Skip to main content

The Price of Hospice Rate Cuts


It goes without saying one can’t put a price on the last months, weeks and days of a life shared with a loved one. But in addition to improving the quality of the lives of millions of terminally ill individuals and their families each year, hospice care has also been proven to save the government money. Sounds like a win-win situation, right? Well, not judging by Congress’ proposed rate cuts.

The high-quality, compassionate end-of-life care Americans depend upon is threatened by not one but two devastating rate cuts. Already bracing for a 3 percent regulatory rate cut starting this month (the Budget Neutrality Adjustment Factor or BNAF), hospice, along with most other Medicare providers, is also facing additional cuts through a “productivity adjustment” to help finance health care reform.

These new reductions would slash rates by a damaging 11.8 percent throughout the next 10 years to fund new health care initiatives written into the bill. Combined, the impact of these two cuts would mean an astounding 14.3 percent loss to hospice. Considering hospice, as sited by MedPac, already operates on a very small profit margin of 3.4 percent, this means programs will go broke, doors will close, and Americans will be left without or with limited options of having hospice at home. In response to the proposed cuts, The Alliance for the End of Life Care and the National Hospice and Palliative Care Organization (NHPCO) have launched “Two Cuts Are Too Much,” a grassroots campaign.

As part of this effort, I traveled throughout central Iowa videotaping touching testimonials, putting faces on the cuts Congress is about to pass. As is the case of many hospice employees, I learned about hospice care when my loved one needed it. I cannot imagine what my family would have done without the compassionate care we received, which allowed Grandma and Bessie to live the end of their lives in comfort and with dignity, according to their wishes. In my position as community relations coordinator for Hospice of Central Iowa, the largest non-profit hospice organization in the state, I see the benefits hospice brings to our communities each day. My colleagues and I are very concerned the proposed cuts would limit both our ability and that of other hospices likes ours to provide this needed service. Because care is most expensive to provide in rural areas like much of Iowa, many hospices here would have no choice but to close their doors or severely limit service areas.


But together, we can help. Contact your members of Congress TODAY to tell them that “Two Cuts are Too Much for Hospice!” Visit NHPCO’s Legislative Action Center for steps to educate your Congressional representatives about how additional rate cuts would impact patient care in your local hospice community. Also encourage your friends and family to join the effort. Less than five minutes of your time can make a difference to fight for those who cannot fight for themselves and ensure that hospice is available now and for generations to come.

Thank you,

Katie McIntyre
Community Relations Coordinator
Hospice of Central Iowa

Comments

Eric Widera said…
Thank you Katie for spreading the word about hospice rate cuts. The 'My Representatives' tool is a terrific resource at the NHPCO website. I just spent the last 1/2 hour playing around with it!
Anonymous said…
Well said.
Katie McIntyre said…
Here a full legislative update on hospice cuts from NHPCO:

On October 13, with a vote of 14-9, the Senate Finance Committee completed its health care reform deliberations. The 14 votes in favor of moving the bill forward represented unanimous support from the Committee Democrats and Republican Senator Olympia Snowe (ME). The draft legislation, entitled America’s Healthy Future Act, includes drastic rate cuts to hospice, yet closing statements from both sides of the aisle made clear that this is just one step in a complex process. Here’s a recap of the provisions of interest to the hospice community contained in the Finance Committee proposal:
• Hospice Annual Market Basket increase reduced by Productivity Factor Adjustment,
FY 2013-2019
• Allows for concurrent, curative and hospice care for children in Medicaid
• Establishes a 26-site Hospice Concurrent Care Demonstration Project in Medicare
• Requires HHS Secretary to establish Medicare Hospice Quality Reporting
• Physician assistants would be recognized as attending physicians to serve hospice patients
• Requires improved data collection to inform payment reform for hospice
• Requires physician or APN visit at recertification
Really good article related to the each type of patient in the hospice, for medicare facility this blog was good.Thanks for the supportive article.

Popular posts from this blog

The Future of Palliative Care: A Podcast with Diane Meier

There are few names more closely associated with palliative care than Diane Meier.  She is an international leader of palliative care, a MacArthur "genius" awardee, and amongst many other leadership roles, the CEO of the Center to Advance Palliative Care (CAPC).  We were lucky enough to snag Diane for our podcast to talk about everything we always wanted to ask her, including:
What keeps her up at night?Does palliative care need a national strategy and if so why and what would it look like?The history of CAPC and the leadership centersAdvice that she has for graduating fellows who want to continue to move palliative care forward as they start their new careersWhat she imagines palliative care will look like in 10 or 15 years?What is the biggest threat facing palliative care? So take a listen and if you want to dive a little deeper, here are two articles that we discussed during the podcast:
A National Strategy For Palliative Care. Health Affairs 2017Palliative Care Leadership…

Elderhood: Podcast with Louise Aronson

In this week's podcast we talk with Louise Aronson MD, MFA, Professor of Geriatrics at UCSF about her new book Elderhood, available for purchase now for delivery on the release date June 11th.

We are one of the first to interview Louise, as she has interviews scheduled with other lesser media outlets to follow (CBS This Morning and Fresh Air with Terry...somebody).

This book is tremendously rich, covering a history of aging/geriatrics, Louise's own journey as a geriatrician facing burnout, aging and death of family of Louise's members, insightful stories of patients, and more.

We focus therefore on the 3 main things we think our listeners and readers will be interested in.

First - why the word "Elder" and "Elderhood" when JAGS/AGS and others recently decided that the preferred terminology was "older adult"?

Second - Robert Butler coined the term ageism in 1969 - where do we see ageism in contemporary writing/thinking?  We focus on Louise's…

Lost in Translation: Google’s Translation of Palliative Care to ‘Do-Nothing Care’

by: Cynthia X. Pan, MD, FACP, AGSF (@Cxpan5X)

My colleagues often ask me: “Why are Chinese patients so resistant to hospice and palliative care?” “Why are they so unrealistic?” “Don’t they understand that death is part of life?” “Is it true that with Chinese patients you cannot discuss advance directives?”

As a Chinese speaking geriatrician and palliative care physician practicing in Flushing, NY, I have cared for countless Chinese patients with serious illnesses or at end of life.  Invariably, when Chinese patients or families see me, they ask me if I speak Chinese. When I reply “I do” in Mandarin, the relief and instant trust I see on their faces make my day meaningful and worthwhile.

At my hospital, the patient population is about 30% Asian, with the majority of these being Chinese. Most of these patients require language interpretation.  It becomes an interesting challenge and opportunity, as we often need to discuss advance directives, goals of care, and end of life care options…