NHPCO Draws Providers’ Attention to Article in New York Times

NHPCO members may have seen the article from Kaiser Health News that was posted on the New York Times website yesterday and appears in print in the Health & Science section today, "Concerns about costs rise with hospices' use."

NHPCO wanted to let members know that President/CEO Don Schumacher wrote a letter to the editor reminding the NY Times that growth in hospice over the past decade reflects our caring more compassionately for the dying in this country. He also made the point that NHPCO has been calling for more federal oversight of hospice for many years.

The NY Times blog page, New Old Age, welcomes comments from readers. Please feel free to share any thoughts you might have through the comment section of the New Old Age blog. An insightful comment was posted on the New Old Age blog that NHPCO would like to draw provider's attention to. An individual wrote: "I'm so thankful that this article was published, because we weren't aware that hospice care was available for end stage Alzheimers. We want to do everything we can to honor my mother's wish that she die in her own home, but if things become impossible,,,well it gives me great comfort to know there is another option."

To many of us, so close to issues that involve the field, it can be easy to forget that many members of the public are concerned about issues as they affect them in a personal way. Even challenging news articles can provide valuable information about hospice that is important to the public.

In addition to Don's letter to the editor, we are submitting an op-ed to the NY Times that we hope will get serious consideration.

Additionally, the Public Policy team has put together some specific talking points they are sharing with legislators and their staffs on Capitol Hill who may have concern or confusion resulting from this article.

We wanted to assure members that NHPCO has been actively responding following the release of this article.

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Costs of Care at EOL

Discussions About End-of-Life Care Reduce Healthcare Costs in Last Week of Life

NHPCO Encourages Dialog between Patients and Physicians

(Alexandria, Va) – Patients with advanced cancer who reported talking about their end-of-life wishes with their physicians had significantly lower healthcare costs in the last week of life. Researchers found that these conversations between patients and physicians led to fewer cases of aggressive care, which saved money and resulted in a far more peaceful death for patients.

The study in the March 9 issue of Archives of Internal Medicine suggests a tangible benefit to advance care planning discussions with physicians – lower costs and reduced utilization of aggressive care, including admission to the Intensive Care Unit.

Thirty percent of Medicare’s annual costs are spent on the five percent of beneficiaries who will die in a given year. Additionally, about one-third of those dollars spent in the last year of life are spent in the last month.

“Discussions about care at the end of life result in a higher quality of life for patients – and cost the healthcare system less money, that is something that hospice and palliative care providers have long known” said J. Donald Schumacher, president and CEO of National Hospice and Palliative Care Organization.

A 2007 study out of Duke University found hospice saves Medicare about $2,300 per beneficiary that receives hospice care.

Researchers in this recent survey looking at costs in the last week of life indicate that if 50 percent of people had a discussion with their physician about end-of-life care preferences, the cost difference in a year could be more than $76 million dollars.

Study participants who discussed end-of-life care preferences were more likely to be referred to hospice sooner than those who did not.

“In fact, patients who received less invasive or aggressive treatments lived as long as patients who did not, indicating that attempts to prolong life in end-stage cancer patients might be futile,” noted Schumacher.

Research published in the Journal of Pain and Symptom Management (March 2007) found that Medicare beneficiaries who opted for hospice care at the end of life lived on average 29 days longer than similar patients who did not take advantage of hospice.

NHPCO has been a longtime advocate for people having frank discussions about the care they would want – primarily to ensure that a person’s wishes are honored and that they experience the highest quality of life possible.

“An important time to talk to your doctor about the kind of care you would want at the end of your life is not when you’re days away from death but much earlier in the course of an illness,” said Schumacher.

“In fact, I cannot stress the importance of advance care planning for all people. Taking time, right now, to have these discussions with family and loved ones can be very important in making sure wishes are honored should a medical crisis come along,” added Schumacher.

Last year, more than 1.4 million Americans with life-limiting illness received the quality care from the nation’s 4,700 hospice care providers.

Information on care at the end of life, starting these important conversations with loved ones and care providers, and state specific advance directive forms, are all available free-of-charge on NHPCO’s Caring Connections Web site, www.caringinfo.org, or from the Helpline at 800-658-8898.

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For more information visit, http://www.nhpco.org