Attention on Medical Overtreatment Raises Awareness on Advance Care Planning, Hospice and Palliative Care

NHPCO's Caring Connections Encourages People to Learn More

(Alexandria, Va) – Recent media coverage (Associated Press 06/29/10) on the challenges patients and families face with overtreatment of a life-limiting illness brings the issues of hospice and palliative care and advance care planning to public attention.

“It’s important to remember that quality of life and a patient’s personal wishes, beliefs and values must be a factor when making care decisions brought about by a serious or terminal illness,” said J. Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization.

“Discussions helping patients and families understand the many benefits of hospice and palliative care must be more common and held long before a family faces a medical crisis,” Schumacher added.

Advance Care Planning

Advance care planning—which includes completing a living will and appointing a healthcare proxy—is somewhat like planning a road trip to an unfamiliar destination. Very few people would expect to get to a destination safely and comfortably without having a well-thought-out map in hand. Yet, it’s estimated that 70 percent of Americans have not completed a living will.

• A living will charts the course for your healthcare, letting your family and health care providers know what procedures and treatments you would want provided to you—and under what conditions.
• A healthcare proxy or healthcare power of attorney form, allows you to choose someone you trust to take charge of your healthcare decisions in case you are unable to make those decisions yourself.
• Advance directives can be changed as an individual’s situation or wishes change.

Hospice and Palliative Care

Many people mistakenly think that hospice is simply a place you go when nothing more can be done to address an illness. That misunderstanding can keep people from accessing the expert care that hospice and palliative care offers.

NHPCO reports that more than a third of hospice patients received care for seven days or less—not enough time to take full advantage of the range of available services.

Hospice and palliative care provide symptom management, pain control, and support to address emotional, psychological, and spiritual needs.

“Hospice brings patients and families compassionate care when a cure isn’t possible. Palliative care provides comfort and support earlier in the course of a serious illness and is not dependent upon prognosis,” explained Schumacher. “Together, hospice and palliative care provide solutions beyond traditional medical care. Most importantly, hospice and palliative care provide dignity at a time when it’s needed most.”

Important Facts

• Over 80 percent of hospice care takes place in the home.
• Over 1,300 hospitals have palliative care programs; many of the nation’s 4,800 hospice providers offer palliative care services as well.
• Hospice care is covered under Medicare, Medicaid, and most private insurance plans.
• Bereavement services are available to family for a year following the death of a loved one.
• Research has shown that hospice patients lived an average of 29 days longer than similar patients who did not opt for hospice care.

Learn more about advanced care planning, hospice care, and palliative care from NHPCO's Caring Connections at www.CaringInfo.org or call the HelpLine at 1-800-658-8898.

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Contact:
Jon Radulovic
NHPCO, Vice President of Communications
Ph: 703-837-3139
jradulovic@nhpco.org

NHPCO & Alliance to Offer Health Care Reform Phone Forum Next Week

The negotiations, progress and temporary set-backs of health care reform continue, and the hospice community has never had more on the line. Will the BNAF rate cuts be addressed in the bill? Will Congress modernize the Medicare Hospice Benefit and expand access to hospice? Could access be hindered by the health overhaul? Will we suffer more cuts to help pay for reform?

Please join NHPCO President/CEO Donald Schumacher, Vice President of Public Policy Jonathan Keyserling, and members of the Alliance for Care at the End of Life lobbying team on Wednesday, July 29 at 3pm EDT for an update and responses to your questions on the timing, substance and process of what’s to come in health care reform.

Register for the Phone Forum Here

This unprecedented opportunity is being offered at no charge for NHPCO members; however, please be considerate of this generous offer by restricting your registrations to one phone line per hospice program.

Register for the Phone Forum Here

Important Information: Registration closes at noon (EDT) on Monday, July 27. Registrants will receive the call instructions on Tuesday, July 28. CEUs will not be offered for this event. Please send any questions to advocacy@nhpco.org.
We hope you will join this important discussion!

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

NHPCO Statement on MedPAC Recommentdations to Congress

(Alexandria, VA) – Today, the National Hospice and Palliative Care Organization released the following statement upon the release of the Medicare Payment Advisory Commission’s (MedPAC) March report to Congress. The report includes recommendations to revise the Medicare hospice benefit.

Each year, more than 1.4 million patients and family caregivers seek hospice care. The Medicare hospice benefit is responsible for millions of people living as fully as possible until the end of life. The hospice community is dedicated to not only preserving the benefit, but enhancing it so that hospice is able to continue to appropriately serve the unique and changing needs of dying Americans. Hospice and palliative care providers, through the support that comes from Medicare, are recognized as the leading providers of the interdisciplinary, holistic care considered to be the “gold standard” of end-of-life care.

Hospice care is also cost-effective. As was reported in a 2007 Duke University study, hospice reduced Medicare costs by an average of $2,300 per patient, amounting to a $2 billion savings in a single year.

Statement on MedPAC’s Recommendations for Hospice Reform:

Over the past several years, MedPAC has undertaken a review of the Medicare hospice benefit. While specific reforms and enhanced accountability measures are laudable and should be encouraged, those changes should be framed in the context of a comprehensive review of the various and complex components of end-of-life care, and how the continuum of care can be expanded to increase access for patients and families. Included in this comprehensive review of hospice should be payment methodologies, fiscal constraints review, alternative eligibility criteria, testing of new models of care, as well as any number of other issues. The hospice community is committed to work toward these goals.

Guiding this review ought to be several clear principles. Among them are:

• Advancing hospice and palliative care programs as the recognized providers of end-of-life care;
• Preserving and enhancing the Medicare hospice benefit;
• Recognizing “high quality” as the standard to which all providers must subscribe;
• Ensuring accountability through transparency and fair regulatory scrutiny; and
• Promoting increased access through expansion and collaboration.

Payment policy is one of the areas of the Medicare hospice benefit that needs to stay current, so that payment appropriately recognizes changes on patient demographics and treatment protocols. Updates should be carefully considered and evidence-based to ensure that behavioral consequences are understood prior to implementation. The present payment methodology has served the hospice community and the public well since its inception, virtually without change. Analysis of both current and historical patient level data is necessary to fully understand and predict future behavior and needs, and make changes that continue to provide benefits to patients and to the Medicare system.

As with any payment system, dramatic changes to the hospice benefit from established patterns of reimbursement are sure to produce displacements and unintended negative consequences. Given the nature of hospice referrals and the unique characteristics of the end-of-life patient demographics, unintended consequences of such changes are inherently difficult to predict. Any number of issues might warrant attention, but effectively quantifying such items in terms of behavior changes of patients and providers would be difficult. Payment reforms should be incremental, based on adequate data analysis, and need to be undertaken carefully, with effects on the patient and family in mind.

The hospice community applauds the open and informed process that MedPAC undertook to produce the recommendations, and looks forward to working with the Commission, appropriate oversight agencies, and Congress to ensure that the Medicare hospice benefit continues to serve patients at the end of life in the compassionate and high-quality manner that they deserve and expect.”

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Contact:Sara Perkins
Manager, Public Policy Communications
Ph: 703-837-3135
sperkins@nhpco.org
For more information visit, http://www.nhpco.org