Showing posts with label healthcare. Show all posts
Showing posts with label healthcare. Show all posts

Thursday, June 9, 2011

A Member of NHPCO’s Leadership Team Shares Thoughts on Death(ly) Panels

I spent Memorial Day Weekend with a group of Cub Scouts ranging in age from six to 11. My son, who is eleven, was excited to be “crossing the bridge” from Cub Scouts to Boy Scouts. The formal ritual, which involved his Den leader saying some nice words about his growth and older Boy Scouts welcoming him to their midst, was an important milestone in my son’s life. He isn’t a little kid any more, he’s a teenager. I have no idea when that happened.



Nor do I know the specific moment when I became the adult caregiver of my mother, who turns 80 this year and has been in good physical and mental shape for years. Yet it hasn’t been easy. The death of her two sisters within six months of one another and two knee replacements surgeries of her own during those difficult months left her exhausted as well as emotionally and physically frail. I flew to Florida to visit her in the facility where she is receiving rehab, arranged for non-medical aides to help her when she moved back home and spent a few days with her so she wouldn’t be alone. This was an important milestone for me as an adult daughter. My responsibility level has increased and there really isn’t any going back.



As adults we experience multiple milestones – planned and unplanned – that mark our progression through life. One day we are happily single and the next we’re in a committed relationship. We’re childless and then become parents in a few short months. We are healthy and the next day we’re told we have a potentially life-limiting illness. It all happens so fast and there’s little we can do to slow down this inevitable march onward, through life’s stages.



We can’t stop it, even though many people try to slow down the aging process through surgery, exercise, nutrition or just plain denial. We can save money for our kids’ education. We can put money away for retirement. But eventually we’re all going to face the fact that we’re all mortal. Even as aware as we all are that we will die some day, we do little to plan for it.



When there is a healthcare crisis, which happens to so many people, we are unprepared, as are our families. We haven’t thought about the type of care we want or don’t want. We haven’t selected someone to speak for us if we can’t talk to the doctors ourselves. We haven’t told anyone whether we would or would not want to be kept alive through medical interventions if the chance of recovery was slim. We haven’t planned properly to make sure we are in control during what might be the last phase of our life.



My son is now memorizing all the Boy Scout pledges, laws and mottos in preparation for his first meeting. To me the most important one, besides “do a good turn every day,” is the one that is best known and yet universally most ignored – “be prepared.”



You can’t avoid the last milestone in life. Hopefully you won’t face it for many years to come. But it will happen, in some shape or form, to all of us. Take a lesson from my son, be prepared. Download a free advance directive, read it through and talk about with your doctor and family members, sign it and give copies to folks who will need it during a crisis. Take control of the phase of your life before that milestone creeps up on you and catches you unprepared.

GUEST BLOGGER: Kathy Brandt, MS, the Senior Vice President, Office of Education and Engagement at the National Hospice and Palliative Care Organization, is a passionate believer in the need to plan for, talk about, and document end-of-life care wishes, and the proud mother of an amazing eleven year Boy Scout.

Wednesday, January 5, 2011

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.

Thursday, September 30, 2010

Schumacher Quoted in Oncology Times

NHPCO's Don Schumacher is quoted in an article in Oncology Times, "Helping Prevent Suicide in Cancer Patients," (September 25, 2010 issue). The article by Robert Carlson begins:

"Oncologists who say they've never had a patient commit suicide simply might not know. The patient who doesn't return for treatment or reportedly died of an accidental drug overdose could have decided, in their suffering, that life was not worth living."

Dr. Schumacher offers some insight from his 30 years of running a hospice program. This is an informative article for oncologists and other healthcare providers.

Read the article online! What are you thoughts?

Wednesday, August 25, 2010

August 2010 ChiPPS Newsletter Released

NHPCO’s Children’s Project on Palliative/Hospice Services has just released the new issue of its newsletter. This issue of the ChiPPS newsletter offers a PDF collection of articles that illustrate the importance of memory making and legacy building in pediatric palliative and hospice care. A message from NHPCO President and CEO J. Donald Schumacher was included – and is shared below.

(Download the PDF collection of articles)

A Message from Don Schumacher

On August 2, I opened NHPCO’s conference, Developing the Care Continuum, with a discussion about the importance of hospice and palliative care in the continuum of care. I wanted to share just a few thoughts with the readers of the ChiPPS newsletter.

