Elizabeth Edwards Opens NHPCO's 24th Management and Leadership Conference

Reforming Healthcare and Improving End-of-Life Care: Awakening Our National Conscience

Elizabeth Edwards is a strong and deeply committed advocate for improved and accessible healthcare. She was publicly introduced to America when her husband, then Vice-Presidential candidate John Edwards, was launched into the spotlight in 2004. But it was her down-to-earth personality that charmed America.

Living with Strength, Comfort and Dignity
Mrs. Edwards knows from firsthand experience the need for changes to the healthcare system that will improve access, quality, and – for those facing the end of life – comfort and dignity.
Her personal experience in coping with cancer, caring for aging and ill parents and her professional work in the legal and policy areas have made her a passionate proponent for change.
Strength for the Future from the Foundation of the Past
Mrs. Edwards stated: “It is a test of our characters, individually and communally, what we value and honor when facing the end of life. Individually we do well: hospice professionals, who are trained, do extraordinarily well and even those, like me, who stumble through, do as well as can be expected. Communally, particularly as a nation, we do less well. The regulatory limitations on reimbursement for hospice care under Medicare do not reflect our national will that the ends of life – and all our lives will end – be as comfortable and dignified as possible.”

At NHPCO's 24th Management and Leadership Conference, Mrs. Edwards will share her ideas, perspectives and passion for improving healthcare during the opening plenary session. She will encourage the hospice community to hold fast to the values that founded the modern hospice movement while challenging all to continue to be champions for those at the end of life.
Make plans today to attend the premier end-of-life leadership conference.

• Agenda at a Glance


• Online Registration


• Mail or Fax Registration


• Conference Website

Register today to experience this special plenary session and over 100 innovative sessions at the 24th MLC.

• Preconference Seminars: April 21-22, 2009


• Main Conference: April 23-25, 2009


• Location: Omni Shoreham Hotel, Washington, D.C.

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

Continuity of Physician Care

For Immediate Release:
March 16, 2009

Study Finds that Dying Patients and Families Suffer from Lack of Continuity of Physician Care

NHPCO Stresses the Importance of Continued Involvementbetween Hospice Providers and Patient’s Primary Physicians

(Alexandria, Va) – In a study published in the March 9 issue of Archives of Internal Medicine, researchers found that patients and families can suffer from feelings of abandonment when a physician who had been actively involved in care is no longer involved. Additionally, when there was no continuity between care providers, a lack of closure following the patient’s death was found among families as well as the referring physicians and their staff.

National Hospice and Palliative Care Organization wants to emphasize the importance of the primary physician’s ongoing involvement with a patient and family once a person has been referred and made the transition to hospice care.

“There are certainly challenges in maintaining ongoing communication between referring physicians and hospice providers, but this study demonstrates that there is a need,” said J. Donald Schumacher, NHPCO president/CEO NHPCO. “Having a process in place that enables all parties to stay connected and informed is critically important in keeping the patient at the heart of care. In fact, regulations require it.”

In the Centers for Medicare and Medicaid Services conditions of participation (CoPs) for Medicare certified hospice providers, involvement of the primary physician is indicated. Current CoPs require that the hospice interdisciplinary group complete the patient’s initial comprehensive assessment in consultation with the individual’s attending physician (if any) within five days of the election of hospice. And the care plan developed by the hospice team must be done in consultation with the patient’s attending physician.

As healthcare providers continue to work on creating a more seamless continuum of care from diagnosis through hospice, the need for patients and families to feel supported is critically important.

“All physicians who have cared for a person during a life-limiting illness should continue to be a part of the patient’s journey at the end of life. While the primary physician’s role will change, his or her involvement should not stop when hospice starts,” Schumacher noted.

Recognizing the importance of supporting families, hospices offer bereavement services to family members for a year after the death of their loved one.

Information about hospice, palliative care and advance care planning is available from NHPCO’s Caring Connections, www.caringinfo.org or 800/658-8898.

