More Data Needed Before Changing Medicare Hospice Funding, Report Finds

According to MedPAC, an independent agency established to advise Congress on Medicare issues, 40 percent of Medicare decedents chose hospice care in 2005, compared to 27 percent in 2000. Medicare's payment system for hospice care has changed relatively little in the 25 years since Medicare implemented the hospice benefit.

"It is in our nation's fiscal and moral interest that hospice remains an option for all who need these unique services," said Jonathan Keyserling, executive director of the Alliance for Care at the End of Life, an affiliate of the National Hospice and Palliative Care Organization, which represents 4,000 hospices nationwide. The Alliance, like MedPAC, recognizes that changes are needed in Medicare reimbursement, since the structure of the hospice Medicare benefit has been virtually unchanged since 1983. "But before we change the benefit, let's slow down, gather the data, and let the data drive policy," said Keyserling.

The Administration announced in April a plan to slash hospice reimbursement rates. Today's MedPAC report is further spurring on the Alliance for Care at the End of Life to reiterate its call on Congress to reverse the Center for Medicare and Medicaid Service's (CMS) proposal.

"Congress needs to step in and stop the Administration's Medicare plan to dramatically cut hospice reimbursement rates, a move that would lead to hospice closures and force many patients into more expensive, impersonal acute care settings. It's unjustifiable based on currently available data," said Keyserling.

MedPAC noted that there are no standardized data collection methods or models to analyze hospice operations. Data are also lacking when it comes to tracking the services provided to patients with specific diagnoses, making it difficult to gauge whether Medicare reimbursements are in line with the cost of hospice care.

In the past, Congress has rejected Administration requests to reduce the level of hospice reimbursement, realizing the harmful impact such cuts would have on care at the bedside. Today, sentiment on Capitol Hill largely remains the same -- a bicameral and bipartisan group of more than 90 members of Congress have sent a letter to Health and Human Services Secretary Mike Leavitt in opposition to the proposed rule.

Hospices provide compassionate care for those reaching the end of life, and they do it while saving Medicare an average of $2,300 per patient, according to an independent 2007 Duke University study, amounting to savings of more than $2 billion last year. The focus is on caring, not curing, and, in most cases, care is provided in the patient's home.

Hospice programs served more than 1.3 million patients and their families in 2006 and that number is expected to continue to rise as more terminally ill patients seek high quality, compassionate end-of-life care. Close to 99 percent of families who experienced hospice for their loved one would recommend it to others.

The Alliance for Care at the End of Life

The Alliance for Care at the End of Life is a 501(c) 4 organization created by the National Hospice and Palliative Care Organization (NHPCO) to provide a more aggressive and comprehensive advocacy voice to serve the entire field and, ultimately, one of America's most vulnerable populations -- those nearing the end of life.

SOURCE Alliance for Care at the End of Life

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