I think many people would agree that the US healthcare system is quite fragmented – hence the importance of creating a continuum that includes hospice and palliative care. This must include pediatric palliative care.

Pediatric care has always been near to my heart and as quality-driven providers, we should be able to support the needs and/or assist in care coordination of all those coping serious and life-limiting illness – this includes children, adolescents, and their family members.

I recognize that pediatric palliative care is something many providers feel uncomfortable offering, but it is something we should understand more fully. We must expand our skill set and explore what resources are available to families in the communities we serve. I commend the work of the Children’s Project for Palliative/Hospice Services in developing new tools and resources to move the field forward.

Pediatric palliative care was specifically addressed in the health care reform legislation passed this year. This was a provision that NHPCO strongly lobbied for. The law allows children who are enrolled in either Medicaid or CHIP to receive hospice services without foregoing curative treatment related to a life-limiting illness. This should provide for a more seamless continuum.

When there is a seamless care continuum, providers work together to develop a coordinated plan that addresses all the needs of the patient and family caregivers. Those of you involved in pediatric palliative care know all too well that the needs of these seriously ill young people and families encompass physical, emotional, social, spiritual, nutritional and financial as well as practical and logistical needs. Care and services should be coordinated by professionals who understand the range of options available and appropriate in each situation.

I also want to stress that the concept of the care continuum is not – indeed, cannot be – solely geared to hospice providers. I know there are many hospice professionals working with ChiPPS but there are many others representing a range of provider types and disciplines, and we all must be involved with the development of the care continuum. Working together towards the creation of a seamless continuum will require us to collaborate and partner in a more expansive way than we’ve ever seen in the hospice community.

I believe that every single hospice provider needs to offer non-hospice palliative care. If you do not, somebody else will. Hospices are the experts in serious and life-limiting illness in their communities and they must be leaders in developing a seamless continuum of care.

So what I’m hoping is that hospices in the United States, in addition to the wonderful things they already do providing care in the last months of life, will become more visible and available as providers of or experts in pediatric palliative care.

Thank you for all you do to advance care for young people and their families.

J. Donald Schumacher, PsyD
NHPCO President and CEO

Monday, July 26, 2010

FY2011 Wage Index and Tools for NHPCO Members Now Available

CMS has posted the FY2011 hospice rates and aggregate cap. NHPCO offers members two important tools.

1) FY2011 Excel spreadsheet with the FY2011 wage index and the FY2011 rates for each county in each state.
2) FY2011 rate calculator that projects the wage index values and rates through FY2019. The calculator also allows you to project a percentage growth in your hospice's census for each year.

Links to these tools are available on the Wage Index page of NHPCO's website. Here's a link to the Regulatory Alert that went out to members on July 26, 2010.

Additionally, the PDF of CR7077 is available on the CMS website.

Monday, June 14, 2010

A Message from Don Schumacher, June 2010

Becoming a Larger Part of the Care Continuum

My opening plenary at the Management and Leadership Conference in April touched on many issues that, as an industry, we must be keenly aware of—and address together. In the limited space I have here, I’d like to talk about one of the issues of increasing import right now. That is, finding additional ways to serve more people in our communities.

I actually raised this issue when I became NHPCO’s president/CEO in 2002. As an industry, we were far too dependent on reimbursement from the very fragile Medicare system—and we still are today. While hospice payment reform will be the ultimate catalyst for change, my hope is that all providers will begin taking steps now to assess the needs in their community and explore ways to utilize their skills to meet their broader community’s needs. This is what I mean when I speak of becoming a larger part of the ‘care continuum.’ Much of my plenary address was devoted to this issue and I truly believe it is the very crux of our future success or demise as an industry.

The diversification or expansion of our services is, of course, not a quick or easy task to undertake. It requires planning and a thoughtful business strategy. But it is doable—there are programs which are now demonstrating just how doable it is.

Some hospices are now offering adult day care and home-diversion programs, others have become PACE providers, and still others are expanding into palliative care. In some cases, these providers are partnering with other organizations and in other cases they are going it alone. So I ask that you study the work now being done; explore various reimbursement models, including community-based waiver programs; and identify and begin dialog with potential partners in your community. Our cover story this month shares the process that Pathways Hospice followed to develop its community grief center in Fort Collins, Colorado—an excellent example of how one program assessed a community need and, building on a core strength, expanded its services. Our thanks to Nancy Jakobson, director of the center, for sharing her program’s experience with us.

