(Alexandria, VA)—The National Hospice and Palliative Care Organization today urged the Medicare Payment Advisory Commission to adjust the community’s 2010 projected profit margins from 4.6 to 2.6 percent in order to more accurately reflect hospice’s unique, mandatory program costs of volunteer and bereavement services.
The Medicare (and Medicaid) hospice benefit includes all care related to the terminal illness, as well as requires programs to provide up to 13 months of bereavement services to the families and loved ones of the beneficiary after he or she dies. In addition, the Medicare hospice benefit requires that trained volunteers provide at least 5 percent of the patient care hours. These services are mandatory as detailed in the hospice conditions of participation, and this is unique to the hospice benefit.
“While other providers also may establish volunteer programs, and perhaps the cost of those programs are considered non-reimbursable costs on the Medicare cost report, we know of no other provider that is federally required to establish and maintain a volunteer program and to track and document the cost savings achieved,“ said NHPCO Vice President of Public Policy Jonathon Keyserling. “The costs of both volunteer and bereavement services must be included in the margin computation.Any other approach would ignore the financial reality of hospice programs bearing these mandatory costs.”
MedPAC staff projected hospice margins of 4.6 percent for 2010. NHPCO contends this figure overstates the actual margin being experienced by most hospice programs.
“The MedPAC staff previously noted that they estimated bereavement costs to be about 1.5 percent. Another cost for every hospice program is the cost of administering and tracking volunteer services, but these also are not considered in margin calculations. We estimate that the cost of volunteer services would be 0.5 percent. Therefore, the “true” margins of hospice programs, providing the range of required services under Medicare, would then be 4.6 percent minus 1.5 percent minus 0.5 percent yielding a ‘real’ margin of 2.6 percent,” Keyserling said.
The 2008 MedPAC projection for hospice margins was 3.4 percent. NHPCO argues that a 4.6 percent projection for 2010 indicates, mistakenly, that hospice margins are growing.
“The discrepancy in the numbers is an indication of a change in the calculation methodology, by excluding the costs of delivering statutorily mandated services, rather than pointing to the fact that hospice margins are actually shrinking. For MedPAC to recommend countering an erroneous growth in hospice margins by reducing the annual inflationary adjustment is absurd and potentially devastating to the hospice community,” Keyserling concluded.
NHPCO is committed to working with the MedPAC staff and Commissioners to address and resolve issues, both perceived and real, within the hospice community.
“We look forward to working with MedPAC staff and Commissioners to fully explore the available data before payment reform is implemented,” said NHPCO President and CEO J. Donald Schumacher. “NHPCO is also committed to a full discussion of the costs of care and a detailed analysis of the data elements that will be necessary for comprehensive data collection.”
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Media Contact:
Michele Matthews
Manager, Public Policy Communications
Direct: 703-837-3135
mmatthews@nhpco.org
For more information visit, http://www.nhpco.org
Thursday, January 14, 2010
Tuesday, December 22, 2009
New Legal Guide for the Seriously Ill
Legal Guide for the Seriously Ill Written by the American Bar Association
Guide Commissioned by NHPCO and Created by American Bar Association Commission on Law and Aging
(Alexandria, Va) -- The onset of a serious illness or injury can affect much more than a person’s health. Knowing what steps to take to get one’s financial and legal affairs in order is often vitally important not only to the affected individual, but to his or her loved ones as well.
The "Legal Guide for the Seriously Ill" -- a project by the American Bar Association Commission on Law and Aging commissioned by the National Hospice and Palliative Care Organization -- was designed for both the seriously ill individual and those caring for someone who is seriously ill. The guide explains “Seven Key Steps” in a brief, clear way while offering additional tips and resources for readers looking for more detailed information and guidance.
The recently released guide addresses societal issues that have gained prominent media attention in recent years, such as paying for health care, managing health and personal decisions, and patient rights. In addition, the Legal Guide for the Seriously Ill sheds light on recent legislative and regulatory changes, such as the recently enacted American Recovery and Reinvestment Act of 2009, which provides a 35 percent subsidy of the COBRA premium for up to nine months.
“The Legal Guide for the Seriously Ill is a great resource for anyone facing a serious illness. The book provides critical tools that help readers understand their options, make informed decisions, and minimize some of the anxiety they may be feeling about their financial and legal affairs at this stage of life,” said ABA President Carolyn Lamm.
J. Donald Schumacher, president and CEO of NHPCO added, “Hospice and palliative care organizations are frequently asked for information regarding end-of-life planning and decision-making. This guide will be a tremendous resource to them as well as faith communities, caregiver organizations, aging service providers, hospitals and others who work to support people living with a serious illness.
Ellen M. Klem, staff attorney of the ABA Commission on Law and the Aging, reminded readers that the book does not give legal advice, but will “arm readers with knowledge about the options they have during this difficult time.”
The views expressed in the book have not been approved by the House of Delegates or the Board of Governors of the American Bar Association and, accordingly, should not be construed as representing the policy of the ABA.
"Legal Guide for the Seriously Ill" is available online at the Caring Connections Web site.
With nearly 400,000 members, the American Bar Association is the largest voluntary professional membership organization in the world. As the national voice of the legal profession, the ABA works to improve the administration of justice, promotes programs that assist lawyers and judges in their work, accredits law schools, provides continuing legal education, and works to build public understanding around the world of the importance of the rule of law.
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. NHPCO's Caring Connections provides free resources and information to help people make decisions about end-of-life care and services before a crisis. Learn more at caringinfo.org or by calling the HelpLine at 1-800-658-8898.
