Hospice Community Disappointed in Administration’s Decision and Reminds All Americans of the Value of Advance Care Planning

(Alexandria, Va) – “We are surprised that the Administration has decided to reverse the decision to include voluntary advance care planning consultations as part of a Medicare beneficiaries’ annual wellness exam,” remarked J. Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization.

Despite this action, NHPCO strongly encourages all Americans to think about their wishes for care at the end of life and engage in advance care planning. This includes having discussions with healthcare providers and family members, completing an advance directive (which includes a living will and healthcare proxy), and making sure their loved ones understand their wishes.

“Frankly, we are somewhat disappointed that the regulatory guideline making this part of the annual Medicare exam and compensating the physician for taking time to talk about personal preferences has become such a political issue,” continued Schumacher. “It's simply about educating patients about the types of decisions they might need to consider in future healthcare situations, and then supporting them as they make their own choices based on their values, beliefs and preferences.”

The opportunity for this voluntary consultation with a physician has been part of the “welcome to Medicare” exam since 2008.

Research has shown that patients who discuss their care options when facing a serious or life-limiting illness report a higher quality of life, less hospitalizations and fewer visits to the emergency department. Family caregivers have also been shown to benefit from discussions held between physicians and patients.

Far too often, patients and their families are forced to make decisions in times of crisis; these voluntary advance care planning consultations would have facilitated informed conversations prior to the onset of an illness or medical crisis.

“Death and dying can be a difficult topic for people to deal with – this includes politicians crafting legislation, healthcare providers caring for patients, and people who may be confronting a serious illness. But as hard as this can be, it’s far more difficult for a patient and family to face a medical crisis without a prior understanding of an individual’s wishes and how quality of life might be addressed. Knowing a loved one has engaged in discussions with a knowledgeable physician can bring comfort to patients and families—and that can be quite a gift at a challenging time,” Schumacher said. “Having this option spelled out in Medicare regulations would have raised awareness of advance care planning and potentially opened the door for valuable conversations.”

NHPCO emphasizes that advance care planning is not about discontinuing treatment, saving money, or having someone else make decisions for you; it’s about making sure your wishes are known and then honored, regardless of whether you choose every medical intervention available, discontinue non-productive treatments, or something in between.

There is concern among hospice providers that the debate about this regulation and last year’s “death panel” rumors will cause additional confusion to members of the public and make them even more suspicious of advance care planning.

Hospice and palliative care providers are skilled in helping people understand issues of importance when facing a serious or life-limiting illness and can be important resources for those looking to learn more or make their wishes known.

NHPCO’s Caring Connections offers information on care at the end of life and provides free, state-specific living will and healthcare proxy forms: Visit www.caringinfo.org or call the HelpLine at 1-800-658-8898.

The Moran Data Project: Is your hospice participating?

The participation of all hospice providers across the country is needed for a very important project that has the potential to impact every provider in the U.S. I'm writing about the Moran Data Project.

For those not familiar with the project, last July, NHPCO retained The Moran Company (a healthcare research and consulting firm specializing in payment reform) to conduct our own data collection and assessment project on behalf of the hospice and palliative care field. This is in response to impending work on hospice reimbursement reform that is now required as a part of the new health care reform law and requires CMS to initiate hospice payment reform no earlier than 2014.

I would like to share the video message linked below:




For those unable to access the video, here is some additional information about the Moran Project.

The Moran Data Project

Through data collected and analyzed in the Moran Data Project, NHPCO will develop and present to CMS and MedPAC alternative Medicare hospice payment reform models that fairly reimburse us for the care we provide. This proactive approach allows us to exert some influence on the process rather than relying solely on government regulators and the data they can access. However, in order for our models to be sound, we must have comprehensive, patient-level data—and for that, we need the assistance of all hospice providers.

The data collection phase of this project began in February and there are now about 200 providers which are submitting data—but we need 800 more providers of all sizes, type and from all areas of the country to step up and contribute data.

By coming together to present to MedPAC and Congress comprehensive data from a unified hospice industry, we can help preserve our core values and our revenue streams. NHPCO will fight for this—but we can't do it alone. Working together to collect data, we can make our voices heard. Members can learn more online at nhpco.org/moran or contact Amanda Forys at The Moran Company at aaforys@themorancompany.com.

Thank you for your participation!

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NHPCO would like to thank the software vendors who are participating in this important data collection project:

• Allscripts
• Cerner BeyondNow
• Consolo Services Group
• Delta Health Technologies
• Homecare Homebase
• McKesson Corporation
• HPMS - Mills & Murphy Software Systems, Inc.
• mumms® Software
• Suncoast Solutions