Wednesday, January 27, 2010

Los Angeles Times Series on End-of-Life Care

There is a great series of three articles on end-of-life care that appears in the Los Angeles Times. I was interviewed for the article, “Hospice care helps patients and loved ones” that ran in print January 25. The writers for the pieces spoke with many well known names in the field. There are some very poignant photographs that accompany the series as well.

Media attention to the range of issues involving care at the end-of-life are always important and this series, which is available on the LA Times website, will certainly provide a great deal of helpful information to those not familiar with some of the issues involved in care at the end of life.

“Hospice care helps patients and loved ones: More patients use the service for end-of-life care. But what is it? “
January 25, 2010

“Study: Doctors delay communicating end-of-life care issues with terminally ill patients “
January 25, 2010

“Choices at the end of life”
January 22, 2010

I was pleased to see that NHPCO's Caring Connections website,, was offered as a resource for those looking for advance directives and information on advance care planning.

Friday, January 22, 2010

NHF Donates $15,000 for Haitian Earthquake Relief

$15,000 for Haitian Earthquake Relief

Usings funds from our Disaster Relief Fund, we were able to donate an initial $15,000 to Haitian earthquake relief. Three organizations doing on-the-ground work in Haiti have each received $5,000: Holy Angels Hospice, Partners in Health, and the Hôpital Albert Schweitzer (Albert Schweitzer Hospital). We invite you to donate directly to these organizatons or make a contribution to NHF's Disaster Relief Fund.

Just like everybody who has been watching the heartbreaking images from Haiti, NHF’s board and staff have reacted with horror and sadness to the tragedy unfolding in that nation,” said J. Donald Schumacher, President & CEO. “We were so grateful that past donations to the NHF Disaster Relief Fund allowed us to respond quickly with cash to these three fine organizations. It feels good to know we are doing something tangible to help in the wake of such devastation.”

Holy Angels Hospice & Orphanage is located in Port-au-Prince. Although much of the capital city has been destroyed, their facility is still standing. Holy Angels is in dire need of financial resources to ramp up service provision. Prior to the earthquake, they focused exclusively on caring for children. With the enormous need created by the earthquake, Holy Angels plans to expand their services.

Partners in Health (PIH) is a Boston-based international health agency that has been working in Haiti for more than 20 years. PIH works to bring modern medical care to poor communities in nine countries around the world. The work of PIH has three goals: to care for patients, to alleviate the root causes of disease in their communities, and to share lessons learned around the world. Right now in Haiti, one of PIH’s main goals is to help with pain relief. PIH has deep roots and a major presence in Haiti, particularly in the Central Plateau region that sits northeast of Port-au-Prince.

The Hôpital Albert Schweitzer (HAS) is located 42 miles outside of Port-au-Prince and escaped damage, although buildings even further away from the capital city were destroyed. According to the hospital director, the 120-bed hospital went over capacity within minutes following the earthquake and the staff of 200 immediately shifted into a mass casualty protocol. With so many of the injured arriving with broken or crushed bones, the x-ray machines and operating rooms are in constant use.

Knowing that the need for assistance is both immediate and long-term, NHF will monitor the situation in Haiti and make additional donations during the long period of rebuilding.

Thursday, January 21, 2010

What Does the Future Care Continuum Look Like?

Create the future care continuum for those facing the end-of-life by lending your expertise to a conference devoted to creating a seamless system of care. Serve as faculty for the National Conference on Developing the Care Continuum: Innovative Models to Meet the Unique Care Needs of Patients/Families, in Boston, MA from August 5 – 7, 2010. National experts and local providers will gather in Boston to explore best practices and innovative models and your voice is needed. Submit a proposal for a 30, 60 or 90 minute session that demonstrates significant work and achievement in meeting one or more of the conference objectives and that features innovative program models, methods, strategies and approaches to care for children, adults and seniors in the last phase of life. The Call for Proposals is open through February 8 and will not be extended.

For more information visit,

Thursday, January 14, 2010

Hospice Objects to MedPAC Margin Projections and Reductions

(Alexandria, VA)—The National Hospice and Palliative Care Organization today urged the Medicare Payment Advisory Commission to adjust the community’s 2010 projected profit margins from 4.6 to 2.6 percent in order to more accurately reflect hospice’s unique, mandatory program costs of volunteer and bereavement services.

The Medicare (and Medicaid) hospice benefit includes all care related to the terminal illness, as well as requires programs to provide up to 13 months of bereavement services to the families and loved ones of the beneficiary after he or she dies. In addition, the Medicare hospice benefit requires that trained volunteers provide at least 5 percent of the patient care hours. These services are mandatory as detailed in the hospice conditions of participation, and this is unique to the hospice benefit.

“While other providers also may establish volunteer programs, and perhaps the cost of those programs are considered non-reimbursable costs on the Medicare cost report, we know of no other provider that is federally required to establish and maintain a volunteer program and to track and document the cost savings achieved,“ said NHPCO Vice President of Public Policy Jonathon Keyserling. “The costs of both volunteer and bereavement services must be included in the margin computation.Any other approach would ignore the financial reality of hospice programs bearing these mandatory costs.”

MedPAC staff projected hospice margins of 4.6 percent for 2010. NHPCO contends this figure overstates the actual margin being experienced by most hospice programs.

“The MedPAC staff previously noted that they estimated bereavement costs to be about 1.5 percent. Another cost for every hospice program is the cost of administering and tracking volunteer services, but these also are not considered in margin calculations. We estimate that the cost of volunteer services would be 0.5 percent. Therefore, the “true” margins of hospice programs, providing the range of required services under Medicare, would then be 4.6 percent minus 1.5 percent minus 0.5 percent yielding a ‘real’ margin of 2.6 percent,” Keyserling said.

The 2008 MedPAC projection for hospice margins was 3.4 percent. NHPCO argues that a 4.6 percent projection for 2010 indicates, mistakenly, that hospice margins are growing.

“The discrepancy in the numbers is an indication of a change in the calculation methodology, by excluding the costs of delivering statutorily mandated services, rather than pointing to the fact that hospice margins are actually shrinking. For MedPAC to recommend countering an erroneous growth in hospice margins by reducing the annual inflationary adjustment is absurd and potentially devastating to the hospice community,” Keyserling concluded.

NHPCO is committed to working with the MedPAC staff and Commissioners to address and resolve issues, both perceived and real, within the hospice community.

“We look forward to working with MedPAC staff and Commissioners to fully explore the available data before payment reform is implemented,” said NHPCO President and CEO J. Donald Schumacher. “NHPCO is also committed to a full discussion of the costs of care and a detailed analysis of the data elements that will be necessary for comprehensive data collection.”


Media Contact:
Michele Matthews
Manager, Public Policy Communications
Direct: 703-837-3135

For more information visit,