Solutions to Not Only Survive, But Thrive

Leading and Managing in Tough Economic Times is a unique program designed to provide hospice CEOs and other organizational leaders with specific tools and resources to help their programs survive and thrive in the months and years to come.



Date: September 24-25, 2009
Location: Hyatt Regency Denver and Colorado Convention Center, Denver, CO


For more information visit, http://www.nhpco.org/ctc2009

New Leadership Program to be Offered at CTC

NHPCO Announces New Professional Development Program for Hospice Leaders to be Part of the 10th Clinical Team Conference

Curriculum will Focus on Leading and Managing in Tough Economic Times

(Alexandria, Va) – With the healthcare reform debate, threats to reimbursement, increased regulatory demands and an economic downturn, hospice leaders are reeling and reaching out for guidance and practical solutions to weather this period of change and transition. In response to the needs of the hospice community, NHPCO has announced a two-day professional development intensive that will be part of its Clinical Team Conference in Denver, CO, September 24-25, 2009.

A survey conducted by NHPCO earlier this year indicates that the recent economic downturn has negatively impacted hospices across the country, with nearly 75 percent of respondents reporting an overall negative financial impact in 2008. A majority of respondents (58.4%) said they experienced a reduction in revenue in 2008. Over three-quarters of respondents (77.9%) said they had implemented reductions in spending in 2008. (Learn more about the findings from NHPCO’s economic impact survey in July’s NewsLine, pg. 6.)

Leading and Managing in Tough Economic Times is a unique program designed to provide hospice CEOs and other organizational leaders with specific tools and resources to help their programs survive and thrive in the months and years to come.

The program's education agenda runs throughout the first two days of the 10th Clinical Team Conference. Attendees of this program may attend all or some of these sessions as well as programs and events offered during the first two days of the CTC (September 24-25), including plenary and concurrent sessions, networking and conference exhibit hall events.

“In years to come if asked how you responded to these financial challenges will
you be able to say you proactively developed and executed a plan?” asked J.
Donald Schumacher, president and CEO of NHPCO. “We’ve created this intensive
specifically to address the needs and concerns we hear from provides in the
field.”

Confirmed Speakers include: Mark Murray, The Center for Hospice & Palliative Care, South Bend, IN; Charlene M. Bunts, WellStar Community Hospice, Austell, GA; Christie Franklin, Bristol Hospice, Salt Lake City; Mary Sheehan, Midwest Palliative & Hospice CareCenter, Glenview, IL; and Greg Wood, Hospice of North Central Oklahoma, Ponca City.

Registration is now open for Leading and Managing in Tough Economic Times. Visit nhpco.org/ctc2009 for more information on this timely program.

Agenda

Thursday, September 24, 2009

• 8:30 AM – 10:00 AM CTC Opening Plenary
• 10:15 AM – 11:45 AM Quick Cuts, Contingency Plans and Long-range Planning: Developing a Road Map for an Uncertain Future – Charlene and Mary
• 11:45 AM – 1:30 PM Complimentary Box Lunch
• Noon – 1:15 PM Discipline-Specific Networking Meetings (NCHPP)
• 1:30 PM – 2:30 PM Creating a Culture of Belt-Tightening
• 2:45 PM – 3:45 PM Doing More with Less? Yes, It Can Be Done
• 5:00 PM – 7:00 PM CTC Welcome Reception and Exhibition

Friday, September 25, 2009

• 8:15 AM – 9:30 AM General Plenary II
• 9:30 AM – 10:30 AM Networking Break with Exhibitors
• 10:45 AM – 11:45 AM Utilizing Financial Data to Enhance Patient Care
• 11:45 AM – 1:15 PM Networking Lunch with Exhibitors
• 1:30 PM – 3:00 PM Downsizing with Compassion
• 3:15 PM – 4:15 PM Panel: Been There, Done That and Still Learning as We Go
• 4:30 PM – 5:30 PM General Plenary III

For more information on this program, contact NHPCO member services team at 1-800-646-6460 or visit nhpco.org/ctc2009.

Monthly Message from NHPCO's President and CEO Don Schumacher

July 2009


Exploring Multiple Pathways to Earlier Referrals


Our cover story this month draws needed attention to the myths surrounding palliative care. Much like hospice, palliative care is not being fully utilized within our nation’s healthcare system due to sheer misunderstanding on the part of patients and physicians. As the author notes, there are nearly one million patients who are dying in hospitals or other institutions each year who are unaware of the palliative care services available to them—care that would not only help them, but would also reduce hospital and pharmacy costs.


While it’s certainly our collective responsibility to help educate our communities about palliative care, we are missing a very important opportunity if we don’t do more—if we don’t expand into palliative care ourselves. In one of my first conference plenary addresses as president/CEO of NHPCO, I urged members to “think outside the Medicare Hospice Benefit box” and explore palliative care as a pathway to earlier referrals. I was not asking members to do something I had not done myself. While president/CEO of a hospice program in Buffalo, I was one of the first providers to integrate palliative care into our continuum of care and saw firsthand the many benefits of such expansion.