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Contact:
Jon Radulovic
NHPCO
Ph: 703-837-3139
jradulovic@nhpco.org
For more information visit, http://www.nhpco.org

White House Health Care Forums and Hospice

For Immediate Release:
March 12, 2009

Reiterate the Value of Hospice Care by Participating in White House Regional Health Care Forums

This week, the White House launched a series of regional Health Care Forums to give Americans a chance to submit ideas and ask questions on how to improve our nation’s health care system. These forums offer Hospice Advocates an opportunity to talk about the value of hospice by either attending one of the regional forums, or by submitting questions and ideas through healthreform.gov.

The Regional White House Forums on Health Care are taking place on the following dates and locations. Please keep in mind that tickets are being made available through each state’s Governor’s Office, so policies and ticket availability will vary.

• March 12 – Dearborn, Michigan
• March 17 – Burlington, Vermont
• March 23 – Des Moines, Iowa
• March 31 – Greensboro, North Carolina
• April 6 – Los Angeles, California

President Obama recently introduced the administration’s FY2010 budget proposal, where many health care sectors saw dramatic decreases to their funding as part of a “down payment” to pay for the massive health system overhaul. It’s important to note that Medicare funding for hospice care was not part of that group; however, reducing overall Medicare expenditures will continue to be part of this debate. That’s why it’s important for administration officials and Congress to hear from the community that hospice is part of the solution for families, and for health care reform. The end-of-life care community should rest assured knowing NHPCO is at the negotiating table on Capitol Hill caring the same important messages.

"The debate on overhauling our nation’s healthcare system has been launched in
earnest as lawmakers begin exploring options to meet President Barack Obama’s
goals of improving access and quality during tough economic times," said J.
Donald Schumacher, NHPCO president and CEO.

Should you want to submit suggestions through healthreform.gov or attend a Regional White House Forum by contacting the hosting governor’s office, please feel free to use these suggested talking points:

• Hospice care is part of the solution for patients and families, and as a model of cost-efficient and high-quality health care delivery.
• Hospice is a Medicare cost saver. An independent 2007 Duke University study found that hospice reduced Medicare costs by $2,300 per patient, amounting to $2 billion in savings per year.
• Hospice provides the high-quality care that patients and families want, with more than 98% of served families willing to recommend hospice to others.
• Financial strain could be taken off of the health care delivery system if measures were taken to have patients access hospice earlier
  

The NHPCO Public Policy Team will be happy to answer any questions, contact them at advocacy@nhpco.org.

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

FHSSA Calls Attention to National Women and Girls HIV/AIDS Awareness Day

FHSSA Announces Three Partnerships in Kenya and One in Uganda

(Alexandria, VA) - On March 10, women and girls throughout the United States and around the world, join together to encourage dialogue on the increasing impact of HIV/AIDS. Why is this awareness needed?

• an estimated 61 percent of adult women (age 15+) live with HIV/AIDS in Sub-Saharan African;
  
• globally, the number of woman and girls infected by HIV continues to rise; and
  
• women now comprise half of adults living with HIV.
  

The focus of the fourth annual National Women and Girls HIV/AIDS Awareness Day is HIV is Right Here at Home. The focus is two-fold, to raise awareness and to encourage women and girls to take action - within their communities in which they live.

In honor of this global day of discussion and awareness, the Foundation for Hospices in Sub-Saharan Africa's (FHSSA) is proud to announce four more partnerships that join FHSSA's partnering initiative:

• Hinds Hospice of Fresno, CA with KITOVU Mobile AIDS Program in Masaka, Uganda.
  
• Hospice of Lancaster County, Inc. of PA with Kenya Hospice and Palliative Care Association (KEHPCA) in Nairobi, Kenya.
  
• Hospice of Washington County, Inc. of Hagerstown, MD with Coast Hospice in Mombasa, Kenya.
  
• VITAS Innovative Hospice Care of Chicagoland, Lombard, IL with Eldoret Hospice in Eldoret, Kenya.
  

FHHSA's unique partnering initiative links African hospices and palliative care providers with American hospices and organizations. The partners offer technical support, financial assistance, and perhaps most importantly, encouragement and friendship.

Currently, 78 U.S. organizations in 27 states are partnered with a hospice in one of 16 African countries. These U.S. and African care providers have joined together to make a difference for those suffering with HIV/AIDS, cancer, and other life threatening illnesses.

In many countries in African there is little or no access to adequate pain medication, little or no access to hospice and palliative care and desperate situations of suffering, stigma, poverty, and isolation. This is particularly acute for women and children.

