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In-House Hospice opposes Medicare rate cut
Says increasing costs due to aging America
If you ask Laura Ann Wagner, president and CEO of In-House Hopice, based in Southfield, MI, the explanation why costs are increasing for the Medicare hospice benefit — the answer is a simple one: Baby boomers are aging, and more of them are taking advantage of that benefit.
Regarding the rate cut, she says, "It goes without saying [that] it's going to threaten the access to compassionate, high-quality, end-of-life care."
Smaller hospice programs, which tend to serve rural areas, are particularly threatened. Wagner notes that out of 4,500 hospice providers in the U.S., 83% see fewer than 100 patients a day.
And while Wagner says it is "well documented" that hospice costs have increased for Medicare, she also notes that CMS "themselves put forth a very focused effort several years ago to communicate to physicians and hospitals and other health care providers along the continuum, encouraging them to refer their patients at end of life to hospice."
Wagner stresses that patients who do not choose hospice care end up in the emergency department and/or the intensive care unit — care she translates to anywhere from $1,000 to $3,000 a day — compared to hospice, which costs about $135 a day.
Wagner also notes that it is also well documented that hospice saves Medicare about $2,300 per patient.
Caps in place on hospice care today
There are caps in place for the Medicare hospice benefit, which is at about $22,300, Wagner says. That's true if a patient accesses the entire 180-day, or about six months, benefit, but typically patients do not receive the entire benefit, she says.
Wagner cites statistics from 2007, when the median length of stay in hospice was 20.6 days, or about 11.5% of the intended benefit. The average length of stay in 2007 was 59 days, about 33% of the intended benefit.
"So, you can derive from those numbers that there's not a lot of overutilization going on here," she says.
And she suggests that in today's continually downward spiraling economy, people need this Medicare benefit more than ever.