This press release has been issued in response to the June 9 Government Accountability Office (GAO) report, Medicare Hospice: Action Needed to Pay More Efficiently for Routine Home Care.
WASHINGTON, D.C. — The National Partnership for Healthcare and Hospice Innovation (NPHI), the national voice for nonprofit hospice and advanced illness care, is calling for thoughtful modernization of the Medicare Hospice Benefit while raising concerns about recommendations contained in a recent Government Accountability Office (GAO) report that could fundamentally alter the hospice benefit and potentially lead to substantial changes in provider reimbursement.
NPHI is exploring potential reforms to the current hospice payment structure, including steps to reduce incentives for bad actors and poor-quality care by lowering the hospice aggregate cap, and reallocating dollars within the existing payment methodology to better compensate high-quality, mission-driven providers caring for the sickest patients. Longer term, NPHI is evaluating potential options to help hospices share in the savings they provide to the Medicare program relative to intensive, often futile hospital-based treatment. NPHI believes these types of reforms would better align reimbursement with patient needs, preserve the core principles of hospice care, and encourage providers to deliver care based on patient need rather than financial incentives.
“We welcome the conversation around hospice payment modernization,” said Tom Koutsoumpas, Founder and CEO of NPHI. “The current structure was developed decades ago for a different healthcare landscape and does not fully reflect the realities of caring for today’s hospice patients. As policymakers consider reforms, we believe there is an opportunity to better reward providers caring for patients with the greatest needs while preserving access to high-quality hospice care in communities across the country.”
Recently, NPHI participated in interviews conducted as part of the GAO’s examination of hospice payment policy and appreciates the attention being given to the need for payment reform. However, NPHI has significant concerns about recommendations that could effectively result in broad reimbursement reductions for hospice providers nationwide.
“We share the belief that hospice payment policy should be modernized, but we have serious questions regarding the approach outlined in the GAO report,” said Ethan McChesney, Senior Policy Director at NPHI. “Hospice is fundamentally an interdisciplinary model of care built around meeting the needs of patients and families, not a collection of individually billable visits.”
NPHI looks forward to continuing conversations with Congress, CMS, and other stakeholders to advance policies that promote program integrity, strengthen quality, reward community-based, mission-driven providers, and ensure patients and families continue to have access to compassionate hospice care in their communities.
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