Today, with healthcare reform very much a reality and with CMS now looking at ways to serve more Americans more cost effectively, there is even greater reason to expand our expertise into other cost-effective services. Palliative care is a natural fit for hospice providers.


Opportunities at the National Level


This month’s secondary feature recaps findings from NHPCO’s recent Economic Impact Survey. Understandably, most programs reported a reduction in revenue, with reasons ranging from reductions in average daily census to expected reductions in philanthropic contributions and changes in payment rates. First, on behalf of NHPCO, my thanks to all of you who took time to respond. Secondly, NHPCO hears you.


While NHPCO can’t address all of the factors that are impacting your bottom line, we are committing significant resources to the one that poses the greatest threat to the majority of members—Medicare Hospice Benefit rates. In partnership with The Alliance for Care at the End of Life, protecting these rates remains our top priority (see page 16 for an update on our advocacy efforts). However, we are also exploring other ways to improve your bottom line through expansion of the Benefit. NHPCO’s Public Policy Committee recently approved two potential demonstration projects to examine concurrent care and transitional care, both of which would enable hospice providers to build relationships with patients and families earlier in the illness trajectory and, in so doing, improve hospice utilization.


A favorite expression of mine reminds us that there are, indeed, many paths up a mountain. In today’s hospice environment, we must be open—and willing—to explore them all.

Don

Read July NewsLine

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

Comments from Provider Needed to Protect Rates!

To: NHPCO Membership
From: NHPCO Regulatory Team
Re: June 16, 2009

The rates for hospice will be cut by 3.2% in October, and an additional 1% the following year unless CMS halts its plans to phase out the Budget Neutrality Adjustment Factor (BNAF) in the hospice wage index. Have you done everything you can to tell CMS to eliminate this rate reduction? Did you know that CMS has received NO comments from providers so far on this proposed rule? Regulators could take this lack of response from the hospice community as an indication that rate cuts will not present any problems for providers.

Act now…. Time is short...Comments are due next Monday, June 22...Tell your story about how the rate cut is affecting you and your hospice program. Here’s how...

How You Can Help
Key Issue and Talking Points: FY2010 Proposed Hospice Wage Index
Sample Letter

How You Can Help

Review the talking points below and submit your comments on the proposed rule to CMS. When preparing comments, please refer to file code CMS-1420-P. Comments must be received no later than 5:00 pm on Monday, June 22, 2009.


Electronic Comments:
The fastest and easiest way to submit comments would be electronically; visit http://www.regulations.gov/fdmspublic/component/main?main=SubmitComment&o=0900006480968c04 and follow the instructions to comment. Make sure you reference the document number: CMS-1420-P.


Written Comments:
You may mail written comments to the following address ONLY. Please allow sufficient time to ensure that mailed comments are received before the close of the comment period.

Centers for Medicare & Medicaid Services
Department of Health and Human Services
Attention: CMS–1420–P
P.O. Box 8012
Baltimore, MD 21244–8012

Express Mail:
You may send written comments (one original and two copies) to the following address ONLY.

Centers for Medicare & Medicaid Services
Department of Health and Human Services
Attention: CMS–1420–P
Mail Stop C4–26–05
7500 Security Boulevard
Baltimore, MD 21244–1850

Key Issue and Talking Points

Issue: FY2010 Proposed Hospice Wage Index

CMS proposes to continue its phase-out of the BNAF over the next two years, with a 75% reduction in FY 2010 and a complete phase-out in FY 2011.

Member Talking Points:

1. A 75% reduction in the BNAF is equal to a rate reduction of 3.2 % in FY2010, beginning October 1, 2009, and an additional one percent reduction in FY 2011, ultimately resulting in a rate reduction of approximately 4.2% for most hospices.
   Describe any direct impact the proposed rate cut will have on:
   - Patient and family services, such as: (services cut back, services discontinued, etc.)
   - Reductions in service area;
   - Employee layoffs;
   - Higher case loads;
   - Any other negative impact on program services because of the reimbursement cuts.
   
2. In a time of economic uncertainty and loss, with escalating costs (gas prices are on the rise again), a rate cut is exactly the wrong action for CMS to take.
   
3. CMS ought to encourage more patients and families to elect hospice care so that they will receive the care they need and deserve, and save the Medicare system money.

NHPCO will submit comprehensive comments but that is not enough. It is imperative that Regulators hear from members of the hospice community. It is especially important that you explain the impact these rate cuts will have on staffing and patient services.Thank you for your ongoing efforts to protect hospice!

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Note: NHPCO Regulatory Team issued a comprehensive Alert and Call to Action on June 9 that goes into more detail and looks at some of the broader issues. That alert is available on the NHPCO Web site.

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