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News & Member Events: Hospice News

Modernizing the Medicare Hospice Benefit

Friday, September 27, 2019   (0 Comments)
Posted by: Katherine Lally
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Full article here. 

The Medicare Hospice Benefit is aging along with the patients it is designed to serve. Nearly 40 years since its inception, it may be time to re-examine aspects of the program in light of the ways that patient populations and the larger health care system have changed. 

The hospice benefit was established as a demonstration project in 1970 and became a formal part of Medicare in 1983. At the time, nearly all of the patients who enrolled in hospice were suffering from cancer, and the U.S. Centers for Medicare & Medicare Services (CMS) and its collaborators designed the program around the needs and illness trajectory of those patients. 

Though cancer remains the most prevalent diagnosis among hospice patients, the proportion it represents has shrunk. 

Of the 1.49 million Medicare decedents who enrolled in hospice during 2017, cancer patients represented only 30%. Patients with cardiac conditions, such as congestive heart failure, accounted for nearly 18% of enrollees. For more than 15% of patients, their principal diagnosis was dementia, according to the National Hospice & Palliative Care Organization (NHPCO).

“When the benefit was set up, and they were putting those constructs in place, it was exclusively for cancer, which has a very predictable decline and a very predictable median length of stay,” Nick Westfall, CEO of VITAS Healthcare, a subsidiary of Chemed Corp. (NYSE: CHE), told Hospice News. “Now we are caring for patients with neurological conditions, the Alzheimer’s and dementia components, patients with cardiac conditions, typically in the home, and we do what we can to help keep them in their homes. It’s become more complicated. We have an opportunity to start a dialogue about ways we could consider enhancing the benefit.” Read more here. 

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