"The Visiting Nurse and Hospice Care team of Santa Barbara, CA is extremely impressed by the progress and achievements made within the past 18 months by our Kenyan parter, Viagenco Integrated Comprehensive Care Program," said Susan Saperstein, RN, of Visiting Nurse and Hospice Care. "The organization provides a holistic interdisciplinary approach to health care and social programs for the community. We feel proud of our involvement and support of Viagenco." 

J. Donald Schumacher, FHSSA presidend and CEO, remarked, "FHSSA's partners are making a profound difference through their efforts and on National Women and Girls HIV/AIDS Awareness Day, we are all working to draw attention to the needs of those who are bravely living their lives in spite of incredible suffering and limited resources. The humanitarian needs are overwhelming but we are seeing partners in the U.S. responding in creative ways. And the support and learning goes both ways. Those in the U.S.  reach out and our friends in sub-Saharan African return the caring and support through powerful lessons we share every day."

To learn more about FHSSA and the partnership initiative or to support this important work, please visit www.fhssa.org, email info@fhssa.org, or call 703/647-5176

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Media Contact: 

Alexzandra Shade

FHSSA Partnering Manager

Ph: 703/ 647-8506

ashade@fhssa.org

Founded in 1999, FHSSA is working to support organizations in their development and provision of hospice and palliative care in sub-Saharan African.

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

NHPCO Responds to Misleading Associated Press Quote

NHPCO Comments on Misleading Quote in Associated Press Article and Provides Helpful Information

Hospice is about Living Life as Fully as Possible

(Alexandria, Va) – The National Hospice and Palliative Care Organization wants all people to know that hospice delivers the highest quality care and services to patients and family caregivers who are coping with life-limiting illness. A recent article carried by the Associated Press (“Assisted Suicide Presents Legal Quandary,” by Greg Bluestein, 03/02/09) carries a misinformed quote from an attorney who incorrectly compared hospice to suicide. This remark was incorrect and demonstrates a lack of understanding about the hospice philosophy of care.

“Hospice compassionately cares for people who are near the close of life – but hospice isn’t about how you die, it’s about how you live. Hospice and palliative care focuses on how dying persons and their loved ones live each day, providing comfort and guidance along the way,” said J. Donald Schumacher, president and CEO of National Hospice and Palliative Care Organization. “The quote from that news article demonstrates a callous disregard for all those who receive care, including family caregivers, from our nation’s hospice programs.”

Hospice is widely recognized as the model for quality, compassionate care for people facing a life-limiting illness or injury. Hospice and palliative care involve a team-oriented approach to expert medical care, pain management, and emotional and spiritual support expressly tailored to the person’s needs and wishes. Support is provided to the person's loved ones as well.

“A common misconception people have is that hospice means you’re ‘giving up’ or ‘that there’s nothing left for the doctor to do,’ and that’s absolutely wrong. Hospice is not about giving up but is about maximizing the quality of life, no matter how long that might be,” Schumacher said.

When cure is no longer possible, hospice provides the type of care most people say they want at the end of life – comfort and quality of life. The most common statement made by families who chose hospice for their loved one is, “we wish we had known about hospice sooner.”

• Hospice focuses on caring, not curing and, in most cases, care is provided in the person’s home.
• Hospice care also is provided in freestanding hospice centers, hospitals, and nursing homes and other long-term care facilities.
• Hospice services are available to patients of any age, religion, race, or illness.
• Hospice provides bereavement support to families for 12 months following the death of their loved one.
• Hospice care is covered under Medicare, Medicaid, most private insurance plans, HMOs, and other managed care organizations
• Research has shown the Medicare beneficiaries that opted for hospice care as opposed to other medical interventions when faced with a terminal illness lived on average 29 days longer than those who did not receive hospice care.

Foundational values of NHPCO include universal access to high quality hospice and palliative care, fully informed decision-making, mitigation of unwanted suffering, non-abandonment and support for the bereaved. NHPCO would encourage all those struggling with serious and life-limiting illness to fully explore hospice and palliative care services before they find themselves in a crisis situation involving options for care of a dying loved one. To learn more about hospice and palliative care, dealing with pain, and advance care planning, visit NHPCO’s Caring Connections at http://www.caringinfo.org/oror call 1-800-658-8898.

