Monday, December 16, 2019

Request for a Delay in VBID Model Implementation

On December 13, 2019, the National Hospice and Palliative Care Organization and the Medicare Rights Center submitted a letter to the Centers for Medicare & Medicaid Services (CMS) requesting the addition of consumer protections to a CMS proposal to carve in the Medicare hospice benefit in Medicare Advantage, as well as a delay in implementation of at least one year. 

As it stands, the CMS Innovation Center is planning to expand the Value-Based Insurance Design (VBID) Model to allow Medicare Advantage plans to include hospice coverage in plan designs for the first time in 2021. Since the inception of Medicare Part C, MA plans have “carved out” hospice care, leaving plan enrollees to receive end-of-life care under traditional Medicare Part A.

The VBID model is designed to reduce Medicare program expenditures, enhance the quality of care for Medicare beneficiaries, and improve the coordination and efficiency of health care service delivery. CMS has not yet shared information necessary for plans to begin to include hospice in their covered benefits, contract with providers, or communicate with consumers. From the limited details currently available, it is impossible to assess whether stakeholder feedback has been incorporated into the design of this new model. 

“We are thrilled that CMS and the Innovation Center are making efforts to increase access to care for seriously ill patients and their families,” said NHPCO President and CEO Edo Banach. “However, we are concerned that hospices and plans will not have sufficient time to assure that any model will enhance access to quality hospice care.”

To ensure the model best promotes beneficiary access to high-quality hospice care, NHPCO and the Medicare Rights Center urge CMS to release information about the policy and its operational details without delay.

NHPCO and the Medicare Rights Center are also requesting that an Ombudsman Program be established to support the model and those who will be impacted by its implementation – payers, providers, and most importantly, patients.

Friday, December 6, 2019

Survey Finds Californians Seek Support Around Serious Illness and End-of-Life Care

Nine in 10 would want as much information as possible about what to expect if they faced a serious illness.

Living with a serious illness impacts all facets of a person’s life. Results from a statewide survey released by the California Health Care Foundation (CHCF) show that the vast majority of people with serious illness want the kinds of supportive services provided by palliative care, which focuses on providing relief from the symptoms and stress of serious illness and can be provided alongside curative treatment.

Californians also express a desire for as much information as possible about what they can expect with their illness now and in the future. This sentiment poses a challenge to the current health care system, where such conversations are not the norm and the majority of people with serious illness do not receive palliative care.

Help Wanted: Californians’ Views and Experiences of Serious Illness and End-of-Life Care reports selected findings from the new survey and highlights key differences by race/ethnicity and income level. The survey is a follow-up to the foundation’s influential Final Chapter report released in 2012.

“Californians overwhelmingly want their health care provider to address the physical, emotional and practical stresses of serious illness,” said Sandra R. Hern├índez, MD, president and CEO of CHCF. “While many people do receive services, like palliative care, it tends to happen toward the end of life. These services could make a much bigger difference if they were delivered earlier.”

Monday, November 25, 2019

Education Developed for the Hospice and Palliative Care Professional

The annual webinar series offered by the National Hospice and Palliative Care Organization provides professionals – individuals and teams – with education to help develop professional skills and keep providers up to date on current practices in the field.

Each webinar topic and faculty are carefully curated by NHPCO Committees and Councils and incorporates feedback from the provider community.

The webinars reflect the most current and pressing needs of the hospice and palliative care field. Here are some of the 2020 topics:
  • Strategies for Engaging Referral Sources
  • Caring for Difficult Patients and Families
  • Implementing the Hospice Election Statement Addendum
  • Dashboards and Metrics to Communicate Outcomes
  • Pain Management for Patients with Addictions
The NHPCO webinar series is one of the most economical ways to offer training to professionals in the field.  Webinar packages are available and increase the savings available to professionals and organizations.

Continuing education/CME may vary by webinar but is generally available  for the following disciplines: Counselors, Nurses and Physicians (a $5 processing fee is required). To determine which credit is available for specific webinars, visit the NHPCO website and click on each webinar description. In addition, NHPCO webinars offer a Certificate of Participation for non-physician healthcare professionals, learn more about CE/CME provision.

See the full list of 2020 topics and order a package on the NHPCO Website.

Wednesday, November 13, 2019

6 Ways To Prepare Your Hospice For The Primary Care First Application

Setting yourself up for application acceptance and ongoing success
by Jeremy Powell, CEO of Acclivity Health

The Centers for Medicare & Medicaid Services’ Primary Care First (PCF) model is rolling out in 2020, and applications will become available in a matter of weeks. The Seriously Ill Population (SIP) model under PCF is designed to improve care for high-need, high-risk patients who currently receive fragmented or inadequate care. To do this, CMS will assign SIP patients to participating hospice programs, paying the providers to coordinate their care and avoid unnecessary hospitalizations.

There are numerous benefits to hospices participating in the SIP program, but first, your application must be accepted. Hospices interested in participating should take time to adequately prepare for their application based on what is known about the PCF program’s criteria and past CMS applications.

