For those interested, I have cut and pasted from the About.com blog a nice summary on hospice and the healthcare bill (see below). Of note, I will be in DC April 20-21 to lobby Congress on the hospice funding.
1. The bill softens the proposed cuts to Medicare from $10 billion to $7.8 billion. (This is still not enough of a reduction. These cuts on top of the more than 4% reduction associated with eliminating the budget neutrality adjustment factor (BNAF) is more than hospices can sustain. Please visit NHPCO’s Capital Hill Day Information Page to find out how you can help.)
2. It includes a market basket reduction of .3% for hospice providers for years 2013-2019. (Boo. See above.)
3. Payment reforms: the Secretary would collect data on hospice claims, implement revisions for payment, and medically review hospices with a high percentage of long-length stay patients. A physician or nurse practitioner must have a face-to-face meeting with a patient prior to the 180th day re-certification. (Neutral)
4. The bill directs the Health and Human Services Secretary establish a 3 year demonstration program in up to 15 hospices to allow hospice eligible patients to continue to receive all other Medicare covered services while on hospice care. Then there will be an independent evaluation on patient care, quality of life, and Medicare spending. (I like this provision A LOT and can’t wait to see the results.)
5. The bill allows children enrolled in Medicaid or CHIP to receive hospice services and curative treatments at the same time. (Similar to the Nick Snow Act in California. This is a great provision.)
6. The bill creates an independent Payment Advisory Board that will present Congress with comprehensive proposals to reduce excess cost growth and improve quality of care for Medicare beneficiaries as well as those with private insurance. Basically, if the spending of Medicare seems to be unsustainable, the proposals of the board will take effect, barring any action from Congress. (I’m not sure how to feel about this one. Feel free to weigh in!)
7. The bill provides the Health and Human Services Secretary authority to test value-based purchasing systems of hospice providers, no later that January 1, 2016. (Neutral)
8. It requires hospices to report on quality measures or face a 2% reduction in their market basket update. (Ouch! Holding hospices responsible for quality can only be a good thing.)
9. It establishes a nationwide program for thorough state and federal background checks on all employees providing direct patient care. (Hopefully most hospices do this already but this provision will ensure that they won’t have to pay out of their already strapped budget to do so.)
10. The bill authorizes an Institute of Medicine Conference on Pain Care to evaluate the adequacy of pain assessment, treatment, and management. Also authorizes the Pain Consortium at the National Institutes of Health to enhance clinical research on pain causes and treatments and a grant program to improve health professionals’ ability to assess and treat pain. (Yes! We still have a long way to go in pain management.)
All of this information can be found in more detail on the National Hospice and Palliative Care Organization’s (NHPCO) website.