The Centers for Medicare and Medicaid Services announced April 29 that the 2014 hospice reimbursement rate would include an “increase of 1.1 percent.” The CMS announced the proposed “increase” because it cited the fact that spending on hospice services has increased 500 percent since 2000.
That sounds like great news and is fiscally sound, but a closer examination of the numbers reveals the real truth. The current sequester has already mandated a 2 percent decrease in all Medicare reimbursement across the board. That means that the actual reimbursement for hospice would decrease by almost 1 percent year over year, well below the actual increase in the direct cost of doing business next year. It is that kind of “fuzzy math” that has plagued the CMS, and has put providers in a vulnerable position and ultimately put the care at risk.
Cutting the reimbursement rate for hospice does not reduce the overall costs for healthcare. CMS has been promoting Hospice for terminally ill patients for well over a decade. There should be no surprise that this strategy has resulted in more hospice care being provided throughout the country and it has also significantly improved outcomes and cost savings overall to Medicare.
New research published in March by Mount Sinai found that hospice enrollment saves money for Medicare and reduces emergency room stays and hospital readmissions. In that research, providers saved Medicare between $2,500 and $6,000 per patient depending on when the patient begins hospice care. That can more than offset any increase in the hospice reimbursement rate.
Patients need hospice care, because of the positive impact it has for end-of-life care as well as its impact for caregivers. Quality of life is improved, patients actually live longer than those who don’t receive hospice care, and caregivers have also seen tangible benefits. Our patients and their caregivers have given testimonials about how much hospice care has helped them.
This is not the time to manipulate numbers, and in turn, manipulate the end results for patients. Hospice care needs a stronger investment from the CMS, because that investment will pay the most dividends for all.