, staffing, patient support services, and community-based care.  Quality transparency, collaboration, and meaningful data sharing are becoming essential for the future of healthcare and hospice reimbursement.  🎙 Featured Guests:Tom Koutsoumpas — Founder & CEO, NPHICarole Fisher — President, NPHIOur Host:Chris Comeaux — President / CEO of TELEIOS, Author of The Anatomy of LeadershipCordt Kassner —  PhD, Publisher of Hospice & Palliative CareToday & CEO and Founder of Hospice Analytics Teleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

Virtual reality can feel like a toy until you hear what it does for pain, fear, and the kind of suffering that medication cannot touch. In this Part Two episode of TCNtalks / Anatomy of Leadership, Chris Comeaux sits down with Dr. Kathleen Benton, CEO of Hospice of Savannah, and VR healthcare pioneer Teri Yarbrow, Founder & CEO of Magika VRx, to explore how virtual reality in healthcare, hospice care, and palliative care are evolving through immersive technology. Learn how VR therapy is being used to reduce pain, anxiety, and emotional distress in patients facing serious illness and end-of-life care.They talk data, not hype: peer reviewed research, standards organizations like AMXRA, and real clinical adoption from pediatric programs to large scale international work. Then we narrow the lens to hospice and palliative care where the stakes are personal, exploring how VR can reduce pain, anxiety, and distress, and how it may help patients rely less on medications in day to day symptom management. We also dig into an unexpected outcome many teams report: awe inducing content that creates self transcendent experiences, easing existential distress and helping people reconnect with meaning, purpose, and peace.Care does not stop with the patient, so we also look at caregiver and clinician support, including burnout relief, respite room use, and what happens when the patient cannot wear a headset but the family in the room needs help coping. Finally, we look ahead to lighter devices, immersive rooms, and the idea of a curated “VR pharmacy” where clinicians prescribe specific experiences for specific needs.What begins as a conversation about medical virtual reality quickly becomes something deeper—about awe, spirituality, and the human experience at the end of life.In this episode:* The growing research and credibility of Virtual Reality in medicine* Real-world palliative care pilot results and pain reduction* Neuropathic pain relief when medications fall short* Awe and self-transcendent experiences in patient care* Supporting clinicians with burnout and emotional fatigue* Helping families process grief through immersive experiences* The future of Virtual Reality in healthcare and the “VR pharmacy” modelThis episode highlights how immersive VR is becoming evidence-based care—restoring presence, identity, and dignity when it matters most.Guest:Kathleen Benton, Chief Executive Officer, Hospice Savannah, Inc. and Co-Author of the book, Virtual Reality for Serious Illness Teri Yarbrow, the Founder of "Creating AWE", President of Magika VRx and Co-Author of the book, Virtual Reality for Serious IllnessHost:Chris Comeaux, President / CEO of TELEIOS / author of The Anatomy of Leadership👉 Be sure to subscribe to the channel👉 Share this episode with colleagues in hospice and palliative careTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

What if some of the most meaningful moments at the end of life could still be experienced—no matter the physical limitations?In this episode, Kathleen Benton and VR innovator Teri Yarbrow reveal how virtual reality is reshaping hospice and palliative care by restoring something often lost in modern medicine—human experience. As care becomes increasingly clinical and documentation-driven, VR creates space for patients to reconnect with meaning, beauty, and identity beyond their diagnosis.The impact is rooted in how the brain responds to immersion. Through presence (feeling transported), embodiment (shifting out of “patient” identity), and agency (regaining choice), VR helps reduce pain and anxiety while restoring a sense of control. For patients who can no longer travel, move, or explore, these experiences are not trivial—they are transformative.The stories are powerful. A hospice patient skydives. An ALS patient explores space. A fragile palliative care patient surfs and leaves with renewed energy. Each moment underscores a critical insight: when experiences are thoughtfully matched to a patient’s emotional state, VR becomes a form of care—not just distraction.At its deepest level, this work is about awe. The feeling of encountering something bigger than ourselves—oceans, stars, vast landscapes—can bring peace, perspective, and even spiritual grounding. Through VR, awe becomes accessible at the bedside, reminding patients that even in limitation, there is still room for connection, beauty, and meaning.Highlights:VR is emerging as a powerful tool in hospice and serious illness careThree mechanisms drive its impact: presence, embodiment, and agencyReal patient stories demonstrate measurable emotional and physical benefitsMatching VR experiences to patient needs is key to effectivenessAwe is not a luxury—it’s a therapeutic necessity at the end of lifeGuest:Kathleen Benton,  Chief Executive Officer, Hospice Savannah, Inc. and Co-Author of the book, Virtual Reality for Serious Illness; Teri Yarbrow, Founder of "Creating AWE", President of Magika VRx and Co-Author of the book, Virtual Reality for Serious Illness Host:Chris Comeaux, President / CEO of TELEIOS, author of The Anatomy of LeadershipTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

