Policymakers must protect, preserve Medicare’s hospice benefit
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In recognition of National Hospice Month, it’s time to shed light on one of our nation’s most misunderstood and underutilized healthcare resources: hospice care.

Despite the availability of skilled, compassionate care through Medicare’s hospice benefit, families are not taking full advantage of the wide range of services offered that can measurably improve a patient’s quality of life as they approach the end of life. Rooted in a philosophy of dignity, respect and compassion, hospices have a sacred obligation to serve patients throughout their end-of-life journey and are committed to providing the highest quality care to the patients and families they serve.

Unfortunately, a patient’s desire for quality time is often overlooked or unheard by the medical establishment in place of achieving a greater quantity of time. That’s because Americans with advanced illnesses face a fragmented health-care delivery system that sometimes fails to truly listen to what patients want — and instead subjects them to repeat hospitalizations, aggressive therapies, adverse drug reactions, emergency room visits, unnecessary pain and discomfort and conflicting care in order to keep them alive longer, despite a decline in quality of life. Further, patients and families are reluctant to ask about hospice, either because they are unaware of the seriousness of their prognosis or they are fearful that they are “giving up.”

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For anyone diagnosed with a life-limiting illness and fewer than six months to live, hospice offers a patient-centered, cost-effective philosophy of care designed to support patients and their families in those final, precious months of life. With an interdisciplinary team of professionals — including expert physicians, nurses, social workers, volunteers, bereavement counselors and spiritual support — patients can peacefully die at home, surrounded by the people and things they love.

 

It surprises many to learn that research has found that among Medicare beneficiaries with some of the most common cancer diagnoses, those who opted for hospice care instead of more invasive medical treatments lived an average of 28 days longer. While hospice does not guarantee a longer life, many people have found hospice provides a higher quality of life for longer than anticipated. In a recent survey, almost 90 percent of families who utilized hospice were happy with their experience.

When patients and families realize the array of support hospice offers — whether a nurse to administer medications, a social worker to help families navigate complex emotions or a volunteer who keeps vigil — most family members wish they had enlisted the help of hospice sooner. Unfortunately, 35 percent of patients received hospice care for only a week or less – when it was too late to fully experience and benefit from the broad range of support services available for both the patient and the family members.

While the Medicare hospice benefit was instrumental in transforming care for many individuals at the end-of-life, it is clear that more must be done to support patients and families who are experiencing serious, advanced and life-limiting illness. Patients, providers and policymakers alike must work together to ensure that palliative care services are extended to all patients who need this type of compassionate, comprehensive and coordinated care —  not just individuals with terminal illness. Congress and our health care-system must preserve the hospice benefit for patients who need it. End-of-life care goals should be accessible, communicated and honored by all providers across all settings.

To that end, the hospice community is committed to working with policymakers to ensure that patients receive timely and comprehensive counseling about their illness, prognosis and treatment options from reputable and accountable providers. Hospice organizations are also working with Congress to ensure patients have access to the hospice benefit in all regions of the country — including rural America and in medically underserved urban communities — and that patients are able to keep their primary care physician as their attending physician at the end-of-life.

Patients and their families must contend with the sadness that inevitably accompanies the death of a loved one, but no one should face regrets over the manner in which they lived their final days. With sound public policies and greater awareness, hospice can continue to provide stellar care to the dying and their families to help foster the peace that every one of us deserves.

Banach, JD, is president and CEO of The National Hospice and Palliative Care Organization (NHPCO). The NHPCO is the largest nonprofit membership organization representing hospice and palliative care programs and professionals in the United States.