Hospice: Leading Interdisciplinary Care

NHPCO is proud to announce the publication of Hospice: Leading Interdisciplinary Care, a policy brief outlining key aspects, goals, and benefits of hospice care. The document, which was commissioned by NHPCO and developed by Dobson|DaVanzo & Associates, is intended to serve as a comprehensive guide for policymakers and stakeholders who seek to learn more about the Medicare Hospice Benefit and understand why an integrated, person-centered care model should be adopted more broadly in America’s evolving healthcare landscape.

Through evidence-based quantitative research and extensive case-study analysis, Hospice: Leading Interdisciplinary Care illustrates the physical, emotional, spiritual and financial benefits of hospice care for patients, families, and communities throughout the country.

The paper also provides important policy considerations to expand access and availability of this critical model of care. Of utmost importance is preservation of the integrity of the Medicare Hospice Benefit during any changes to care delivery. The paper further concludes that knowledge and access to information and services should be widely available for patients and families evaluating advance care planning and treatment options. The paper recommends policymakers consider expanding palliative intervention earlier in disease progression to further ease care transitions to hospice for constituents.

Specifically, the paper offers the following action items as opportunities for advancing the hospice value proposition:

•  Preserve the integrity of the hospice benefit as Medicare Advantage (MA) plans, ACOs and other organizational delivery forms as they expand in coming years
• Concurrently coordinate the hospice benefit with medical and behavioral care under all Medicare payment model
•  Expand timely access to hospice and palliative care based on the individual’s unique care needs
• Ensure high-quality supply of hospice care providers and professionals who are poised to address the rapidly aging population seeking hospice and palliative care

“We hope this document will serve as a resource for policymakers and others who want to learn more about hospice, and will highlight the value of hospice as an example of a successful coordinated care model,” said NHPCO President and CEO Edo Banach. “Hospice exemplifies the principles of quality, compassionate, personalized care that works for beneficiaries, payers and policymakers.”

A link to the full policy brief is available here.

What Matters

Spring is a time for renewal, for growth, and for change. I am often reminded of this when I see the first daffodils shoot up in March or April. I live in the country and call myself a “gentleman farmer.” I enjoy planting seeds and seeing them grow. But there’s something special about a perennial that comes back each year with simple nurturing and a little love.

As loyal NHPCO blog readers know, I can take Moana or Physics and apply it to Hospice. But this time, my analogy is not a stretch! You see, perennials adapt and live from one year to the next through a form of vegetative reproduction (which sounds racier than it is) rather than seeding. Perennials bounce back when the conditions are again suitable—and they do it because they have adapted to the environment.

So it is with hospice. We planted the seeds long ago and have evolved and adapted to changing needs of our country ever since. HIV and AIDS, dementia, disasters, opioids…we have seen and done it all. And now, while everybody else is planting the seeds of person centered, interdisciplinary, coordinated/managed/integrated care, our community’s already there— ready to show folks how it is done. We don’t survive because we stay still, but because we have continually adapted to change. So let’s keep moving.

As you will see at this year’s Leadership and Advocacy Conference (April 15-17), we are leading person-centered care. We have been managing care for over 40 years. We do provide person centered, interdisciplinary care, and we are experts. We welcome the annuals to our garden. Heaven knows, there is so much need for this kind of care – and so many people who might benefit from the skills we have mastered.

As a field, we will continue to evolve, but the bedrock will always be the perennial hospice and palliative care providers that have been doing this and coming back for over 40 years.

Happy Spring. See you at this year’s conference.

Edo Banach, JD
President and CEO
NHPCO

This year's Leadership and Advocacy Conference is at the Marriott Wardman Park in Washington, DC, the grounds are pictured above. Online registration is available thru March 29. Onsite registration is also available.

A Busy Day in Washington for the HPM Community

On a cold March morning at NHPCO headquarters in Alexandria, Virginia, ten hospice and palliative care CEOs from across the country gathered with NHPCO leadership to meet with officials from the Department of Health and Human Services in Washington D.C.  On the agenda – reinforcing the message that hospice is the original care coordination model and plays an integral role in our healthcare system.