1. Begin drafting responses to narrative applications now.
While the application has not been released yet, because Primary Care First is based on CPC+, the applications are likely to be similar. As with all Alternative Payment Model (APM) applications, it will likely feature a combination of check boxes and narrative answers about your organization, asking how you’ll meet the eligibility requirements and drive success in the program. By preparing responses to narrative questions in advance, you give yourself time to have them reviewed by experts on APMs and improve them as needed.

2. Prepare to analyze patient data provided by CMS.
Although CMS has not announced what types of patient information will be available to participating hospices — which will likely come once the application is approved but before signing the participation agreement — hospices will need a way to make sense of that data. A data analysis platform can provide a glimpse into what 2020 will look like for your hospice, including estimates of the number of patients being assigned to you, their acuity, their prognosis, and more.

3. Determine staffing needs based on the new influx of SIP patients.
By participating in the SIP program, hospices should be able to earn 20 to 25% net profit margins caring for SIP patients. To achieve this, plan for staffing adjustments required to meet the demands of the SIP program. Hospices already employ a multidisciplinary staff to meet patients’ needs; you may only need to redistribute your staff to reflect the forthcoming patient population in your care.

4. Review your technology against PCF’s criteria, including EHR, analytics, and reporting requirements.
To participate in the SIP program, CMS requires a hospice to make use of technology to support care delivery. From certified EHR platforms, to Health Information Exchanges (HIEs), to analytics capabilities, hospices will need to prove to CMS that they are able to make data-driven decisions about a population. Most hospices have never faced this requirement before and may find themselves without a clear path to success, so identifying these gaps as soon as possible is crucial.

5. Reach out to potential community partners to fill care delivery gaps (if any).
Hospices in the SIP program must prove they have a network of providers in the community that can help meet the needs of their patients. While many hospices already offer care coordination, those who currently do not should start engaging in those relationship-building conversations with other providers in the community. This will ensure patients have access to the right care, at the right time, in the right place.

6. Prepare for discussions with Medicare Advantage payers who opt into the program.
With the hospice carve-in looming, hospices need to start thinking about how they will interact with Medicare Advantage payers. SIP is a great first step. Because CMS has made PCF and SIP a multi-payer model, Medicare Advantage payers are invited to participate. Consider how you will hold meaningful discussions with these payers about partnering with them on SIP. Even though the Medicare Advantage payers’ version of the SIP program will be similar to CMS’s, there will be differences, and you’ll need a plan about how you negotiate the details.

For more information about how to prepare for the application, or how Primary Care First’s SIP program can benefit hospice programs, visit

  • NHPCO Members: SIP Webinar from Edge Business SeriesJoin NHPCO for a free webinar on Friday, November 15 at 2:00 pm EST focusing on the recently released Request for Applications for the Primary Care First – Seriously Ill Population model. We will provide a detailed overview of the RFA and how hospices and palliative care organizations can be best prepared to apply and participate. We will also explore hospices’ readiness to provide SIP programming as well as the specific areas for providers to address to take advantage of this opportunity. NHPCO members are invited to register online.

Wednesday, October 30, 2019

November 1 is Social Media Action Day!

A Day of National “Hospice Awareness” Friday, November 1, 2019

#HospiceMonth   #HospiceAwareness #hpm

In recognition of National Hospice and Palliative Care Month, NHPCO encourages all member organizations, professionals and supporters to participate in our annual social media action day, traditionally the first Friday in November – this year, it’s Friday, November 1, 2019.

NHPCO wants the hospice and palliative care community to flood social media with images that promote awareness of hospice and palliative care. This guiding theme, My Hospice: A Program that works. A Benefit that Matters, will allow participants to share a wide range of photos, images or videos – all to help people better understand the value of hospice and palliative care.

Social media posts on November 1 should feature photos, graphics or short videos provided by hospice and palliative care organizations/professionals or individuals that capture hospice and/or palliative care at its best – the specific post we leave up to you!

Spread positive messaging on November 1 - and all month long in recognition of National Hospice and Palliative Care Month.

Download NHPCO's Social Media Action Day tip sheet (PDF).

Monday, October 21, 2019

Birdie's Heart for Hospice

As I walk into the Malone, New York office of Hospice of the North Country, I’m reminded of all the memories I have from working at the organization. I started my career in hospice and communications there twelve years ago.  Every day I was amazed at the work my clinical colleagues were doing. I wasn’t at the bedside, but occasionally, I got to go into patient’s homes and interview them and their families. It was the highlight of my job. I looked forward to lunches spent with the nurses, who would talk about the different events of the day. They never stopped thinking about their patients…even at a lunch break where they could easily use the time to talk about the latest episode The Bachelor (okay we did that sometimes!).

Now that I work at NHPCO, I am more aware of what is going on with hospice care on a national level. Regulatory changes, reimbursement cuts, and new payment models are just some of the things we are currently facing as a community. Healthcare in this country is constantly evolving and hospice is facing many challenges. The reality is that hospice will probably look different in five years. We are seeing a greater need for providers to be innovative when it comes to care delivery all while preserving the mission of hospice care.

