Part Two - CMS Leader Explains Hospice Fraud, Medicare Risks, and the Future of Healthcare

In Part Two of this compelling TCNtalks / Anatomy of Leadership conversation, Kim Brandt, Chief Operating Officer and Deputy Administrator at CMS, joins Chris Comeaux and pulls back the curtain on one of the most urgent challenges facing healthcare today: hospice fraud, Medicare abuse, and the evolving future of end-of-life care.  

Brandt offers an inside look at how CMS is aggressively combating fraudulent hospice operations, recovering billions in suspect payments, and leveraging AI and machine learning to protect both patients and the integrity of Medicare.  The discussion also explores the broader future of hospice care, including lessons learned from the Medicare Advantage Value-Based Insurance Design (VBID) hospice carve-in demonstration, concerns about administrative burden and care coordination, and the growing need for data-driven leadership in healthcare. 

Brandt shares candid insight into how federal policy may reshape hospice and palliative care models in the years ahead, while emphasizing the importance of collaboration between providers and regulators.  Most powerfully, the episode closes with a deeply human conversation about dignity, compassion, and what hospice care should look like for future generations.

Key Takeaways

• CMS has stopped more than $2 billion in suspect healthcare payments through its Fraud Detection Operations Center and removed hundreds of fraudulent providers from Medicare participation.
• Hospice fraud operations are increasingly tied to organized crime networks using fake providers, stolen beneficiary identities, and deceptive enrollment tactics.
• The future of hospice care is expected to become more data-driven, integrating analytics, quality metrics, and broader palliative care coordination.
• CMS leaders are actively exploring how AI and machine learning can strengthen fraud prevention and improve healthcare oversight.
• Kim Brandt emphasizes that meaningful collaboration between hospice providers and regulators is essential to protecting patients while advancing compassionate, dignified care.

Transcript

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