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Study highlights effect of cuts
In a report produced by The Moran Company for the National Hospice and Palliative Care Organization in Alexandria, VA, data from the Hospice Cost reports and the Medicare Claims data were used to evaluate the impact of Medicare reimbursement cuts on the hospice industry.
Medicare profit margins were estimated using Medicare costs including the costs of statutorily required services, such as bereavement and volunteer services. Annual changes in costs were calculated using the estimated annual market basket updates. Revenues were estimated per year, accounting for projected changes in the market basket, the reduction in the market basket due to a decrease in the productivity factor, and the BNAF phase-out.
Hospices were classified as urban, moderately rural (50%-74% of patient days in rural counties), or mostly rural (75%-100% of patient days in rural counties) using patient county data from the 2008 Medicare SAF denominator file.
The median Medicare profit margin for the hospice industry could decrease from 2% in 2008 to -14% by 2019.
Hospices that serve mostly rural patients would be the most severely affected (profit margin decreases ranging from -2% in 2008 to -19% in 2019).
Hospices that serve moderately rural areas fare better than the mostly rural hospices (median profit margins range from 1% in 2008 to -14% in 2019).
88% of hospices could have negative Medicare profit margins by 2019 (92% of moderately rural and 91% of mostly rural hospices).
Paul Malley, President, Aging with Dignity, Tallahassee, FL. Telephone: (850) 681-2010. E-mail: email@example.com.
Jon Radulovic, Vice President of Communications, National Hospice & Palliative Care Organization, 1731 King St., Suite 100, Alexandria, VA 22314. Telephone: (703) 837-1500. Web: www.nhpco.org.
Aging with Dignity, Tallahassee, FL. To obtain a copy of the "Five Wishes" advance care planning toolkit, selling for $5 for individual copies with free shipping or $1 per copy for orders of 25 or more (depending on quantity, shipping costs $10+), visit its web site: www.agingwithdignity.org. Click on "Five Wishes" icon, and then select the toolkit for ordering.
Caring Connections of the National Hospice and Palliative Care Organization of Alexandria, VA. Helpline: (800) 658-8898. The web site contains free, state-specific advance care planning information at www.caringinfo.org. Click on the icon that says "Download Your State Specific Advance Directive."
For more information about veterans' end-of-life experiences, contact:
Department of Veterans Affairs at: (800) 827-1000 or www.va.gov.
Peace at Last: Stories of Hope and Healing for Veterans and Their Families by Deborah Grassman, RN, contains veterans stories, hospice experiences, and a series of appendices providing sample materials that can assist with healing; call (800) 551-7776 for more information.
Hospice Foundation of America; www.hospicefoundation.org/hfacares or call us at: 800-854-3402.
Robert D. Orr, MD, CM, Director of Clinical Ethics, Loma Linda University Medical Center, 24760 Stewart St., Loma Linda, CA 92350. E-mail: firstname.lastname@example.org.