Naturally, it’s easy to get wrapped up by these issues. They are so important to our community and at NHPCO, we must do everything we can to guide providers through these challenges. However, I wanted to get back to the basics, back on the ground meeting with those who are doing the work at the bedside. So, I went back to HONC and interviewed an amazing human being and hospice volunteer – Birdie Leavitt.

Birdie is a person I will remember for the rest of my life. She checks off all the hospice volunteer criteria – because her husband and family member received such quality hospice care, she felt she needed to give back and signed up to volunteer. She is willing to visit with anyone at any time, go into any living situation, and drive miles upon miles on country roads, sometimes in a snowstorm, to get to her patient’s home. She will come into the office and stuff envelopes, shred paper, and cuddle the office cats Alice and Tommy.

Birdie and one of the hospice cats.
I talked with Birdie about her experience as a hospice volunteer and I was so pleased to learn that she had the same passion, if not more, for hospice and volunteering now as she did when I worked with her seven years ago. Birdie has a binder that is full of memorabilia from her time at HONC. It’s a lot thicker today than it was the last time I looked through it. Since 2004, she has collected thank you notes, messages, obituaries, and mementos of the patients and families she cared for.

She reminisced about the range of activities she has performed as a hospice volunteer – making breakfast, doing dishes, picking up a few items at the grocery store for a family after their loved one died, singing along as a patient performed her daily comforting activity of playing the piano, and visiting with a patient and family on Thanksgiving Day.

Birdie told a story about a nursing home patient who didn’t have any family to provide support and companionship. This person had only the staff charged to care for them. The team at HONC made a commitment to staff five volunteers daily so the patient wouldn’t be alone in their final days. Birdie visited the patient and would wheel them out to the courtyard to look at the flowers and plants. It was one of the only times this patient left their room since being admitted weeks before. The patient’s disease had made it difficult for them to speak but, during one of Birdie’s visits, they communicated by grabbing Birdie’s hand and placing it against their cheek. Birdie had made an impact on this patient and they remembered her through the dementia and loneliness.

Many people don’t understand that hospice teams will go into any home and living condition to ensure that a patient is cared for. Birdie talked about two patients she was volunteering for. One of the patients lived in a beautiful home with a gorgeous chandelier. The other patient lived in a trailer with a hole in the floor. When Birdie sat down, a chipmunk peeked out its head. Her comment to this contrast in living situations, “With hospice, no matter how you live where you are, you get the same care as the next person.”

When I asked Birdie if she gets attached to her patients, she said without hesitation, “You do get attached to them. I can tell when the time is getting short, when it’s getting close.”

I learned that HONC is taking steps to provide emotional care for their volunteers, to ensure that they understand and recognize the symptoms of grief that they might feel after losing their patients. Bereavement coordinators will be providing a seminar for all the volunteers in the organization this fall. Volunteers are encouraged to attend and have been told they can bring friends along because hospice cares for the whole community, not just those receiving hospice care.

Finally, I asked Birdie what hospice meant to her. She answered, “It means everything. It means doing something for somebody else. It means more for me than I could ever do for them.”

Birdie is the model hospice volunteer. But she’s so much more than that...just like hospice is more than just a piece of the United States healthcare system. There are thousands of hospice volunteers, like Birdie, across the country and they are one of the reasons hospice care is so unique. We often hear that volunteers are the “heart of hospice.” They are also the foundation of hospice, as this movement was started by volunteers. They are an integral component of the interdisciplinary model of care that makes hospice special. 

You will not find this type of care in any other part of healthcare in this country. I didn’t need to go back to HONC to understand why hospice is so important because I was already a believer and advocate for our community. But it’s always good to be reminded that people like Birdie are out there, willing to sit with your dying loved while you take a much-needed break, do the dishes that are piling up because you are more focused on caregiving, or sit by your side as you take your final breath.

Hospice might look very different five years from now. Let’s preserve and protect that pieces of  hospice care that make it so special. Let’s make sure the Birdies out there can continue to make house calls to patients and families who need a little extra help.

By Amanda Bow
Senior Director, Communications and Digital Strategy

Thursday, September 26, 2019

OIG Virtual Town Hall for NHPCO Members

NHPCO will host a free Virtual Town Hall for members on Thursday, October 24, 2019 from 1:00 – 2:00 p.m. ET with the Office of Inspector General for the Department of Health and Human Services.

As providers are likely to remember, in July 2019, two OIG reports were released (PDF) that identified concerns with the large number of hospices with survey deficiencies and examples of hospice patients in immediate jeopardy for harm. These two reports have received media and policymaker attention since their release.

This virtual town hall offers members a unique opportunity to learn more about the OIG's specific findings and the suggested reforms OIG is recommending for both CMS and Congress to undertake.

Participants will have the opportunity to learn and ask questions with the authors of the reports including Assistant Inspector General Erin Bliss, Assistant Inspector General for Evaluation and Inspections at HHS Office of Inspector General, Nancy Harrison, Deputy Regional Inspector General Office of Evaluation and Inspections in New York and Jodi Nudelman, Regional Inspector General for the Office of Evaluation and Inspections in New York.

