Tuesday, June 16, 2009

NAHA Release New Study of Medicare Hospice Data

The National Alliance for Hospice Access issued a press release and data analysis regarding appropriate access to hospice. This is a significant issue for members of the NAHA because they are supporting reform to the current Aggregate Medicare Hospice Cap in addition to other reforms. The NAHA has voiced displeasure with lack of support from the NHPCO on NAHA positions. A more detailed comparison of the NAHA report to the NHPCO report may show some differences some may find compelling to change their mind and support the NAHA Cap Reform position.

Light at the HospiceImage by Daniele Sartori via Flickr


The main points from the NAHA data analysis include:
  • 4 out of 10 hospice patients got no more than 10 days of care
  • Only 16% of hospice patients get 60 to 180 hospice days, the range that improves quality and costs
  • Minority access to hospice care trails access for whites by 25%
I am going to have to spend some more time comparing the NAHA and NHPCO data before I can give it a full post. Here is a link to the NAHA report and the blog post on the NAHA site.

The poll on views towards the hospice cap last week while non-scientific leaned heavily towards cap reform. Much more than I ever expected given what I have heard in conversations from peers. 214 people voted (you could vote more than once - a significant problem with the poll structure) 13 people thought the cap was fine as it is. 25 wanted to know more about it and a whopping 176 thought it should be reformed. The reason I don't think this poll was accurate is because of people I have talked to at national palliative care meetings the number is more like 3:1 in favor of leaving it be. Also of the 4,000+ hospices, the majority of them are not members of NAHA.

So what that leaves me with is the opinion that we need to have some more open discussions about what the hospice cap problem is, who is affected and what should be done about if anything. If there are enough people discussing this issue in the comments, we will dedicate some more time to the hospice cap and maybe invite representatives of the major hospice organizations to have a roundtable discussion on the subject here on neutral ground at Pallimed.

So if you want it, make some noise. It sure worked for the FDA - morphine issue.
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