Promising Steps

I am heading to our conference on “Developing the Care Continuum” next week and I’m looking forward to what I know will be some thoughtful, forward-thinking discussions. Devoting an entire event to exploring the various ways we can become more visible, more available, and more valuable to the people in our communities is, in itself, a forward-thinking strategy—and also very timely.

Greater attention will be placed on improving care coordination and eliminating duplicative services as the health reform law is implemented over the next several years. All hospices, not just a select few, need to begin thinking, planning, and taking steps toward greater collaboration or the diversification of their services if they want to grow their census. Palliative care is certainly one option that is already on the rise in hospitals. However, other services are also helping hospices to establish relationships with patients and other providers earlier in the life cycle. In the coming weeks, NHPCO will make available both webcasts and session tapes from the conference to help members who were unable to attend.

Be mindful, too, of the positive steps that are also being taken here in Washington (yes, Washington!):

• From our conversations with Senator Ron Wyden, we know the Concurrent Care Demonstration Project is now taking shape. This three-year project, which will be conducted by CMS, will monitor patients at 15 different hospice programs who will be permitted to receive other Medicare-covered services as well as hospice care. The goal is to evaluate the impact of concurrent care on the patient and family’s quality of life as well as the cost of care. It has the potential to strengthen the bridge between hospice and palliative care—and may be another good reason to consider a partnership or expansion into palliative care.
• Undaunted by the ‘death panel’ debacle of last summer, Representative Earl Blumenauer has also re-introduced legislation calling for Medicare and Medicaid to cover voluntary consultations about end-of-life care planning between patients and their physicians. NHPCO worked with the Congressman to help advance this valuable legislation, including a formal letter of support.

I know that running a hospice program today is not easy, given the regulatory and economic challenges of our times. As one colleague admitted, “it’s easy to get stuck in the weeds.” But it is far too critical a time to let that happen. This new decade holds much promise—if we are all poised and ready to be part of it.

Don

NHPCO Calls for Hospice Community to Make its Voice Heard

More Cuts to Hospice Announced: Hospice Community Responds
with Virtual Lobby Day on July 15

(Alexandria, Va) – The nation’s hospice providers are facing proposed cuts of $2.3 billion over a five-year period and $9.8 billion over a ten-year period in the preliminary estimates of the House of Representatives health reform proposal, released last week by the Congressional Budget Office.

These cuts are in addition to the cuts scheduled to go into effect on October 1 as a result of the elimination of the Budget Neutrality Adjustment Factor (BNAF), an issue the hospice community has been fighting to overturn for some time.

This new development makes the need to stop the BNAF cuts even more urgent for hospice providers. On Wednesday, July 15, NHPCO and The Alliance for Care at the End of Life are sponsoring a nationwide Virtual Lobby Day. All Hospice Advocates are called to join together to protect patient access to compassionate and high-quality end-of-life care.

If the BNAF cuts move forward on October 1, just 80 days from now, the hospice community is potentially facing a 6.4 percent reimbursement cut in federal fiscal year 2010 (October 1, 2009 - September 30, 2010).

“The situation facing the hospice community is clear: we are now facing cuts on top of cuts. When you take these proposed cuts, and place them on top of the BNAF scheduled cuts, it is simply unacceptable,” said J. Donald Schumacher, NHPCO president and CEO.

Here's how Virtual Lobby Day will work:

• On Wednesday, July 15, all Hospice Advocates registered on NHPCO’s Legislative Action Center will receive the Virtual Lobby Day information via email.

• The email with include instructions about who to contact, how to contact them, and specific talking points.

• Participants will call and write throughout the day on July 15.

People who have not previously registered on NHPCO’s Legislative Action Center can sign up now—it’s free and open to any interested individual. Go to nhpco.org/advocacy and click the “Legislative Action Center” box.

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Contact:
Angie Truesdale
Ph: 703-647-5163
atruesdale@nhpco.org
or
Jon Radulovic
Ph: 703-837-3139
jradulovic@nhpco.org

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

The Latest News on Hospice & Health Care Reform

As Congress prepares to depart Washington for the July 4th District Work Period, health care reform activities refuse to wind down. Higher than expected cost estimates by the Congressional Budget Office (CBO) sent Washington into a flurry of activity over the past few weeks, as stakeholders try to rein in the price tag associated with the reform effort. Here’s what’s been going on:

The President
President Obama continues to reiterate his two goals for the overhaul – reducing overall health care costs and covering the uninsured. At the same time, the President has demanded that larger members of the health sector come up with their own savings to pay for the plan, and the pharmaceutical industry responded this week with $80 billion over 10 years.

Senate Activity
The mark-up of the proposal drafted by the Senate Finance Committee, the committee which was previously out in front on health care reform, has stalled due to the lack of a bipartisan consensus. Chairman Max Baucus and the committee staff continue to work around the clock to refine their bill to gain support on both sides of the aisle.
The Senate Health, Education, Labor and Pensions (HELP) Committee was been holding a week-long marathon of a mark-up on its proposal. NHPCO has been asked by Committee staff to comment on proposed amendments that would expand efforts to increase utilization of Advance Directives. This mark-up is expected to continue through the week, and may need to reconvene after next week’s District Work Period.

House Activity
Late last week, the committees of jurisdiction in the House of Representatives released a nearly 900-page draft of the House health care reform proposal. Buried in that draft document is a reduction in the productivity factor, which amounts to an across-the-board rate reduction for all Medicare providers. This is an early draft of one Chamber’s proposal, and we don’t know whether it will come out in the final package. We are still combing through the hefty document to determine if there are other provisions that might impact hospice.
The Ways & Means Committee continues its hearings on health care reform this week, and is expected to begin mark-up of the proposal after the District Work Period. The Energy & Commerce Committee heard testimony from Department of Health & Human Services Secretary Kathleen Sebelius this week and also continues hearings on health care reform.

NHPCO
ABC News hosted a Healthcare Reform Town Hall Meeting on June 24, at the White House. The program was moderated by Diane Sawyer and Charlie Gibson and featured a cross section of Americans asking President Obama questions about healthcare issues as they relate to their personal needs. NHPCO provided information on end-of-life care to ABC News producers, and helped the news team covering this town hall meeting to find additional professional contacts in the field.
NHPCO and the Alliance for Care at the End of Life continue to be in contact with the key Committees of jurisdiction, and try to advance end-of-life care proposals that would pave the pave the way for modernizing the Medicare Hospice Benefit in the future. Check out of the proposals endorsed by NHPCO in recent weeks.
Please stay tuned for future health care reform updates. The President continues to push for passage of bill by the end of the summer and the coming weeks will be full of activity as the various Committees of jurisdiction try to meld their proposals together and pass their bills.

New Health Care Reform Resource Center
Please visit the new Hospice & Health Care Reform Resource Center. There, you can find our current and past updates on health care reform activities. You’ll also find what we are sending to the Hill on hospice and health care reform, and many other valuable resources.
Providers with questions may contact NHPCO's Public Policy Team at advocacy@nhpco.org.

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