Prior to registering for the Virtual Town Hall, members should review the OIG talking points (PDF) prepared by NHPCO.

Members will find a registration link in NewsBriefs issued September 26, 2019 and available online.

Wednesday, September 18, 2019

NHPCO Hospice Ambassadors on Capitol Hill

Hospice providers from NHPCO are on Capitol Hill, September 17 and 18, to advocate for reforms that would increase access to hospice and palliative care in America’s rural towns and improve hospice care quality.

“All Americans should be given access to quality hospice care, no matter their zip code,” said Sandy Kuhlman, Executive Director of Hospice Services of Northwest Kansas and one of NHPCO’s visiting My Hospice Ambassadors.  “For this reason, we are bringing our message to Washington and asking our representatives to improve and reform hospice and palliative care policies that will increase access, refine oversight, advance education and improve transparency for providers and consumers alike.” 

Hospice advocates are urging lawmakers to support the Rural Access to Hospice Act of 2019 (H.R. 2594), bipartisan legislation introduced by Representatives Ron Kind (D-WI) and Jackie Walorski (R-IN) that will allow Rural Health Centers (RHCs) and Federally Qualified Health Centers (FQHCs) to receive payment for serving as the hospice attending physician. If passed, the legislation would fix a technical glitch that currently prevents terminally ill beneficiaries in underserved and rural communities from utilizing the physician of their choice when entering hospice care.

NHPCO members will also talk to lawmakers about the organization’s Program Integrity Initiative, which overviews provider supported reforms and opportunities for proactive collaboration with Congress and federal regulators to increase oversight, education, and transparency.

“We look forward to working with the Administration and Congress to simplify and streamline the hospice benefit and compliance process to ensure taxpayer resources are spent wisely,” noted Kuhlman. “More oversight of new and poor-performing hospice providers would protect the most vulnerable, while easing unnecessary governmental red tape on honest and law-abiding hospice providers so they can continue to provide high-quality, person-centered care.  Accountability leads to credibility. Our goal is to ensure patients and their families have the utmost confidence in their hospice program.” 

Learn more about the My Hospice Campaign.

My Hospice Ambassadors with members of the board at NHPCO offices on September 17.

Friday, September 13, 2019

Final Day of Virtual Hill Week - Take Action!

Activity throughout Virtual Hill Week (September 9 – 13) has been amazing. Almost 400 advocates have taken over 2,500 Advocacy Actions! This morning, Hospice Action Network announced that there are 18 (!!) New Bill Cosponsors for legislation the hospice community supports.Click here for the list of new cosponsors.

HAN really want to get up to 500 Advocates and 3,000 Advocacy Actions, as well as ensure that every state has their voices heard! Today is the final day of Virtual Hill Day 2019. If you haven’t yet contacted your Members of Congress, please take five minutes to do so.

If you are very short on time, the most important action you can take is making a phone call on behalf of the Rural Access to Hospice Act. When you log in to the Take Action Module and put in your home address, look for the phone icon on the far left to get the phone numbers and short script. Phone calls have a higher likelihood of making an impact, so we encourage everyone to PLEASE, make your phone calls and send emails!

Hospice Action Networks thanks everyone who has participated so far: it is amazing to see the impact you can have in just a few days.

Tuesday, September 10, 2019

Hello and Goodbye: Perinatal Loss Doula Volunteers

The Suncoast Hospice Perinatal Loss Program started in 2004, has recently grown to include a new focus on early first trimester losses and expanded training of volunteer perinatal loss doulas. Our program offers specialized comfort, education, and support to patients and families who may experience, or have already experienced, a pregnancy loss, stillbirth, or death of a baby shortly after birth. Our compassionate team of expert nurses, social workers, chaplains, and trained doula volunteers help patients and their families find understanding and peace through every step of their journeys.

Perinatal loss is often disregarded, its impact negated, leaving the woman and her family struggling emotionally and spiritually. Our doulas (also known as birth companions) understand that birth is a key life experience. They listen thoughtfully to what is important to the woman and her family regarding the birth, providing insight on options for managing the labor and delivery. Doulas offer physical and emotional support to mothers and their partners during labor, delivery, and the immediate postpartum period. They provide a quiet, consistent presence throughout this experience.
After delivery, memory making is an important service that our doulas provide. This involves bathing and dressing the baby, creating hand and foot prints and molds, and obtaining hair locks. Empath Health sewing volunteers make special clothes and blankets used for the baby. These items are placed in a memory box for them to keep. Support pamphlets, brochures, and resources are given to the mother and family as applicable.

In addition, our counselors provide counseling prior to and after the loss. If the pregnancy results in a live birth, our team can work with the family and hospital staff to create a meaningful experience no matter the length of the child’s life. When appropriate, the family can be transferred home to receive care from our Suncoast Hospice pediatric team.

Our Perinatal Loss Program continues to grow and evolve which includes expansion to other hospitals. In turn, we have, and continue to expand the number of volunteer doulas in the program. This entails enhanced doula recruitment and training. To accomplish this, we continue to develop closer collaboration with our Empath Health volunteer department.

