Back during the Clinton Administration, federal bureaucrats launched a devastating assault on hospice—called “Operation Restore Trust”—in which the Feds presumed that a patient who did not die within 6 months of entering hospice was there fraudulently, and as a consequence, demanded tens of millions in refunds from hospice programs throughout the country. I was a hospice volunteer at the time and saw the devastating effect: My last patient, who was dying (and died) of ALS—was tossed out on his ear because he had unexpectedly survived 18 months. The chilling effect placed on the entire hospice movement by Operation Restore Trust continues to this day—along with the suffering it causes.
Well now, the government under President Bush is at it again: This time they seek to cut hospice payments under medicare by billions of dollars per year. From the advocacy plea by from the National Hospice and Palliative Care Organization that seeks to prevent this undermining of a noble calling:
According to a recent MedPAC findings, the National Median Margin for hospices is 3.4% and with such a thin margin, a cut in rates will put undue pressure on providers of this high quality care.
Hospice programs rely on Medicare for a disproportionate share of their revenues,totaling 80-85%. Given the patient population that hospice serves, this is understandable, but cutting rates by billions of dollars would reduce the resources available to continue providing this necessary care.
Hospice is a cost effective and compassionate health care delivery system for the terminally ill. A recent independent Duke University study clearly demonstrated that on average, hospice saves Medicare more than $2,300 per patient and goes on to say, “Given that hospice has been widely demonstrated to improve quality of life of patients and family members…the Medicare program appears to have a rare situation whereby something that improves quality of life also appears to reduce costs.”
Why go after hospice? Because it is politically weak. So why not save a few billion on the backs of dying people?
HT: Judy Dobson
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