L to R: Edo Banach; Melinda Gruber, Caring Circle; Reggie Bodner, Carroll Hospice, Greg Wood, Hospice of the Ozarks, Ann Mitchell, Montgomery Hospice; Dame Cicely in bronze; Norman McRae, Caris HealthCare; Susan Lloyd, Delaware Hospice; Ben Marcantonio, Hospice of the Chesapeake; and Rafael Sciullo, Empath Health/Suncoast Hospice.

Provider members had the opportunity to share patient and family stories to demonstrate how hospice not only provides services to eligible beneficiaries at the end of life, but in many other meaningful ways.  Several examples were cited of how hospices have filled the gap in times of crisis by offering grief support and other services for not only victims of the opioid crisis, mass shootings, community tragedies, and natural disasters but also their families.

“We appreciate how the administration welcomed us and were truly engaged in the conversation,” says NHPCO President and CEO Edo Banach. “They connected with how our work directly supports the Secretary’s four top priorities – particularly around the opioids crisis and value-based healthcare.”

At the Department of Health and Human Services in Washington, DC.

Edo continues, “Sometimes face-to-face conversations are needed to really help focus everybody on what is important.  Instead of bickering, we spent yesterday focusing on expanding minds and connecting on how hospices and palliative care programs are integrally involved in helping people live their best life.”

“The topics were not uplifting:  Disaster relief, grief counseling, opioid addiction, serious illness and death.  However, connecting on ways that we are helping communities and people get through these issues, was uplifting.  I think we melted some hearts on a cold day in March, and I am so grateful for the members and board members that accompanied us.”

The meeting was a success and HHS officials were left with a positive impression of hospice, our providers, and acknowledged that they learned something new about the care we provide.

After the meeting at HHS, Edo and Darren and Brian Bertram of Infinity Hospice, traveled to Capitol Hill to meet with Senator Jacky Rosen.  It was another successful meeting and opportunity to talk about the importance of hospice care. Senator Rosen is a founding member of the bipartisan Palliative Care Task Force in the House and is committed to continuing to find ways to improve care for those with serious illness.

L to R: Darren Bertram, Edo Banach, Senator Rosen, Brian Bertram.

At NHPCO, we are proud to take the lead on shaping what the future of hospice and palliative care could look like, and we are proud to partner with our provider members to make those recommendations. It is vital that we, as one community, rally together to carry our message to the regulators and policymakers who have the control to change the care we provide to patients and families every day. 

Want to be looped in to our community's advocacy efforts, connect with the My Hospice Campaign. 

An Evening for Celebration

In her role as Development Specialist, Emily Van Etten plays a significant part in the planning and hosting of the annual National Hospice Foundation Gala. She shares some thoughts in preparation for the April 16 event.

On our way back to the office from the Marriott Wardman Park Hotel in Northwest, D.C., my colleagues Edo Banach and John Mastrojohn commented that the menu tasting we had just done was the best part of planning a gala. I definitely agree with that sentiment. Between the many emails and meetings to determine décor and secure sponsorships, it’s nice to get out of the office and get a real feel for what the evening will be like for our guests – and sampling the Gala menu is a great way to do just that.

This year’s National Hospice Gala, to be held on April 16 in conjunction with the Leadership and Advocacy Conference, will be my third gala with NHF. I’m much more deeply involved with the event this year, and it’s been a great experience to get to know our supporters and see the event come together.

What makes NHF’s gala particularly special is the unique opportunity it provides to celebrate the hospice and palliative care community. End-of-life care attracts people with a passion for others, who happily give much of their time and hearts for the dying and their loved ones. So often when we give much of ourselves to others, we forget to nourish ourselves. The annual gala encourages us to step back, take a breath, and have fun with friends and colleagues.

Along with a delicious meal and a live band, the fun is rounded off with an auction and fundraising appeal. This year, the live appeal will support one of NHPCO’s most successful initiatives – our Veteran Services programs. These initiatives, such as community outreach and the We Honor Veterans partnership program, empower hospices and caregivers to provide Veterans at the end of life with the best care possible.

I think I speak for the entire NHPCO team in saying how much we’re looking forward to this very special evening. I hope you can join us; I’ll save a seat for you.

By Emily Van Etten
Development Specialist
National Hospice and Palliative Care Organization

There’s still time to join us for the 2019 National Hospice Gala! Visit the NHF website for more information about sponsorship opportunities and tickets. For questions, contact Emily at evanetten@nhpco.org.

Photos from the 2018 NHF Gala.