This session is intended to develop an increased recognition of the role of the doula during a perinatal loss. Provide a description of the special recruitment and training needs and requirements of Empath Health perinatal loss doula volunteers. Present and describe strategies to develop and implement a perinatal loss program using volunteer doulas.

By Vicki Haywood MSN,  RN, CPAN
Senior Staff Nurse/Care Team Manager
Children’s Program
Empath Health


Vicki Haywood is among the faculty for NHPCO's 2019 Interdisciplinary Conference at the Gaylord Palms in Orlando, Florida. She will be presenting as part of the session, "Hello and Goodbye: Perinatal Loss Doula Volunteers," on Wednesday, November 6, 2019.

Monday, September 9, 2019

Virtual Hill Week Starts Today!

September 9-13, 2019, all hospice and palliative care advocates and supporters should join in Virtual Hill Week and contact their elected officials regarding the importance of hospice and palliative care and some of the legislation that will help improve access.

The Hospice Action Network makes participation easy. Visit the HAN online Take Action Module and you will find everything you need, from reviewing key messaging to finding your legislators and contacting them.

Should you want to take a couple extra minutes to familiarize yourself with this year's policy asks, so you can feel prepared, there is information on the HAN website.

All this week - Monday through Friday - join thousands of hospice and palliative care advocates to make your voice heard on Capitol Hill.  As a participant in Virtual Hill Week, you are standing up for patients and families!

Take action - and spread the word via social media with hashtag #MyHospice.

Friday, September 6, 2019

Fearing Death Can Cause Suffering

When in life does one come to confront the tough truth that each of us will eventually die? In my years as an internist caring for young and old alike, some people understand this early, and some people never get it. In denying death, we intensify our fear of it. Usually, however, it is sometime during their 50s that people first look into the eyes of death. Put it off as we may, the hard certainty is that we are all aging and one day an end will come. Shakespeare described advanced age in his play As You Like It, Act II, Scene VII (All the world’s a stage):

“. . . Last scene of all, That ends this strange eventful history, Is second childishness and mere oblivion, Sans (without) teeth, sans eyes, sans taste, sans everything.”

Shakespeare’s description of advanced age during the 1600s is rather bleak and scary. I think, with modern medicine and the support of a loving family, we could do better. I clearly believe that advanced age and facing our own death should not fill us with dread. The following is a more hopeful version to end Shakespeare’s excerpt:

“. . . He did not have to end his life alone; If over time he’d shared his caring, raised the worth of others, fed the love he’d sown. His death would find him kindly prized and praised, While kin sang festive songs of joy, amazed.”

Fear comes from the oldest reptilian part of our brain. Fear helps us run from attackers but can also make us run from making important choices about our health. Fear can even bring us to push forward with treatment that may cause significant suffering, even when we are very old and even when treatment is futile and it’s time to quit.

Fear of dying can prevent us from making plans about end-of-life care and, most importantly, prevent us from talking to our families about those wishes. How do we want to be cared for if we should lose mental capacity from a stroke or dementia? Do we wish to have a feeding tube, resuscitation, antibiotics when there is no quality of life left, when one doesn’t recognize family and when the only option will be residing in a bed somewhere “sans everything.”

I would rather die and be:

“. . . kindly prized and praised, While kin sing festive songs of joy, amazed.”

By Richard P. Holm, MD
Medical Director
Brookings Hospital Hospice


Dr. Holm is among the faculty for NHPCO's 2019 Interdisciplinary Conference at the Gaylord Palms in Orlando, Florida. His session, "How the Fear of Death Can Be Dangerous To Your Health," will be offered on day one of the IDC.

About the Author
A native of De Smet, South Dakota, Holm earned his B.S. in medicine in 1973 from the University of South Dakota and his M.D. from Emory University School of Medicine in 1975. Holm taught at Emory for three years and practiced medicine in Brookings, South Dakota for 38 years. He was inducted into the South Dakota Hall of Fame and cited as “South Dakota’s Voice of Healthcare” in 2017. His television show, a state-wide weekly call-in show on South Dakota Public Broadcasting is entering its 18th season and his musings on health, Prairie Doc® Perspectives are currently published as weekly columns in more than 100 newspapers in five states including South Dakota, North Dakota, Wyoming, Nebraska and Kansas. “Life’s Final Season: A Guide for Aging and Dying with Grace” is currently available from Holm participates as a Goodreads Author and ongoing updates about his work can be found on the Prairie Doc® Facebook page and website.
Holm is semi-retired and continues to serve as Hospice Medical Director in Brookings.

Magical Orlando Opportunity for Pediatric Patients and Families During NHPCO’s 2019 IDC

In conjunction with the National Hospice and Palliative Care Organization’s 2019 Interdisciplinary Conference at the Gaylord Palms Resort and Convention Center in Orlando, Florida, fundraising affiliate National Hospice Foundation (NHF) is partnering with Give Kids the World Village to provide a special experience to a limited number of pediatric hospice or palliative care patients and their families.  

This trip would include theme park tickets, all meals and lodging for the patient and their parents and siblings, and travel reimbursement from NHF’s Lighthouse of Hope Fund.

