Friday, May 24, 2013

Devastation in Oklahoma: A Message from Don Schumacher

The destruction caused by the violent tornado that hit Oklahoma earlier this week – and in the violent storms occurring due to the severe weather conditions in our nation’s heartland – is overwhelming. Particularly heart wrenching is the devastation and loss of life seen in Moore, Oklahoma.

As the full impact of the devastation continues to unfold, NHPCO extends its thoughts and prayers to all those whose lives have been affected.  As hospice and palliative care professionals, we recognize the significance of loss within a person’s life, we also understand how those not directly affected may identify with victims and struggle with their emotions. Ultimately, tragedy can show people they have more resiliency and strength then they realized.

For those programs and professionals providing care, we offer our respect and admiration for the challenges faced in continuing to provide the compassionate services that are the hallmark of hospice palliative care. And to all hospices and palliative care programs forced to reach beyond their previously known limits, we salute you. We honor your dedication to serve beyond what could ever be expected.  Your commitment and courage reflect positively and shine a bright light on all those providing and receiving care. 

I also salute the first responders who were on the ground as soon as the tornado lifted to help those in need. There are many moving examples of neighbors coming to the aid of neighbors and the broader community. While we cannot stop the forces of Mother Nature, we learn that the care and support of family and friends is essential. 

NHPCO is reaching out to the state organization and other contacts in the region to get an assessment of how the hospice palliative care community has weathered this disaster. The needs of those who have been hurt and the extensive damage done to homes and businesses will take time to address, and those needs will be significant.

When our country suffers a disaster like this, all attention seems to focus on the devastation and loss. At a time like this it is so important that we monitor how our children may be affected by what they may be seeing on television or news reports. And even for those of us who are fully grown, it’s important that we take note of how the images of destruction might be impacting each one of us.

NHF Disaster Relief Fund
Some of you may be aware of the Disaster Relief Fund created by the National Hospice Foundation to support the hospice palliative care community when disaster overwhelms regularly-available resources.  NHF works to make funds available to our state organizations as they respond to recovery efforts of providers at the local level.  In the past, funds have also gone to support grief and bereavement programs to foster community healing following traumatic events.

We welcome your support of the disaster fund and to enhance NHF’s ability to care for the hospice palliative care community.  To donate, please visit

 J. Donald Schumacher, PsyD
President and CEO
National Hospice and Palliative Care Organization

Thursday, May 2, 2013

Comments on CMS Proposed Payment FY2014 Update for Hospice

On Monday, April 29, The Centers for Medicare and Medicaid Services released a proposed rule which would update the fiscal year (FY) 2014 hospice reimbursement rates.  The CMS notice claimed that hospices would receive a 1.1 percent market basket increase in their reimbursement.

NHPCO's official comment letter to CMS will be submitted as instructed; however, J. Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization offers the following public comments on the proposed rule.

Beyond the policy considerations, the numbers just do not add up. For CMS to characterize hospices as receiving a positive update, much less an $180 million dollar increase, without factoring in the impact of the sequester is disingenuous.  The truth is, under current law, CMS’ proposed payment update would mean a -.9 percent decrease for the nation’s hospice community.

Hospices are already struggling with an increased regulatory burden and productivity cuts associated with PPACA.  For the hospice community, which has a high proportion of Medicare/Medicaid patients (almost 90 percent) and an average margin of 4.6 percent – without even taking into account the impact of sequestration – any proposed negative update could be catastrophic.

This is a time when access to hospice should be encouraged, not threatened.  Virtually every responsible policy maker acknowledges that more end of life care patients should have access to the high quality and compassionate services offered by the nation’s hospice programs.  

New research out of Mount Sinai’s Icahn School of Medicine, published in the March 2013 issue of Health Affairs, (affirming previous cost saving research from Duke University) found that hospice enrollment saves money for Medicare and improves quality from Medicare beneficiaries by reducing emergency room stays, ICU days and hospital readmissions.  And yet, we’re already seeing layoffs and consolidation in the hospice community.  The proposed negative update sends a message to the hospice community to expect more of this disturbing trend.

J. Donald Schumacher, PsyD
President and CEO
National Hospice and Palliative Care Organization