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Note: NHPCO’s position statement and narrative on physician assisted suicide is available via the Communications section of NHPCO’s Web site.

Media Contact: Jon Radulovic

NHPCO, Vice President of Communications

703-837-3139

jradulovic@nhpco.org

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

NHPCO Policy Alert regarding the Economic Stimulus

For Immediate Release:
February 18, 2009

President Obama & Congress Act to Ensure Access to Compassionate End-of-Life Care for Patients & Families

One-Year Moratorium on Cuts in Medicare Hospice Funding Signed Into Law

(Alexandria, Va) – The nation’s hospice community claimed a significant victory this week after President Barack Obama signed a bill (H.R. 1-The American Recovery and Reinvestment Act of 2009) into law that includes a one-year moratorium on cuts in Medicare funding for the more than 4,700 hospice programs nationwide. The action ensures that access to quality and compassionate end-of-life care will be maintained for the more than 1.4 million patients and their family caregivers who seek hospice each year.

Over the past year, the National Hospice and Palliative Care Organization, the Alliance for Care at the End of Life, and hospice advocates from across the country have been working to overturn a 2008 regulation issued by the Centers for Medicare and Medicaid Services, which eliminates a key component of the Medicare hospice reimbursement formula known as the budget neutrality adjustment factor (BNAF).

The phased funding cut would have taken $135 million away from quality and compassionate end-of-life care in fiscal year 2009, and has already jeopardized the survival of many hospice programs, particularly smaller, more rural ones. Approximately 3,000 hospice provider jobs were threatened to be cut this year, with deeper job losses expected in fiscal year 2010 as the funding cut enters its second year.

The effort to halt the hospice rate cuts has been underway since the Bush Administration announced its intention to eliminate the BNAF in its FY09 budget

NHPCO and its partners within the hospice community have been engaged in an aggressive grassroots program, mobilizing patients and their families, professionals, physicians, nurses, home health aides, spiritual and bereavement counselors, and volunteers, that has resulted in tens of thousands of calls, emails and letters being sent to elected officials in the House and Senate. As a result, a bipartisan group of lawmakers worked together to have the hospice provision included in the economic stimulus package approved by Congress, and signed into law by President Obama.

“From the start, our efforts have been about ensuring access to high-quality and compassionate end-of-life care for Americans coping with life-limiting illness. We thank our supporters at the grassroots level and in Congress for securing a one-year moratorium on cuts in hospice funding. It’s important that we continue to build upon the momentum that we have now to ensure that patient access is protected in future years by permanently overturning these devastating rate cuts,” said J. Donald Schumacher, president and CEO of NHPCO.

Despite strong, bipartisan opposition in Congress, CMS began implementation of the final rule on October 1, 2008. “If allowed to move forward in FY10, this misguided rule will slash hospice payments by approximately $2.18 billion in the first five years, despite the fact that hospice has been found to be a cost saver for the Medicare program,” Schumacher noted.

A 2007 independent Duke University study found that hospice reduced Medicare costs by an average of $2,300 per hospice patient, amounting to a total of more than $2 billion in savings in a single year.

With the one-year moratorium in place, NHPCO, the Alliance for Care at the End of Life, and Hospice Advocates will now turn their attention to working with the new administration and Congress on permanently overturning the CMS rule to eliminate the BNAF.

NHPCO leadership are meeting with CMS on February 19 to discuss the subsequent process necessary to address the one-year moratorium.

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Contact:

Sara Perkins

Ph: 703-837-3135

sperkins@nhpco.org

or
Jon Radulovic

Ph: 703-837-3139

Jradulovic@nhpco.org

NHPCO is the oldest and largest nonprofit membership organization representing hospice and palliative care programs and professionals in the United States. NHPCO’s mission is to lead and mobilize social change for improved care at the end of life.www.nhpco.org

The Alliance for Care at the End of Life is a 501(c) (4) organization created by the National Hospice and Palliative Care Organization (NHPCO) to provide a more aggressive and comprehensive advocacy voice to serve the entire field and, ultimately, one of America’s most vulnerable populations – those nearing the end of life.www.afceol.org