In the coming months, NHPCO will be providing tools and resources to help you in this process. Our specialty conference in August, “Developing the Care Continuum: Innovative Models to Meet the Unique Care Needs of Patients/Families” will also serve as a dynamic forum to help jumpstart discussions among providers.

I encourage every provide-member to find additional ways to become a larger part of the care continuum. If we don’t step up, others will—leaving our industry a very marginalized component of the nation’s new healthcare system.

Don

Note: Don’s monthly message appears in NewsLine; members can access this month’s and previous issues at www.nhpco.org/newsline.

Tuesday, March 23, 2010

Health Care Reform Bill Has Moved Through Congress and Signed by President Obama

A Quick Recap

For more than a year, the hospice community has been on the edge of our collective seat, watching the political process that has consumed health care reform. First there were three bills, and then the House and Senate each settled on one version they each wanted to put forth.  At the end of 2009, we were waiting to see if and when the White House would weigh in and choose a direction to pursue toward passage. At the same time, Republican leadership continually urged for a re-start of the process, from scratch. Along the way, we lost Senator Ted Kennedy, a long time health reform champion and a very good friend of the hospice community. We’ve also had multiple changes in leadership of the committees with jurisdiction over health care reform. To say that this journey has been a winding road is an understatement, but with each curve, Hospice Advocates have been very clear and unified in our messaging to Congress. During this process, we have sent Purple Folder Letters to the White House by the dozen, filled up the White House Comment Line, and contacted Congress (more than 70,000 contacts) so much that they probably recognize you by name!, Now this part of the process is drawing to a close. In the past 24 hours, Congress has moved into the final stages of this round of health care reform.
 
What Passed and What it Means for End-of-Life Care

Sunday night, by a vote of 219-212, the House passed H.R. 3590, the Patient Protection and Affordable Care Act. H.R. 3590 is actually the version of health reform that originated and passed out of the Senate last December. This version of the bill, the one that has now passed both chambers of Congress, softens the productivity cuts to hospice from a proposed $10 billion to $7.8 billion. Here’s an overview of what is in the final package relevant to end-of life care:
 

  • Market Basket Cuts & Productivity - Incorporates a productivity adjustment reduction into the market basket update beginning in fiscal year 2013, as well as a market basket reduction of .3 percent for hospice providers from fiscal years 2013-2019.  Note that these cuts will not take effect until FY 2013.
  • Hospice Payment Reforms – (1) This provision would require the Secretary to collect data and update Medicare hospice claims forms and cost reports by 2011.  (2) Based on this information, the Secretary would be required "implement revisions to the methodology for determining the payment rates for routine home care and other services included in hospice care" no earlier than FY 2013.  (3) After January 1, 2011, a hospice physician or nurse practitioner must have a face-to-face encounter with each hospice patient to determine continued eligibility for hospice care prior to the 180th-day recertification and each subsequent recertification, and attest that such visit took place.  In addition, the Secretary will medically review certain patients in hospices with high percentages of long-stay patients.
  • Medicare Hospice Concurrent Care Demonstration Program - Directs the HHS Secretary to establish a three-year demonstration program that would allow patients who are eligible for hospice care to also receive all other Medicare covered services while receiving hospice care. The demonstration would be conducted in up to 15 hospice programs in both rural and urban areas and would undergo an independent evaluation of its impact on patient care, quality of life and spending in the Medicare program.
  • Curative and Palliative Care for Children in Medicaid and CHIP - Allows children who are enrolled in either Medicaid or CHIP to receive hospice services without foregoing curative treatment related to a terminal illness.
  • Independent Payment Advisory Board - Creates an independent Payment Advisory Board tasked with presenting Congress with comprehensive proposals to reduce excess cost growth and improve quality of care for Medicare beneficiaries as well as the private health system. When Medicare costs are projected to be unsustainable, the Board’s proposals will take effect unless Congress passes an alternative measure that achieves the same level of savings. Congress would be allowed to consider an alternative provision on a fast-track basis. Requires the Board to make non-binding Medicare recommendations to Congress in years in which Medicare growth is below the targeted growth rate.  Beginning in 2020, requires the Board to make binding biennial recommendations to Congress if the growth in overall health spending exceeds growth in Medicare spending.
  • Hospice Value Based Purchasing/Promoting High Value Health Care - Provides the Secretary of HHS the authority to test value-based purchasing programs for long-term care providers, including hospice providers, no later than January 1, 2016.
  • Quality Reporting - Requires hospice to report on quality measures determined by the Secretary (endorsed by the new quality measure consensus-based entity) or face a 2 percent reduction in their market basket update. Measures published in 2012 for reporting to begin in 2014. 
  • Nationwide Program for National and State Background Checks on Direct Patient Access Employees of Long-term care Facilities and Providers - Establishes a national program for long- term care facilities and providers to conduct screening and criminal and other background checks on prospective direct access patient employees.
  • Advancing Research and Treatment for Pain Care Management - Authorizes an Institute of Medicine Conference on Pain Care to evaluate the adequacy of pain assessment, treatment, and management; identify and address barriers to appropriate pain care; increase awareness; and report to Congress on findings and recommendations. Also authorizes the Pain Consortium at the National Institutes of Health to enhance and coordinate clinical research on pain causes and treatments. Establishes a grant program to improve health professionals’ ability to assess and appropriately treat pain. 
  • Education and training programs in pain care - Secretary may make grants available to hospices and others to develop and implement pain care education and training programs for health care professionals. 