“We are excited to offer pediatric patients and families this special opportunity to visit Orlando while hundreds of hospice and palliative care team members from across the country will be there for our annual Interdisciplinary Conference,” said President and CEO of NHPCO and NHF Edo Banach.

“Maximizing quality of life for patients and family caregivers is at the heart of the hospice philosophy of care. As part of our commitment to leading person- and family-centered care, NHPCO is honored to help some special young people make treasured memories with loved ones,” Banach added. 

Eligible patients for this opportunity are between the ages of 3-18, are under the care of an NHPCO member provider, and have not had a prior experience through a wish-granting organization. More information about this opportunity and the application form are available on NHF’s website.

Applications from NHPCO provider members are due October 14; questions may be directed to

About NHPCO’s Interdisciplinary Conference 
The 2019 Interdisciplinary Conference offers a unique blend of keynotes, educational sessions, preconference learning and networking opportunities grounded in the philosophy of the interdisciplinary team.  Attendees engage with colleagues from across the country as they learn about new approaches, successful models, and innovations from the field.

Friday, August 30, 2019

Don't Miss This 2019 IDC Preconference Offering

"Don’t Throw Solutions at the Problem to See What Sticks…a Six Sigma Approach to Focused Problem Solving" 

Hospice programs are experiencing increased scrutiny around the delivery, cost and quality of care.  Hospice providers may encounter further scrutiny from the general public due to the recent OIG report – Hospice Deficiencies Pose Risks to Medicare Beneficiaries, dated July 2019, as well as the media coverage on the report.  It is imperative that hospice providers continue to educate the public about quality care delivery.

Using a systematic approach to improve your quality of care delivery is now more important than ever.    Six Sigma/Lean Sigma is a process improvement method that provides organizations with the tools to improve business and quality processes. The increase in performance and decrease in process variation leads to a reduction in deficiencies, improvement in profits, better employee morale, and a higher quality of services.

At the upcoming 2019 Interdisciplinary Conference in Orlando, Florida, a session about the Six Sigma/Lean Sigma process will be available during the preconference offerings on Sunday, November 3. Participants will learn the difference between Six Sigma and the Lean Sigma approach to problem solving, as well as how to apply a systematic approach to process improvement and identification of root causes of any variance in quality.

As CMS moves closer to a restructured payment model for hospice, providers must ensure efficient delivery of quality hospice care.  An increase in performance and a decrease in process variation, by clinical staff, leads to a reduction in survey deficiencies and an increase in quality metrics reflected in CAHPS scores and Pepper Reports.  Please join us for this preconference offering - Don’t Throw Solutions at the Problem to See What Sticks…a Six Sigma Approach to Focused Problem Solving.

For more information about this preconference offering and the 2019 Interdisciplinary Conference, please visit

Submitted by Sarah McSpadden
President and COO, The Elizabeth Hospice

Sarah McSpadden

Thursday, August 22, 2019

World Hospice and Palliative Care Day, October 12

People from around the world who have been impacted by a life-limiting illness - either personally or by supporting a loved one - will be making their voices heard calling for greater awareness and support of global palliative care services on Saturday, October 12, 2019.

The theme My Care, My Right aims to communicate that palliative care can be demanded by the public - and that, together, every person impacted by a life limiting illness can advocate for palliative care. 

This year's WHPCD 2019 comes on the heels of the UN High Level Meeting on Universal Health Coverage (UHC) on September 23, 2019. Therefore, a key action for the campaign will be to call on governments to listen to people who need or access palliative care and support the inclusion of the essential package of palliative care in all national Universal Health Coverage (UHC) schemes.

The theme of My Care, My Right will address the importance of mobilizing communities, particularly volunteers to ensure that patient’s right to care are supported. Specifically addressing the premise that if care is a patient's right, how can UHC support carers to improve their well being under Sustainable Development Goal 3.8. 

How to get involved:
  • Subscribe to the WHPCA's newsletter for campaign updates and the launch of new campaign materials: 
  • Follow @worldhospiceday on Twitter
  • Follow hashtags: #mycaremyright and #whpcd19
Visit the World Hospice and Palliative Care Day website for resources and consider hosting an event in your community that you can register on the World Day website. 

This is a great way to get reach for November's National Hospice and Palliative Care Month outreach in the U.S.

Friday, August 16, 2019

Virtual Hill Week: Preparatory Webinar #2

Calling all hospice and palliative care advocates!

In preparation for Virtual Hill Week, September 9 – 13, 2019, Hospice Action Network is happy to present the second of three preparatory webinars offered free of charge.

Join the Hospice Action Network lobbying team on Wednesday, August 21 at 3:30 EDT for webinar #2.  Hear the latest news from Capitol Hill, including information on PCHETA and the Rural Access to Hospice Act. Gain a better understanding of how the legislative process works and learn about issues affecting our community.

Register here to attend this free webinar.

If you missed the first webinar, don’t worry. You can view the recording and complete the post-webinar survey here, as well as register for the third webinar in the series.

