Agency Head Laments Proposed Funding Cut

By Delania Trigg, Gainesville Daily Register, Texas

Jun. 27–An attempt to balance the federal budget could lead to a cut in Medicare funding for home hospice organizations across the country.

“There are two proposals on the table,” Sherry Little Home Hospice’s executive director said in a telephone interview Thursday.

“The first proposal includes a regulatory maneuver to cut hospice reimbursement under Medicare,” she said. “The Centers for Medicare and Medicaid Services (CMS) has moved forward with the Notice of Proposed Rule Making and could announce the rate cute as soon as August 1. This action would result in hospice payment reduction of 4.6 percent nationally over five years, approximately $2.29 billion,” she said.

The second measure would change the “market basket adjustment” for hospice rates to zero percent for fiscal years 2009-2011, she noted. The adjustment takes inflation into account when determining reimbursement rates.

The rate would continue being slashed into 2012 and 2013 resulting in a cut of more than $5.1 billion in payments to hospice agencies across the country, Little said.

She said she hopes lawmakers stand up against the proposals which threaten to take funding from home hospices.

“If both proposals are implemented, their implementation will result in $11.55 per day being cut from the hospice benefit rate for patients in Cooke County,” Little said.

And cuts to Medicare often mean cuts to Medicaid, she said.

The Medicare benefit for hospice care was established in 1982 “to ensure that high quality care was available to patients facing the end of their lives,” Little said. “It has proven to be a compassionate and cost-effective health care delivery system during the past twenty-five years.”

Since 1982 when approximately 25,000 patients sought care from hospice organizations, the use of hospice as an end-of-life care option has risen to 1,300,000 in 2006.

Hospice care is also economically sound, she added.

“An independent study released late last year by Duke University found that the use of hospice saved Medicare an average of $2,300 per patient over other care delivery (services) during this stage of life,” Little said.

The possibility of cuts in Medicare funding are particularly troubling as the cost of transportation and patient care supplies continues to increase, she noted.

“Our concern is that all this is happening in an environment in which the cost of us providing service continues to rise. One of hospice care’s benefits is that we seek to care for the patient in the patient’s home, surrounded by their loved ones. In order to do that, we have to be able to get to their homes. Everyone is aware of what gas prices are doing. As gas prices skyrocket, and we have to continue to get to our patients when they need us –sometimes every day and miles away from our office — to have our resources cut is devastating,” Little said.

She pointed out that Home Hospice of Cooke County is a non-profit agency. Some of the clients who enter service with home hospice have no way to pay for their care. The agency also prides itself on not refusing to help these desperately ill patients regardless of their ability to pay.

“In 2007 almost 7 percent of our patients have no reimbursement for their end of life care,” she said.

Community donations and fund-raisers help the group care for people who don’t have Medicare, Medicaid or private insurance. The organization also receives some assistance from agencies such as the Cooke County United Way.

Still, Medicare and Medicaid funding are vital to the organization.

“Most of the members of our advisory council have mailed letters to lawmakers. We’ve tried to be very proactive to let them know how devastating this will be. This isn’t just us. I believe hospices all across the country are responding,” she said.

What will happen if the reimbursement rates are cut?

“It will be difficult for all of us,” Little said.

Reporter Delania Trigg may be

contacted at dtrigg@ntin.net

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