Hospice does not look like the rest of home-based care, and pretending it does is how a tool loses the room. There is no prior authorization in Medicare hospice and it pays a per diem, so the familiar delivered-but-never-billed story is not the leak. The exposure is the aggregate cap, the level-of-care mix, and eligibility, and it arrives as a clawback a year later. Reeve models that exposure while you can still act on it.
The Medicare hospice aggregate cap limits total payments per patient across your program, and a program that runs long-length-of-stay patients can cross it without a single claim looking wrong. The exposure is concentrated in a handful of states, and it is exactly the kind of thing that is invisible claim by claim and obvious when the whole book is read against the cap. That read is what Reeve does.
The claim looks clean every single time. The exposure only appears when the whole book is read against the cap.
That is a read no billing workflow performs, because a billing workflow checks each claim against its own rules and never checks a year of care against a program-level ceiling. Reeve is the neutral layer that does, read-only, with nothing that has a name ever leaving your building.
Reeve reads your claims, level-of-care and eligibility exports locally. Names and identifiers are dropped before any math runs. Read-only, and it never writes to your system.
The engine projects aggregate-cap exposure from your own length-of-stay and level-of-care mix, and flags eligibility and level-of-care patterns that drive it, while there is still time to act.
Where the data cannot answer a question, Reeve says so rather than inventing a number. The refusal is the product. A hospice owner can tell the difference in one read.
Home care is the only space Reeve has proven on a real book so far. Hospice is a genuinely different product, and we would rather build it with a hospice design partner than pretend the home-care version fits.
The engine is the same underneath. What is proven today is one real home-care book, read in full and published with its own corrections at get-reeve.com/proof. Hospice runs on that same engine as a design-partner build, and any agency we work with hears that in writing before anything is signed.
See your aggregate-cap exposure modeled on your own book, before it becomes a repayment. Free, de-identified, yours to keep.
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