Congress: To Better Understand Value-Based Care, Look to Hospice

Introduced by the Institute for Healthcare Improvement a decade ago, the “Triple Aim” is an approach that focuses on three critical areas of care: improving the patient experience (via increased quality and satisfaction), strengthening population health, and reducing costs to the health care system. The approach is still viewed across the health care sector as the ultimate option for optimizing health system performance, but successful examples remain as elusive as the proverbial “unicorn.”

But unicorns do exist. And Medicare’s hospice benefit is a rare unicorn in our health care system.

Hospice began as a demonstration program over 35 years ago and continues to be an exemplar of the kind of care we want for everyone. Hospice is a value-based, person-centered model of care that works to meet the unique needs of patients and their families by addressing all aspects of a patient’s well-being, including physical and emotional health, spiritual needs, family support and patient preferences. It is quite literally the nation’s first proven integrated — or coordinated care — model of care.

Policymakers have taken notice and proposed models for expanding access to hospice care. While we are encouraged hospice is being recognized as a valuable asset in the care continuum, it is critical that any new models are designed to optimize care for patients and families while not diluting the integrated care approach that makes hospice work.

Hospice is currently only accessible during a patient’s final six months, but this model of care — or one like it — should be offered much earlier than at the end of one’s life. Further, there are ways to strengthen the current Medicare hospice benefit to enable it to improve the lives of more people facing serious illness.

First, any new payment models must protect the integrity of the benefit. The Centers for Medicare and Medicaid Services recently announced plans to expand its Value-Based Insurance Design Model to all 50 states and allow Medicare Advantage plans to provide hospice care.

We are committed to ensuring that MA plans maintain the integrity of the hospice philosophy and care for patients and families entirely. We strongly believe that testing the model first is far more responsible than a premature, broad legislative change.

However, any demonstration must be better for patients, families and those that serve them. The hospice community is ready to work collaboratively to ensure real and legitimate improvement.

Second, we hope to work with Congress to expand access to palliative care that offers patients relief from pain and stress when living with a serious illness. To ensure hospice programs can provide the right care at the right time, Congress should establish a statutory standard definition of community-based palliative care that would allow payment for and access to at least a minimal standard set of palliative care services and supports.

Last, the hospice community welcomes the opportunity to work with the administration as it explores avenues for regulatory relief. While providing high-quality care to the seriously ill demands close oversight including quality outcome measures, regulatory policies must promote and support program integrity rather than create excessive administrative work that leads to unintentional clerical errors and distracts from patient care. The goal of regulation should be to guarantee patient quality of care and the weeding out of willful bad actors, rather than burdening honest providers.

Expanding access to the compassionate and personalized care that patients and families want is not an impossible fantasy, but rather it is attainable. Hospice and palliative care providers are eager to join with policymakers to lead the way. Expanding hospice access, supporting community-based palliative care and reducing regulatory burdens that restrict access to care are a good place to start.

While we are awash in models that promise to meet the Triple Aim by moving away from volume-based care and toward value-based approaches, we often treat the promise as an idea, like a unicorn, as one that exists in our imagination but not yet in reality. As the 116th Congress begins the tough process of governing and advancing policies to further strengthen our nation’s health care delivery system to achieve the Triple Aim, I urge it to look no further than the hospice model — health care’s unicorn — already achieving the desired outcomes of value-based care.

By Edo Banach, JD
President and CEO
National Hospice and Palliative Care Organization 

This op-ed was originally published by Morning Consult.

Call for Conference Session Proposals – IDC 2019

Help strengthen and improve the quality of hospice and palliative care programs.

Submit a concurrent session proposal for consideration to be a part of the esteemed faculty for the National Hospice and Palliative Care Organization’s 2019 Interdisciplinary Conference to be held from November 4 – 6, 2019 at the Gaylord Palms Resort and Convention Center in Orlando, Florida.

The Call for Presentation Proposals is open through March 18, 2019.

Proposals are being sought for intermediate to advanced learning level sessions. Proposals of the highest interest will include attention to both adult and pediatric populations in these specific focus areas:

• Community-Based Palliative Care
• Interdisciplinary Team Leadership
• Medical Care
• Quality
• Regulatory
• Supportive Care (psychosocial, spiritual and bereavement)

Prepare your presentation proposal and submit online; and make plans to join us in sunny Florida in November.