Wednesday, January 8, 2014

Hospice Funding: Why Should Patients be Referred Early?

Over the last few weeks, hospice has gotten a lot of negative press. Consider the article last week in the Washington Post: Hospice firms draining billions from Medicare, reporting on the incentive for hospice businesses to admit patients early so they get paid their $155 daily outpatient per diem for a longer time. Not news to me- just good business sense.

Over the last several decades many hospice organizations have struggled to make ends meet, especially when they have to absorb the high cost of paying for the care patients who die within days of admission.  Hospices need patients with longer admissions and fewer costs to help balance the patients that cost them money. My understanding of the hospice reimbursement system is one of the reasons that I've referred my own family members early- in each case, months before they died. And during this time, even if the nurse only checked in by phone during a given week, I knew they were just a phone call away in an emergency, and that was a tremendous help and comfort for us.

And what amazes me, is that the patients and families who only get a few days  of care with hospice, and who cost hospices a lot of money, are still cared for with great compassion and a rapid outpouring of support. I've never heard of someone being refused for hospice "because they are too sick". I've never heard of hospice providers conveying messages to patients or families about how much money their organization will lose because they were referred so late.

Compassion, symptom relief, honest communication and support- these are what hospice organizations and providers offer, and they do it so well.  Thank you.