Does Hospice Need Reform?

CEO of Horizon, Mary Haynor, Shares Insight into the Newly Proposed Hospice Care Rule

By far the largest payor for hospice care is the government, through the Medicare and Medicaid programs.  The use of hospice care for end-of-life care has become an increasingly frequent choice by US citizens, which has ballooned the dollars paid for hospice care.  Additionally, health care providers have entered this sector of health care as well as entrepreneurs who have marketed this type of care.  The sum result is increased growth and greater expense for the government.

Just last week the federal government proposed that hospices be paid more for care in the first 60 days of hospice and paid less for care provided in the middle of a long stay on hospice. View the full proposal here at the Federal Register's website.

In all honesty the first and last days of life are the most expensive for a hospice.  In Horizon's hospice a large percentage of patients are not with us over 45 days, which is our average length of stay.  We have many high-cost patients, and it would be nice to be fairly compensated for those patients.

Will some hospices drop patients on the 60th day because of the decrease in reimbursement?  I fear that those who have focused their business model on the nursing home resident population may drop patients.  As dollars seem to drive health care behavior, patients at some facilities may be discharged because of the drop in reimbursement. The government is aware of this.  That is the reason for the change.  They want to discourage hospices from admitting patients who are far from death.

So, is the proposed rule a good one?  One never knows for sure until it has been in effect for awhile, say six months or so.  If you are curious, read the proposed rule by clicking the link below.

PROPOSED RULE​