Policymakers and stakeholders seeking to learn more about Medicare benefits of hospice can do so in a new publication released by the National Hospice and Palliative Care Organization (NHPCO) in March 2019, titled Hospice: Leading Interdisciplinary Care. The final report, submitted by Dobson|DaVanzo to NHPCO, is a policy brief that explains why an integrated, person-centered care model, such as hospice, should be adopted more broadly healthcare.
“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.”
The paper shows the physical, emotional, spiritual, and financial benefits of hospice care for patients, families, and communities through evidence-based quantitative research and extensive case-study and demonstrates the value of having a program such as hospice be a part of healthcare.
Hospice is the first coordinated care model that was created with the seriously ill patient and their family’s unique needs in mind. The paper reflects documented research showing that hospice care is cost-effective for Medicare and its beneficiaries. The study showed that if 20 percent of the patients used hospice care for four weeks, the estimated annual cost savings were $316 million. If 100 percent used hospice for 24 weeks, the savings would be $2.43 billion. The study was based on the estimate that about 60 percent of decedent Medicare beneficiaries enter hospice care for an average stay of under two weeks, the hospice program could save the Medicare program $705 million annually.
Not only do hospice users save Medicare dollars while still receiving quality, patient-preferred, end-of-life care on their own terms, but they avoid expensively, invasive procedures created to prolong life despite no chance of disease reversal. There was also a few hospitalizations and Emergency Department visits.
The publication also provides important policy considerations for expanding access and availability of this model of care, the most important of which, preserving the integrity of the Medicare Hospice Benefit during any changes to care delivery. It goes on to emphasize that knowledge and access to information and services should be widely available for patients and families evaluating advance care planning and treatment options and that policymakers should consider expanding palliative intervention earlier in disease progression to further ease care transitions to hospice.
Specific action items as opportunities for advancing the hospice value proposition proposed in the paper include:
- 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 models
- Expand timely access to hospice and palliative care based on the individual’s unique care needs
- Ensure a high-quality supply of hospice care providers and professionals who are poised to address the rapidly aging population seeking hospice and palliative care
The benefits of hospice are clear, monetarily in terms of cost savings to Medicare, but more importantly, providing quality end-of-life care for terminally ill patients and their families in ways that would not be experienced otherwise.