You may still hear talk of the reconciliation bill over the next week or two. More information on that package and the related legislative process can be found in our previous health care reform update. However, we feel confident that all of the health reform provisions that will impact hospice are contained in the package that passed yesterday and are listed above.
 
We’re Still Fighting
While we appreciate the fact Congress continues to embrace hospice as a vital part of health care at the end of life and we’re pleased to see the provisions included expanding access to hospice, we simply can’t afford to lose $7.8 billion from the national investment in end-of-life care. 
 
We have said it all along; two cuts are too much for hospice. And, we mean it. The productivity cuts on top of the more than 4 percent regulatory reduction associated with the elimination of the budget neutrality adjustment factor (BNAF) we are absorbing over the next seven years, is more than the community can or should sustain. As an aside, you, as a Hospice Advocate, working through NHPCO, were the reason the phase-in of the BNAF cuts went from the previous Administration’s plan of three years, to the current schedule of seven years. This gives the hospice community more time to plan for and manage the implementation of these unwarranted cuts.
 
Accordingly, with Capitol Hill Day 2009 just weeks away, NHPCO will be leading the hospice community in a measured, strategic, and phased fight to further soften the cuts before they go into effect in 2013. We’ve done what we needed to do for this phase of health reform. The hospice community was a resource to Congress during this trying past year. We were heard when we said $10 billion was too much to take from hospice and our policy makers heard us when we asked for increased access to hospice for pediatric patients and concurrent care. 
 
NHPCO will continue to ensure that hospice is "at the table" after the political dust settles and before the community and the patients we serve feel the brunt of the cuts.
 
You may be asking, "Why wait until Hill Day, why does it need to be phased?" To be honest, the health care decision makers on Capitol Hill are going to be burned-out and not ready to revisit the reform legislation for a while…probably not until after the November elections. But, that’s good news for us. With Hill Day, away from all the "noise" of health care reform, we will launch an education effort to reacquaint our federal elected officials with the Medicare Hospice Benefit, who we are as a community, the patients we serve and the invaluable services that are provided by hospice in every community across the nation. A focused and consistent re-education effort is critical to a successful, phased strategy to get additional relief from the cuts.
 
Immediate Next Steps
Obviously, the more people we can get on Capitol Hill on April 21st, the stronger the launch of our re-education effort will be. So, visit the Hill Day 2010 Information Page for more information and to register. And for those of you who cannot join us in D.C., stay tuned for exciting opportunities to participate from home!
 
Most importantly, as a unified community with one voice, we need to get the facts together to show Congress what the cuts will mean to the hospice programs that serve their communities and constituents. The NHPCO Regulatory Team has been hard at work on a comprehensive, easy-to use calculator for programs to use to determine the long-term impact of the combined cuts. NHPCO members should receive an email in the coming days with a link to this interactive tool. 
 
As always, we thank you for your Hospice Advocacy. We may not have the end-result we want yet, but your efforts have come a long way in advocating for the patients and families who depend on compassionate, high-quality end-of-life care. Please let us know if you have questions about any of this information by contacting advocacy@nhpco.org.