In Part Two of Future-Proofing Care: The Challenges We Face in Hospice and Palliative Care, Chris Comeaux and Cordt Kassner explore the accelerating forces reshaping hospice and palliative care—from shifting patient demographics to the rapid rise of AI and regulatory complexity. As the industry transitions to serving a more diverse, resource-variable baby boomer population, leaders are challenged to rethink how care is delivered, personalized, and sustained in an increasingly complex environment.  The conversation dives into the tension between innovation and regulation, the transformative (yet imperfect) role of technology, and the growing mental health crisis impacting patients, families, and care teams alike.  With AI poised to revolutionize communication and care delivery—but infrastructure and human connection still critical—the episode emphasizes a central truth: technology must enhance, not replace, the heart of care.  Ultimately, this episode offers a strategic roadmap for leaders navigating uncertainty.  Through the memorable framework “Grow, No, Flow, Sow, R&D,” the hosts provide actionable insight into building resilient, future-ready organizations—equipping healthcare and nonprofit leaders to move from feeling overwhelmed by change to actively shaping what comes next.  Key TakeawaysDemographic shifts—especially the rise of the baby boomer population—are redefining care expectations, financial realities, and caregiver availability.  Innovation is outpacing regulation, creating friction—but also opportunity for leaders to proactively shape policy.  AI and emerging technologies will dramatically transform care delivery, but must be used to enhance—not replace—human connection.  The mental health crisis is increasingly intersecting with hospice and palliative care, exposing systemic gaps and new responsibilities.  Organizational culture (“reculture”) is the critical enabler—or barrier—to successfully navigating rapid change.Co-Host:Cordt Kassner, PhD, Publisher of Hospice & Palliative Care Today & CEO and Founder of Hospice Analytics Host:Chris Comeaux, President / CEO of Teleios, Author of The Anatomy of LeadershipTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast

In Part One of this forward-looking series, Chris Comeaux unpacks the foundational challenges shaping the future of hospice and palliative care. Drawing from nearly a decade of strategic research and collaboration with healthcare leaders, he introduces a powerful framework built around eight core challenges that every organization must navigate.  From intensifying competition to shifting reimbursement models, this conversation equips leaders with a clearer lens to anticipate disruption and respond with intention.What emerges is not just a list of problems—but a strategic roadmap.  Chris explores how “hypercompetition” is reshaping referral patterns, how financial pressures demand organizational agility, and why workforce shortages require a complete rethinking of care delivery.  Throughout the episode, the emphasis remains on proactive leadership: understanding the forces at play, asking better questions, and positioning organizations to thrive—not just survive—in a rapidly evolving landscape.Ultimately, this episode serves as a call for healthcare leaders, nonprofit executives, and hospice professionals to rethink traditional models.  By embracing innovation, diversifying services, and aligning care with what patients truly want, organizations can future-proof their mission and remain deeply relevant in the years ahead.  Key TakeawaysThe future of hospice and palliative care is shaped by eight major challenges, including competition, reimbursement, workforce, and demographic shifts.  Hypercompetition is accelerating, including both direct competitors and “substitution” models that can divert referrals.  Reimbursement pressures are expected to tighten, requiring organizations to become more efficient while exploring new revenue models.  Workforce shortages are a structural reality, demanding an “outside-in” approach that aligns staffing with evolving patient needs.  Long-term success depends on organizational ambidexterity—the ability to optimize current operations while innovating new care models simultaneously.  If you’re leading in hospice, healthcare, or the nonprofit space, this conversation is just the beginning.  Subscribe to the podcast, in Part Two, where we go deeper into solutions and strategies you can apply immediately. Share this episode with your leadership team, and start the conversation: Are we truly prepared for what’s ahead?Co-Host:Cordt Kassner, PhD, Publisher of Hospice & Palliative Care Today & CEO and Founder of Hospice Analytics Host:Chris Comeaux, President / CEO of Teleios, Author of The Anatomy of LeadershipTeleios Collaborative Network   /   https://www.teleioscn.org/tcntalkspodcast