High Quality Hospice: A Medicare Requirement

Beginning in December, Medicare will require that hospice agencies account for the quality of care they are delivering. This includes guaranteeing that patients have a say in the care they receive and showing improvement in areas where the hospice agency has been found deficient.

Some say this is a way for Medicare to limit reimbursement to hospice agencies. Last year alone, Medicare spent about $10 billion on hospice care, up from about $3 billion in 2000. The increase is due in part to the aging population, in part to growing awareness of hospice services, and in part to increasing numbers of hospice agencies in the U.S. Perhaps Medicare is looking for a way out of paying hospice agencies for the care they provide.

I say, so what? Most hospice agencies are welcoming the changes. It means better patient care, does it not? It also means more work for the hospice agencies to implement quality improvement and performance plans but this is something they should be doing anyway. Hospice of the Valley, the agency I work for in San Jose, CA, has been practicing these guidelines long before Medicare made them mandatory.

To help patients and families find hospice agencies with high quality care, the American Hospice Foundation will be keeping "report cards" to rate hospices on pain and symptom management, communication, emotional and spiritual support, coordination of care and following a patient's end-of-life wishes. According the Washington Post article For Hospice, A Higher Authority the National Hospice and Palliative Care Organization (NHPCO) "has been following that effort but believes that the measures aren't standardized enough to go public with a report card yet".

I'll be following that effort as well and will let you know when the report card is available to the public.

What is Hospice?

The Medicare Hospice Benefit