Tuesday, March 16, 2010

Wear a White Ribbon to Raise Awareness of Advance Care Planning

Fifth Anniversary of Terri Schiavo’s Death:
Wear a White Ribbon to Raise Awareness of Advance Care Planning

National Hospice and Palliative Care Organization Reminds People, “It’s About How You LIVE”
(Alexandria, Va) – Five years ago national attention was riveted as the husband and parents of Terri Schiavo waged a very public legal battle regarding who had authority to determine if she would have wanted artificial means to prolong her life. While many Americans learned about the importance of planning for critical healthcare decisions before a crisis, two-thirds of the public have not completed an advance directive.

As the fifth anniversary of Ms. Schiavo’s death approaches on March 31, the National Hospice and Palliative Care Organization is encouraging all Americans to wear a white ribbon to increase awareness of advance care planning. The ribbon also reminds people of the importance of both documenting wishes by completing an advance directive, and talking with their loved ones about their care decisions before a medical crisis.

An individual’s preferences for the kind of medical care they would or would not want are very personal and important decisions. Advance care planning lets you decide the kind of healthcare you want at the end of your life—and helps you make your wishes known.

“It doesn’t matter whether you want every medical intervention available up until the day you die, or whether you want to spend the final period of your life receiving what many call ‘comfort care,’—it should be your decision,” said J. Donald Schumacher, NHPCO president and CEO.

“Another critical piece of advance care planning includes talking about your decisions with your loved ones, healthcare providers, clergy, and others important to you,” Schumacher added.

People are occasionally confused by the terms associated with advance care planning. One aspect of an advance directive, called a living will, lets you explain the care you would want. An advance directive also includes a healthcare power-of-attorney which enables you to appoint someone to make medical decisions on your behalf should you not be able to speak for yourself.

The advance care planning ribbon was created by NHPCO’s consumer-engagement program, Caring Connections, to help people focus on the message: “It’s About How You LIVE.” The vision of the LIVE campaign is to motivate people to take at least one step along a continuum of learning, implementing, voicing and engaging in end-of-life issues before a crisis arises.
Advance Care Planning Ribbon Campaign materials are available online and include pledge cards, flyers, Powerpoint presentations and more. (Note: Advance Care Ribbon lapel pins are available from NHPCO's Marketplace.)

Two weeks after this anniversary, annual National Healthcare Decisions Day will be observed in communities across the country. This national day of awareness, held on April 16 every year, is promoted by national, state, and local organizations including healthcare providers, advocacy groups, attorneys, and other organizations. Learn more about this day of outreach at nationalhealthcaredecisionsday.org.
More information about advance care planning is available at caringinfo.org/planningahead or by calling the HelpLine at 1-800-658-8898.

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

Friday, March 12, 2010

What Are Living Wills? NHPCO offers free advance care planning resources

(Alexandria, Va) – Over the past weeks, Keith Olbermann has shared his personal experience regarding his father’s health crisis on his MSNBC program “Countdown.” On yesterday’s broadcast (03/11/10) Olbermann spoke about the necessity of loved ones talking about the care they would want and completing a living will and appointing a health care proxy.

“Talking with families about health care wishes and completing living wills while you are healthy is about living fully,” said J. Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization. “Planning ahead and understanding the choices you and your loved ones might have to decide during a medical crisis has nothing to do with the infamous ‘death panels’ that have caused such confusion and distraction about an issue important to every single one of us.”

NHPCO’s Caring Connections initiative offers a range of materials and information free of charge—including state specific advance directive forms—at
caringinfo.org/planningahead.

Planning ahead is about preparing for the future today. Communicating your end-of-life wishes to your loved ones, appointing a health care power of attorney, and addressing financial issues such as wills and paying for long-term care are just a few of the issues you can address today to plan ahead.

What are Advance Directives?

An advance directive—often called a living will—allows you to document your wishes concerning medical treatments and care when facing a medical crisis or at the end of life.

A medical power of attorney—also known as a health care proxy—is part of advance care planning. This allows you to appoint a person you trust as your health care agent (or surrogate decision maker), who is authorized to make medical decisions on your behalf. Before a medical power of attorney goes into effect a person’s physician must conclude that they are unable to make their own medical decisions.