As an incentive, upon completing all three webinars and all Virtual Hill Week participation requirements (September 9-13), participants will receive a virtual certificate from the Hospice Action Network designating them a 2019 Virtual Hill Week All-Star. And ONE lucky All-Star will be chosen at random to receive a 50% off registration to the 2020 Leadership and Advocacy Conference in Washington, DC.

Remember, you can advocate for hospice and palliative care from wherever you are and carry the voice of our community to Capitol Hill

Feel free to reach out to the HAN team with any questions.

Monday, August 12, 2019

Registration for IDC19 is Now Open

NHPCO will host the 2019 Interdisciplinary Conference on November 4 – 6 in Orlando, Florida. Preconference offerings are on November 2 and 3.

Join hospice and palliative care professionals from across the country colleagues to experience a unique blend of keynotes, educational sessions, preconference learning and networking opportunities grounded in the philosophy of the interdisciplinary team. Engage with colleagues from across the country as you learn about new approaches, successful models and innovations that will advance your professional skill set and help strengthen your organization.

Who should attend? Professionals in the hospice and palliative care field and related stakeholders in the following disciplines and roles: advanced nurse practitioner, bereavement, nurse, palliative care, pediatrics, physician, quality, regulatory and compliance, social work, spiritual care.

IDC19 educational session tracks:
  • Community-Based Palliative Care
  • Interdisciplinary Team Leadership
  • Medical Care
  • Pediatrics
  • Quality
  • Regulatory
  • Supportive Care

Visit the NHPCO website to learn more about IDC19 and to register – register by September 15, 2019 to catch the early-bird rate!

Friday, August 2, 2019

FY2020 Hospice Wage Index Final Rule

On July 31, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a final rule (CMS-1714-F) that demonstrates continued commitment to strengthening Medicare by better aligning the hospice payment rates with the costs of providing care and increasing transparency so patients can make more informed choices.

This final rule updates the hospice payment rates, wage index, and cap amount for fiscal year FY2020.  This rule finalizes rebasing of the continuous home care (CHC), general inpatient care (GIP), and the inpatient respite care (IRC) per diem payment rates in a budget-neutral manner through a small reduction to the routine home care (RHC) rates to more accurately align Medicare payments with the costs of providing care. Additionally, this rule finalizes modifications to the election statement by requiring hospices, upon request, to furnish an election statement addendum effective beginning in FY2021. The addendum will list those items, services, and drugs the hospice has determined to be unrelated to the terminal illness and related conditions, increasing coverage transparency for beneficiaries under a hospice election. Finally, CMS will continue its work to modernize and strengthen Medicare operations through the Hospice Quality Reporting Program (HQRP).

The hospice payment system includes a statutory aggregate cap. The aggregate cap limits the overall payments per patient made to a hospice annually. The final hospice cap amount for the FY 2020 cap year will be $29,964.78, which is equal to the FY 2019 cap amount ($29,205.44) updated by the final FY 2020 hospice payment update percentage of 2.6 percent.

Read the CMS press release on CMS website.

Members of NHPCO will find a comprehensive Regulatory Alert and additional resources on the NHPCO website.

Monday, July 22, 2019

LAC 2020 Call for Proposals is Open

You are invited to lead the conversation around innovation and change by submitting a session proposal. 

The Conference Planning Committee for NHPCO’s 2020 LAC seeks proposals that are highly interactive and provide participants with relevant content and practical tools that they can apply in their own work. Sessions should be designed to engage CEOs, administrators, directors and other leaders working to promote advancement of hospice and palliative care and plan its future development. 

Help shape the future of hospice and palliative care innovation next March by proposing an idea for a session. Share your work in one or more areas of emphasis:
·         Advocacy
·         Clinical and Operations Management;
·         Emerging Markets and Partnership Opportunities;
·         Engagement and Marketing
·         Finance
·         Fund Development
·         Leadership
·         Palliative Care
·         Quality
·         Regulatory
·         Staff Development/Excellence
Review the Call for Proposals tips and suggestions before you submit online. 
Submission deadline: August 7, 2019.

Wednesday, July 10, 2019

NHPCO Responds to New OIG Reports

On July 9, 2019, the Office of the Inspector General released two new reports following its investigation into hospice care in the U.S.  To briefly summarize, the OIG found that 20 percent of hospices have deficiencies that put patients at risk and the OIG is suggesting that among its recommendations that deficiency data be shared more broadly to help improve quality of care. 

News stories prompted by the OIG reports have been carried by The Washington Post, NBC News, and NPR. The journalists writing some of these news stories have shared selected patient stories based on their own investigation. These patient stories are difficult to read and reflect badly on hospice.  It is likely that other media outlets will carry these articles or generate additional news coverage on this topic.

Many of the issues brought up in the new reports have been discussed in previous OIG documents going back to 2005. 

NHPCO President and CEO Edo Banach released some key messages, most notably:

NHPCO welcomes the opportunity to shed a light on high quality providers as well as those that fall short in providing appropriate care. NHPCO will continue to partner with government agencies to strengthen and make more transparent the tools and data needed to empower consumers when they are choosing a quality hospice program. NHPCO will also continue to provide tools and resources to help our members to meet and exceed quality benchmarks.

