National Issues - The Living Planner

CONCURRENT COVERAGE OF HOSPICE AND CURATIVE CARE

Medicare. We tend to put off knowing too much about it until we come of age (mid-sixties) to receive Medicare benefits, unless we are helping our parents, grandparents or others. It’s a complicated web of policies, rules, choices and coverage that stymies many. As population in the US ages, it is raising interest and concern for many pertaining to costs and coverage. “2012 data reported 49,435,610 total Medicare Beneficiaries in the US” * Data pulled from the Henry J Kaiser Family Foundation January, 2016.

In the past, Medicare did not “cover” or pay traditional curative medical benefits for those who were under the care of hospice providers. It was a stark “black and white” decision between continuing curative care OR making the choice to end curative care and beginning hospice care. This month marks an important change in the way Medicare and hospice providers work together. This change permits patients to receive curative and hospice care simultaneously and qualify for Medicare payment for the services. This program will launch in two phases with hospice providers entering in January, 2016 and again January, 2018. Up to 140 hospice providers will participate. Under this program, patients will continue to receive curative services (physical therapy, prescriptions, medical equipment, physician services and short-term hospital visits) and bill Medicare for these services, while under palliative care services from hospice providers. Hospice care includes palliative care and respite care to assist family caregivers.

The Medicare test will measure the impact of patients entering hospice care while receiving curative services to assess if this combination of services improves overall patient care and patient satisfaction, while also measuring the overall cost impact of this change. Many experts have stated; by offering both palliative and curative care concurrently improves quality of life and won’t raise costs, because patients and their families are more likely to choose hospice care if it doesn’t eliminate opportunities for lifesaving treatments.

Prior to this decision, many patients, families, physicians and hospice provides have faced difficult choices. For many, entry into hospice meant that care and comfort was the only care option. Now, a combination of treatment protocols are permitted. “This model empowers clinicians, beneficiaries and their families with choices and is part of our broader efforts to transform our healthcare system into one that delivers better care, makes smarter payments and puts patients in the center of their own care,” HHS Secretary Sylvia Mathews Burwell said in a news release. “We want to do what we can to help families find the care that is right for their loved one.” Last year, the CMS said only 44% of Medicare patients use the hospice benefit at the end of life and most use it for only a short period of time.

While the Medicare test program impacts only those who qualify for Medicare benefits, this decision also brings to light the issue of care choices for each of us. Do you know what you, your parents, your siblings or your loved ones would want in a situation requiring decisions of overall care choices? What does quality of life mean to you? To them? Has this been discussed in your family?

Time impacts so much. Over time, we evolve through experiences, growth and choices; as do the services, technology, facilities and programs offered for us to consider. Knowing what we want now is a good start. Knowing we are permitted to change our minds after an initial choice has been made, allows us choices and through having choice, we are empowered.

Planning for the unplanned allows us to consider the impact of our decisions and communicate our wishes with those impacted by them. While we cannot predict the future, we can prepare for it. Should you desire support, resources and / or services to assist you in beginning the planning process or assessing what you have in place today, we are happy to shed a practical light on this.

Thanks for being a part of this community, Lynn

We love assessing readiness from all perspectives and invite you to explore how The Living Planner’s services may benefit you and your loved ones.

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