Advance directives are legally valid throughout the United States. It is important to complete and sign advance directives that comply with your state's law. However, you do not need a lawyer to complete and execute a living will or health care power of attorney. Each Caring Connections, state-specific advance care planning packet comes with complete step-by-step instructions. The documents are free of charge.

Visit
caringinfo.org to learn more about planning for the unthinkable before a crisis. Information is also available from the HelpLine at 1-800-658-8898. Providers are encouraged to share these resources with their community.

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Caring Connections offers resources to help providers reach out and educate communities about advance care planning. Here are some of the resources that can be found on the Caring


Connections website:
·
How to Talk with Your Loved Ones
· What to do if Family Members Disagree
· How to Talk with Your Healthcare Providers
· Talking with Others about Their End-of-Life Wishes
· Are You Traveling Without a Map? A Layperson’s Guide to Advance Care Planning
· Advance Care Planning Awareness Ribbon

Contact:

Kathy Brandt
Vice President, Innovation and Access
Ph: 703-837-3125

Jon Radulovic
NHPCO Vice President, Communications
Ph: 703-837-3139

Wednesday, February 24, 2010

Tune In and Tweet Tomorrow for the Health Reform Summit

Tomorrow's Health Reform Summit convened by President Obama will once again bring Health Care Reform to the political forefront and could possibly pave the path forward for the reform effort for the rest of the year. As Hospice Advocates know, the legislative effort toward national health reform has slowed significantly since the political dynamics in the Senate changed with the election of Scott Brown (R-MA).

If health reform regains momentum, the hospice community faces monumental changes in the current reform drafts passed by the House and Senate. While we can't expect the President's Summit to get into the details of how reform would impact end-of-life care, it is important that we understand where the political dynamics are driving the process and what the President and Congress put forth as guiding principles for the effort.

You can witness the bipartisan summit from your television or computer on Thursday, February 25 at 10 a.m. Eastern.

Just tune in to C-SPAN 3 or visit http://www.whitehouse.gov/live to watch Members of Congress and the President have a dialogue on health reform and see how the summit will influence the issue in the coming months. As you watch, share your thoughts with us on Twitter @hospiceaction. Your tweets help us shape our advocacy efforts here in Washington.

For more information on hospice and health reform, visit NHPCO's Health Reform Resource Center.

New to twitter? Email han@nhpco.org for help.

As always, thanks for your Hospice Advocacy!

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

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, http://www.nhpco.org

Tuesday, November 3, 2009

New Facts & Figures - Concern over short stays.

NHPCO Cites Concern Over Growing Short Length of Service in New Facts and Figures on Hospice Care in the U.S.

New Report on Hospice Care in America Released as November’s National Hospice/Palliative Care Month Begins

(Alexandria, Va) – More than 35 percent (35.4) of patients served by hospices in 2008 died or were discharged in seven days or less reports the National Hospice and Palliative Care Organization. This reflects a 4.6 percent increase from 2007, when 30.8 percent of patients had what is considered a short hospice experience.

Patients and families receiving care for seven days or less are often unable to take full advantage of the range of benefits that the hospice interdisciplinary team provides. These benefits include psychosocial support and spiritual care for patients and their families as well as pain management and symptom control,

While the average length of service increased from 67.4 days in 2007 to 69.5 days in 2008, the jump in patients receiving care for a short time is of concern to hospice providers and NHPCO.

Only 12.1 percent of those served died or were discharged with service of 180 days or more.

These statistics are featured in the report, “NHPCO Facts and Figures: Hospice Care in America,” which was released by NHPCO as the hospice and palliative care community begins to mark National Hospice/Palliative Care Month, an annual month of awareness and outreach celebrated every November.

NHPCO emphasizes the value of hospice care over the last months of a person’s life, not just the last days.

“More awareness of the care options available when facing a serious or life-limiting illness—among both the public and healthcare professionals—is still needed,” said J. Donald Schumacher, NHPCO president and CEO.

“The advance care planning provision that has been so hotly debated in health care reform discussions could be an important mechanism for helping dying Americans avoid hospice experiences that are too short to fully help them or their family caregivers.”

Learning about options before a patient and family are faced with a health crisis is strongly recommended by NHPCO. Hospices frequently provide information to community members interested in advance care planning.

Additional information about hospice, palliative care, and advance care planning is available from NHPCO’s Caring Connections at www.caringinfo.org or by calling the HelpLine at 800-658-8898.