Media Contact:
Tina Lanier, ABA
Phone:202-662-1792
tlanier@staff.abanet.org
Or:
Jon Radulovic, NHPCO
Phone: 703-837-3139
jradulovic@nhpco.org
Wednesday, December 9, 2009
NHPCO Releases Updated Resource Manual
NHPCO Releases New Hospice Volunteer Resource Manual to Support Volunteer Programs and the Nation's 550,000 Hospice Volunteers
(Alexandria, Va) – The National Hospice and Palliative Care Organization reports that more than 550,000 individuals across the nation are giving of their time and talents as trained hospice volunteers. These volunteers contribute more than 25 million hours of service annually and reach 1.5 million patients and their family caregivers every year.
These figures, part of the NHPCO report Facts & Figures: Hospice Care in America were shared at NHPCO’s recent 6th National Conference on Volunteerism and Family Caregiving held last weekend in Orlando, Fla.
As part of the conference events, NHPCO released the newly revised edition of The Hospice Volunteer Program Resource Manual.
Hospice organizations have a responsibility to ensure that volunteers are well trained and well cared for and this manual will contribute to those efforts.
“Hospice volunteers are individuals who have stepped forward to make a difference in the lives of other people in their communities and they are vital members of the hospice and palliative care interdisciplinary team,” said J. Donald Schumacher, NHPCO president and CEO.
“The help, kindness and support that patients and families receive from hospice volunteers often profoundly changes their experience at the end of life.”
The manual has been updated to reflect the 2008 hospice Conditions of Participation—the federal requirements that all hospices must meet—and includes fresh ideas on recruitment, retention, training, volunteer manager skills development, program development, and more.
The publication includes a CD-ROM that assists managers in personalizing a volunteer program that meets the specific needs of an organization. Materials that can be adapted include competency checklists, surveys, policies and procedures, visit logs, job descriptions, training outlines, and more.
To ensure that volunteers remain an integral part of hospice care, it is federally mandated that at least five percent of patient care hours be provided by trained volunteers. Providers must track and document this carefully.
When a hospice invests in establishing a fully-functioning volunteer support program, the five percent rule becomes a guidepost, instead of burden.
“I know it costs money to run a well-coordinated volunteer program, however, on every level the benefits exceed the costs. Volunteers and their gift of service can have a huge impact on both the quality of the care your organization provides and its bottom line. A well-trained, engaged volunteer who spends time with patients and families can pick up on changes or challenges before they become crises,” noted Schumacher.
The Hospice Volunteer Program Resource Manual (item #820114) is available from the NHPCO Marketplace and may be ordered online, nhpco.org/marketplace, by phone at 1-800-646-6460, or by downloading and returning theVolunteer Manual order form.
Thursday, December 3, 2009
Wishing You a Peaceful Holiday Season
As the year comes to a close, I would like to thank each one of you, our members, who have offered so much support to NHPCO throughout this very busy year. There have been issues, large and small, that we have had to confront together and I think we’ve risen to the challenge time and time again.
I am so proud of the spirit of collaboration that is so palpable within our community. For this willingness to work together and support one another, I am indeed grateful.
During this holiday season, I encourage you to cherish time spent with your families and loved ones. On a personal note, this holiday season will be particularly poignant for me as I prepare to welcome my first grandchild.
We care for people on a daily basis, most often during one of life’s most challenging journeys. I hope that every one of you find the same peace and kindness that you so generously provide to the people you serve. Enjoy the special gifts found in quiet moments of reflection and in unexpected acts of kindness.
On behalf of the NHPCO board of directors, our staff and our affiliate organizations, I wish you a peaceful holiday season and a happy New Year!
Don
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Wednesday, November 25, 2009
Engage with Grace at www.engagewithgrace.org. Join the Blog Rally. Pass it on. #EWG
Some Conversations are Easier than Others
Take Time this Holiday Season to Ask Your Loved Ones about Their End-of-Life Wishes
Take Time this Holiday Season to Ask Your Loved Ones about Their End-of-Life Wishes
Last Thanksgiving weekend, many of bloggers across the Internet participated in the first documented “blog rally” to promote Engage With Grace – a movement to get more and more people talking about their end of life wishes.
It was a great success, with over 100 bloggers in the healthcare space and beyond participating and spreading the word. Plus, it was timed to coincide with Thanksgiving weekend when most of us are with the very people with whom we should be having these tough conversations – our closest friends and family.
At the heart of Engage With Grace are five questions designed to get the conversation started. National Hospice and Palliative Care Organization wants to share these questions with you. They’re not easy questions, but they are important. Think about them, document them, share them.
Over the past year there’s been a lot of discussion around end of life. Throughout the year, the Engage With Grace team has been fortunate to hear many uplifting stories, as folks have used these five questions to initiate the conversation.
One man shared how surprised he was to learn that his wife’s preferences were not what he expected. Befitting this holiday, The One Slide, seen below, now stands sentry on their fridge.
National Hospice and Palliative Care Organization’s Caring Connections provides a wide range of materials to help families talk about the care they would want and take steps to make their wishes know. This includes state-specific advance directive forms that can be downloaded free-of-charge. Visit Caring Connections at www.caringinfo.org or call 1-800-658-8898.
Learn more about Engage With Grace at http://www.engagewithgrace.org/.
To download The One Slide or for suggestions on using it, go to http://engagewithgrace.org/Download.aspx.
Tuesday, November 10, 2009
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
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