Monday, July 8, 2019

Free APM Webinar offered by National Coalition

The National Coalition for Hospice and Palliative Care will be presenting a free webinar, New Medicare Alternative Payment Models: Options and Opportunities for Hospices and Palliative Care Programs. There are limited spaces available for the webinar offered on Thursday, July 25, 2019 from 2:00 – 3:00 p.m. ET, so those interested should register as soon as possible. (Please note, this is a new date for this program.)

The program is designed to help prepare the U.S. hospice provider community for the new payment models that were announced in April and are coming. This webinar will be helpful to hospice and palliative program managers and leaders in all disciplines and others interested in the new Medicare payment options.

This webinar will help you:
  • Describe how participation and payment would work in these voluntary models, available in 26 geographic regions across the country;
  • Consider the pros and cons of these new payment models; and,
  • Determine whether to apply to participate on your own and/or whether to work with potential collaborators in your local area, by evaluating the program requirements.

Register while space is available for New Medicare Alternative Payment Models: Options and Opportunities for Hospices and Palliative Care Programs.

Thursday, June 13, 2019

NDS – Send us Your Data!

Now through July 26, you have the opportunity to participate in the NHPCO’s National Data Set.

You may ask---what’s that?  Well, with all the data collected by CMS and other industry sources, there is still a gap in information that is useful for benchmarking your staffing, budgets, and supporting your strategic goals.  The NDS serves as a central collection point for some of this key data and brings together provider experience from across the industry.
By participating, you have access to this industry wide data so that you can benchmark yourself against other providers of similar sizes and geography.  This can be a gold-mine to many providers to help set and confirm staffing levels, budgets, influence delivery of care changes, and shape the goals of your Hospice and its services.  For NHPCO, we use this information to help us derive insights coupled with other data to influence lawmakers and policy that positively impacts our industry so it’s a win: win scenario.

Don’t just take our word for it:
Leanne Burrack, vice president from UnityPoint Hospice, says that her organization often depends on the NDS to benchmark operations.  They have used NDS related data and insights to help create staffing guidelines, inform budget projections, and influence on-going hiring and growth expectations across all disciplines.

Jennifer Kennedy, NHPCO’s senior director, regulatory and quality, uses the NDS results coupled with other data sources and her vast experience to create tools for providers such as NHPCO’s Staffing Guidelines which is designed to help providers develop staffing levels for quality patient/family care delivery.
Examples like these highlights how useful it is to have industry data to help us all work smarter, not just harder.  We need your help, please visit our NDS website to learn more about the specific questions, raffled prizes for participation, and/or to access the survey’s link.

By Don Sievert
NHPCO Senior Director, Decision Support

Monday, June 10, 2019

Contribute to The Hospice Music Project

Joy in a Teardrop: The Hospice Music Project was initiated with the creation of a song, Joy in a Teardrop, which was written as part of a songwriting workshop at NHPCO’s Interdisciplinary Conference in November 2018 in New Orleans. Led by GRAMMY award winning songwriter Tricia Walker and John Mulder, hospice professionals shared reflections of their work and put words to the many emotions experienced in caring for those at life’s end. Walker and Mulder shaped those words and added music to bring Joy in a Teardrop to life.

Spurred on by the hospice community’s positive response to Joy in a Teardrop, NHPCO is launching a  new program, Joy in a Teardrop: The Hospice Music Project, which will result in a full album of songs that reflect the experience of hospice professionals in the work that they do – the joys, sorrows, difficult and challenging times, and even the lighthearted and humorous moments that are a part of everyday end-of-life experiences.

Joy in a Teardrop: The Hospice Music Project, will be led by Tricia Walker and John Mulder, they will be assisted by other highly decorated songwriters, including Beth Nielsen Chapman and Marcus Hummon. These writers will take the thoughts and ideas provided by hospice and palliative care professionals and craft original songs, just as Walker and Mulder did with the original song.

NHPCO invites you to share your ideas with us – perhaps just a word or phrase, maybe a concept or thought, or even a meaningful story or vignette. It may be your experience, the experience of a patient or family, or something that was shared by a coworker.  They can be incomplete and scattered thoughts – we’d just like your reflections on this work that we all cherish.

You can submit your ideas at  If you have any questions about the project, you can also submit those to the same address, and we’ll respond to you.

Wednesday, May 29, 2019

Free Webinar: New Palliative Care Measures Project

The American Academy of Hospice and Palliative Medicine, in collaboration with the National Coalition for Hospice and Palliative Care (which includes NHPCO) and RAND Health are pleased to officially announce a free public webinar to educate health care providers and the public about a Palliative Care Quality Measures Project that is currently underway through a cooperative agreement with CMS.

Attend a free webinar, Measuring Up: New Palliative Care Measures Project, June 26, 2019, 11-12:30 pm ET.

Don't miss the opportunity to participate in a complimentary webinar to learn about and discuss an innovative palliative care quality measures project that is engaging patients and caregivers throughout the measure development cycle.

Learn more and register online.

If you have any questions or need more information, please contact