“NHPCO Facts and Figures: Hospice Care in America,” is available in the News Room at www.nhpco.org.

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


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

Friday, August 14, 2009

Misinformation, Health Care Reform, and the Media

A Message from J. Donald Schumacher
August 14, 2009

Misinformation, Health Care Reform, and the Media

As many people know, NHPCO has been working actively to clarify misinformation among national and regional media regarding health care reform legislation. An important part of our outreach has been to correctly explain the advance care planning provision and stress the value of this benefit for all Americans.

NHPCO leadership have spoken with reporters and producers with all the major network news outlets, ABC, NBC, CBS, and CNN, as well as the Associated Press, Wall Street Journal, NY Times, Washington Post, and many others.

Some highlights include NHPCO's Kathy Brandt interview on National Public Radio's "Morning Edition" and Jon Keyserling’s interview on CNBC. NHPCO also provided information for the new feature that debuted on ABC Evening News with Charlie Gibson, "Fact Check," where the inaugural issue on this new segment was the misinformation about the advance care planning provision.

It's difficult to hear false and misleading statements in the media but rest assured that we are responding as effectively as possible. NHPCO offers some information that may be helpful. This includes:

Talking Points on advance care planning and health care reform.
• NHPCO’s press release from August 7.
NHPCO’s analysis about the advance care planning provision in the House’s bill.

NHPCO’s Caring Connections has some useful information about advance care planning that helps explain what it is, including a new piece that uses metaphor to explain the concepts:

What is Advance Care Planning
Healthcare Agents: Choosing One and Being One
Preparing Your Advance Directives
• NEW - Are You Traveling without a Map? A layperson's guide to advance care planning (PDF)

There have been any number of excellent news reports, articles and op-eds that clarify the misinformation but those are often overshadowed by the conflict. Here are some links of interest that people may be interested in looking over:

• "Honest Talk About the End," Newsweek, by Eleanor Clift, 07/31/09.
• "Elderly Americans should read the health care bill: It won't kill them," Cleveland Plain Dealer, by Connie Schultz, 08/02/09.
• "Getting health care healthy: Accepting death outside the hospital," * Chicago Tribune, by Anne Moore, 08/05/09.
• "Health Care Reform: The Assault on Truth," AARP Bulletin Today, 08/14/09.
• “Here’s the truth, Granny,” Obit Magazine, by Judy Bachrach, 08/11/09.
• "Health Care: Will Section 1233 Hasten Patient Deaths?" American Center for Law & Justice (from Christianity Today), 08/11/09.
• "Three Myths about the Ethics of Health Care Reform," Association of Bioethics Program Directors.
• "Advance-directives section fueling concern and, hospice officials say, misunderstanding," Winston-Salem Journal, 08/13/09.
• “While others rant, hospice keeps helping,” Orlando Sentinel, 08/14/09.
• “Doctors Providing End-Of-Life Counseling See Benefit In Current Controversy,” Kaiser Health News, 08/14/09.


At NHPCO, we will continue to do our best to provide accurate information that we hope will help Americans understand the value of advance care planning.

The importance of patient wishes have always been integral to the hospice philosophy of care and we understand why the provision in the House bill would only serve to benefit Americans. We also understand how complicated and challenging issues surrounding death and dying are for many people. And when faced with what seems like sweeping change in health care reform discussions, it is understandable that many people are passionate—and frightened. Yet, I have faith that in the days ahead, the truth about caring for people at the end of life and the importance of advance care planning will begin to spread where there has been misinformation and false accusation.

To cite our outreach materials, hospice and palliative care are about how you live. Making one’s wishes know is an important part of life’s journey.

I encourage all hospice and palliative care providers to continue with the important work they do to help patients and families and their broad communities. I am proud to be working with such a dedicated community—all those providing hospice and palliative care.

Thank you.

J. Donald Schumacher
President and CEO


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

Thursday, July 23, 2009

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

Thursday, July 16, 2009

Google Health and Caring Connections

National Hospice and Palliative Care Organization’s Caring Connections and Google Health Offer New Way to Access Advance Directives Online

Alexandria, VA – Ensuring that one’s healthcare wishes are known and will be honored in the event of a healthcare crisis is what advance care planning is all about. Today, the National Hospice and Palliative Care Organization’s Caring Connections, a leading provider of advance care planning information, and Google Health™ have come together to increase the availability and accessibility of advance care planning information and resources online.

