Buckling our helmets

by Pete Brunnick, HPCCR President & CEO

Hospice care was the headline story in Monday’s USA Today — it certainly says a lot about how we as an industry have grown up.  The story really isn’t news as it rehashes information that was presented in both the March and July reports from the Medicare Payment Advisory Commission and the Office of the Inspector General.  The issues of the growth of the for-profit hospices and their focus on nursing home patients with specific disease characteristics is also not news; it’s something we have been fighting for years. 

Medicare expenses for hospice have grown, but that in itself is not a bad thing as I firmly believe that hospice utilization overall saves the system money.  However, what has always troubled me is that the abuses are often obvious, as frequently revealed in the results of public data collection, and little or nothing is done about it.  Now that hospice is in the headlines, things are clearly about to change.  Hopefully the solution will not rest with rate reductions alone, as that will only force those that abuse the system to do even less for the patients; they will unbundle services, thus maintaining their margins at the lower reimbursement rates.  

The real answer is with oversight and frequent surveys by the state and Medicare to ensure that providers are delivering the services that they not only claim to offer but are obligated to provide.  We are fortunate that North Carolina is a pretty clean state but ultimately in the health care world, the abuses of few affect the whole.  Payment reform will create challenges but enhanced “policing” will deliver opportunities as sub par providers find themselves exiting the market.

So we need to buckle on our helmets because the road ahead may be bumpy.  But I am convinced that there will be rewards for those who preserve and remain committed to doing the right things for the ultimate benefit of our patients.

Explore posts in the same categories: advocacy, awareness, education, health care reform, hospice, Medicare

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2 Comments on “Buckling our helmets”

  1. Cynthia Howard Says:

    “From 1998 to 2008, Alzheimer’s and dementia hospice cases grew from 28,000 to 174,000, reports the Medicare Payment Advisory Committee…”

    This is a pretty sobering statistic. As a baby boomer, currently taking care of my dad with Alzheimer’s, I know first hand the costs and demands associated with home care.

    It is frightening to think of the condition the health care system may be in, by the time I need end of life care.

    Thanks for sharing the article!


  2. Hi! I’m from the Philippines. Here, there is no insurance coverage for hospice patients. Among indigent patients at the end of life, care is almost non-existent.

    I do hope that issues regarding hospice care expenses are resolved. Dying patients deserve all the love and care society can provide.


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