2025 October Coffee Chat-October Coffee Chat Recording

Video Transcription

Video Summary

The HMDCB October coffee chat, facilitated by Dr. Sandeep Grandi, addressed key challenges and updates in hospice medical director practice. Dr. Grandi, a dual Harvard fellowship-trained physician, framed the discussion around clinical, ethical, and leadership roles. Key topics included pediatric concurrent care—under ACA Section 2302—and its complexities with reimbursement and coordination, especially for rare, unpredictable illnesses. The group shared experiences of navigating billing and care challenges in various states like California and Oregon. Remote hospice medical director roles were discussed, with compensation typically ranging from $3,000 to $10,000 monthly depending on hospice size and duties, often structured as a flat retainer. The expiration of CMS telehealth flexibilities for hospice face-to-face recertifications after September 30, 2025, was highlighted, with providers urged to plan for in-person visits while some states allow case-by-case telehealth. Strategies for efficient travel and use of nurse practitioners to manage workloads were shared. Administrative advocacy for moving General Inpatient Care (GIP) units was emphasized to require clear data, risk reduction, and stakeholder support. The session concluded with reflections on hospice care consolidation trends, reinforcing the medical director's role in patient-centered advocacy amid system pressures. The chat underscored the evolving, complex nature of hospice medicine and the importance of leadership grounded in ethics and compassion.

Keywords

hospice medical director

pediatric concurrent care

ACA Section 2302

reimbursement challenges

remote hospice roles

CMS telehealth flexibilities

General Inpatient Care advocacy

hospice care consolidation

ethical leadership in hospice