Advance directives, also known as living wills and healthcare power of attorney forms, allow an individual to express their wishes if they are in a medical crisis and unable to communicate. These documents provide specific information to healthcare professionals and can help guide family caregivers called upon to make decisions on behalf of someone who is not able to speak for themselves.

“How can medical professionals honor your healthcare wishes and preferences if they don’t know what they are?” said J. Donald Schumacher, president and CEO of NHPCO. “Advance directives are useless unless they are available during emergency healthcare situations. Google Health will make these documents accessible online and will eliminate a huge barrier of access during times of need.”

A new feature on Google Health enables users to download a free, state-specific advance directive and store the scanned documents securely online. This will help overcome a common barrier in emergency healthcare situations, where it can be difficult to access a patient’s advance directive.

Google Health is a secure, online Personal Health Record (PHR) that allows consumers to store, organize, and share important healthcare information. Google chose to work with Caring Connections because they are the only provider that offers free, state-specific, online advance directives. In the past three years, Caring Connections has distributed more than 2.5 million advance directive forms. They also provide information to help people understand advance care planning and begin conversations with family and healthcare professionals.

The process to store an advance directive form in Google Health is easy:


  1. Go to your Google Health account at google.com/health, or create a new account if you don’t have one already.

  2. Download and print the advance directive form for your state at caringinfo.org/googlehealth

  3. Complete the form and sign it.

  4. Scan the signed document and upload it to your Google Health account.

By taking time to do these simple steps, you are making your healthcare wishes available to those who may need them in a time of crisis. Not only is this an important step to take for your own well-being but it’s a gift for your family members and loved ones who may need to act on your behalf.

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Contact:
Jon Radulovic
NHPCO
Ph: 703-837-3139
jradulovic@nhpco.org
www.caringinfo.org
Caring Connections is a program of the National Hospice and Palliative Care Organization. Learn more at CaringInfo.org.

Tuesday, June 30, 2009

Monthly Message from NHPCO's President and CEO Don Schumacher

July 2009


Exploring Multiple Pathways to Earlier Referrals


Our cover story this month draws needed attention to the myths surrounding palliative care. Much like hospice, palliative care is not being fully utilized within our nation’s healthcare system due to sheer misunderstanding on the part of patients and physicians. As the author notes, there are nearly one million patients who are dying in hospitals or other institutions each year who are unaware of the palliative care services available to them—care that would not only help them, but would also reduce hospital and pharmacy costs.


While it’s certainly our collective responsibility to help educate our communities about palliative care, we are missing a very important opportunity if we don’t do more—if we don’t expand into palliative care ourselves. In one of my first conference plenary addresses as president/CEO of NHPCO, I urged members to “think outside the Medicare Hospice Benefit box” and explore palliative care as a pathway to earlier referrals. I was not asking members to do something I had not done myself. While president/CEO of a hospice program in Buffalo, I was one of the first providers to integrate palliative care into our continuum of care and saw firsthand the many benefits of such expansion.


Today, with healthcare reform very much a reality and with CMS now looking at ways to serve more Americans more cost effectively, there is even greater reason to expand our expertise into other cost-effective services. Palliative care is a natural fit for hospice providers.


Opportunities at the National Level


This month’s secondary feature recaps findings from NHPCO’s recent Economic Impact Survey. Understandably, most programs reported a reduction in revenue, with reasons ranging from reductions in average daily census to expected reductions in philanthropic contributions and changes in payment rates. First, on behalf of NHPCO, my thanks to all of you who took time to respond. Secondly, NHPCO hears you.


While NHPCO can’t address all of the factors that are impacting your bottom line, we are committing significant resources to the one that poses the greatest threat to the majority of members—Medicare Hospice Benefit rates. In partnership with The Alliance for Care at the End of Life, protecting these rates remains our top priority (see page 16 for an update on our advocacy efforts). However, we are also exploring other ways to improve your bottom line through expansion of the Benefit. NHPCO’s Public Policy Committee recently approved two potential demonstration projects to examine concurrent care and transitional care, both of which would enable hospice providers to build relationships with patients and families earlier in the illness trajectory and, in so doing, improve hospice utilization.


A favorite expression of mine reminds us that there are, indeed, many paths up a mountain. In today’s hospice environment, we must be open—and willing—to explore them all.




Don






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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