National Hospice and Palliative Care Organization’s President and CEO J. Donald Schumacher released the following statement on today’s announcement from Secretary Sebelius of the Department of Health and Human Services regarding the Medicare Care Choices Model.
“End of life is a sensitive and difficult time for patients and families, filled with confusing and complicated choices. For far too long, the decision to elect hospice has been tantamount to ‘giving up’ since a patient must forgo ongoing curative care in order to benefit from hospice care.
“Such patients who choose to continue with aggressive medical services are denied the opportunity to benefit from the holistic, interdisciplinary care provided by the hospice team. Similarly, family caregivers are denied the support from the hospice team that is a hallmark of this model of care.
“On behalf of NHPCO and our country’s diverse hospice provider community, I would like to thank Secretary Sebelius and her team at the CMS Innovation Center (CMMI) for moving forward with the Medicare Care Choices Model – a project to test concurrent care for patients facing terminal illness.
“This new CMMI project will allow Medicare to pilot the innovations that have long benefited patients in the private market. We trust that the Medicare Care Choices Model project will demonstrate that patients who have access to hospice alongside of curative care have better outcomes, higher family caregiver satisfaction, and benefit from the expert support of hospice earlier in their care.
“The findings will provide an answer to an important question regarding healthcare delivery for the terminally ill and access within the Medicare population – and beyond. We’re thrilled that Medicare is leading the quest for answers and a thorough understanding of the concurrent care provision.
“Finally, the hospice community extends its greatest appreciation to U.S. Senator Ron Wyden (D-Ore) for his long-time support of this initiative. Senator Wyden has embraced concurrent care for hospice in various pieces of legislation over the past two decades, and his persistence and dedication on behalf of all Americans facing serious and life-limiting illness have been key to achieving this important milestone.”
In order to access hospice care under Medicare, beneficiaries must agree to forgo curative treatments for the terminal diagnosis. In some circles, this decision has been called “the terrible choice.”
The Medicare hospice benefit is limited to patients who have a life expectancy of six months or less. This should not to be confused as a limit to the amount of hospice care that may be provided; yet, this regulation seems to serve as a barrier for medical providers to make an appropriate referral to hospice.
For well over a decade, NHPCO in collaboration with Hospice Advocates and Congressional hospice champions like Senator Wyden, have called for an official demonstration project to examine provision of hospice care along with ongoing disease-modifying therapies (often called curative care).
More than 1.56 million patients receive care from hospice every year.
In 2012, approximately 35.5 percent of patients died or were discharged in seven days of admission, far too short a time to benefit from the services hospice provides (from NHPCO’s Facts & Figures: Hospice Care in America).