2023 Press Releases Archives

NHPCO Commemorates Former President Jimmy Carter Reaching Six-Month Milestone on Hospice

For Immediate Release
Photo link
August 17, 2023

Hospice and Palliative Care Leaders Gather in Times Square to Celebrate his Life and Legacy

(New York, New York) — Today, the National Hospice and Palliative Care Organization (NHPCO) brought together an intimate group of hospice leaders in Times Square, New York City to acknowledge six months since former President Jimmy Carter entered hospice care and to thank him for his leadership.

Back in February, President Carter and his family chose hospice care for his end-of-life journey. By sharing that choice publicly, the Carters have sparked a national conversation and countless private ones about the value of hospice.

At today’s event, brief remarks were given in front of an illuminated Nasdaq screen by NHPCO COO and interim CEO, Ben Marcantonio, and other hospice leaders who joined together in one of America’s most well-known public squares to express gratitude for President Carter’s leadership and the courageous conversations he has inspired.

“The Carters’ service to humanity has served as a wonderful example to all of us. He has shown us how to be deeply human. President Carter and his family are doing that again now for his end-of-life journey,” said Marcantonio. “I hope we will all take a cue from President Carter and be more willing than ever to have courageous conversations with our doctors and loved ones that help people think about how they want to experience their own hospice journey when it’s their time.”

“The hospice approach is different from any other approach to healthcare. We put patients and their goals at the center of the plan of care. With that approach, we can help people live their final weeks or months to the fullest. For some patients, that means visiting the beach one last time. For others, it means working on their art or recording their memoirs. For some it means attending a grandchild’s wedding,” said Jacqueline Lopez-Devine, Chief Clinical Officer for Gentiva. “In all cases, it includes the patient and their loved ones being clear about what’s important, and then tailoring the plan of care to those goals.”

“Death is one of the few things that all humans have in common, yet we generally avoid talking about it. If we are willing to break through the taboos – if we’re willing to have courageous conversations – we can help people have the end-of-life journey they deserve, and the impact that has on them and their loved ones is profound,” said Susan Lloyd, President & CEO, Delaware Hospice. “Hospice care is not about living longer; it’s about making the most of the time we have left. President Carter and his family are just one example of the ways in which hospice can transform lives.”

A recording of the event is available here.

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About NHPCO

The National Hospice and Palliative Care Organization (NHPCO) is the nation’s largest and oldest membership association for providers who care for people affected by serious and life-limiting illness. Our members deliver and expand access to high-quality, person-centered interdisciplinary care to millions of Americans. NHPCO provides education and resources to support that mission. Together with our advocacy partner, the Hospice Action Network (HAN), we serve as the leading voice advancing public policy to improve serious-illness and end-of-life care, while our CaringInfo program provides free resources to educate and empower patients and caregivers. nhpco.org.

Press Contact:
Madison Summers
Phone: 571-412-3973
Email: msummers@nhpco.org

NHPCO and NAHC Boards Agree to Pursue Creation of a New, Combined Organization

For Immediate Release
August 10, 2023

Newly Created Organization Would be Stronger Voice to Represent the Spectrum of Home and Community-Based Healthcare Providers

(Alexandria, VA and Washington, DC) – The Boards of the National Association for Home Care & Hospice (NAHC) and the National Hospice and Palliative Care Organization (NHPCO) agreed to a joint process to explore the formation of a new organization to combine the strengths of both NAHC and NHPCO and better serve members with a unified voice on behalf of the entire community of hospice, home care, palliative care, serious illness, and other care at home providers.

The Boards of NHPCO and NAHC this week signed a non-binding Letter of Intent to pursue the possible combination of both organizations into a new, as-of-yet unnamed organization. Each Board voted on this course of action following the recommendations of a Steering Committee composed of member and staff leaders from both organizations. The Steering Committee’s recommendations were informed by consultations with members of both organizations. The Committee has been working, with the support of association consulting firm McKinley Advisors, since the March 8, 2023 joint announcement (NAHC website, NHPCO website) that NHPCO and NAHC would explore opportunities for deeper collaboration.

“The American healthcare system is shifting, and home and community-based care options are increasing in a multitude of forms across the country,” said Melinda Gruber, PhD, MBA, CNA, NHPCO Board Chair, and President of Caring Circle/Vice President, South Region, Medical Group and Continued Care of Corewell Health. “With decades of experience in hospice and home care, NHPCO and NAHC members are the long-standing experts, and they are evolving to meet patient needs in a shifting environment. As we look ahead, we see an opportunity for the organizations representing those providers to evolve. In this time of change, we are acting with intention and care to continue meeting the needs of providers, patients, families, and communities well into the future.”

“The collaborative process of the NHPCO and NAHC Boards over the last five months has brought the two organizations closer together,” said Kenneth Albert, R.N., Esq., NAHC Board Chair, and President and CEO of Androscoggin Home Healthcare + Hospice. “In addition to the Board-level discussions, our organizations have been collaborating on multiple advocacy efforts, as well as projects such as the Value of Hospice research. Through these efforts, it has become crystal clear that we can do more on behalf of our members by working together. If the current discussions do not lead to a new, combined organization, the outcome will nevertheless be closer working relationships on behalf of community-based and home care providers.”

In the coming months, the NAHC and NHPCO Boards of Directors will work together, in consultation with member volunteers from both organizations, to determine details of how a consolidated organization could represent the best interests of the combined memberships. The organizations expect this process to take six to ten months. McKinley will continue to support the process as an independent, third-party advisor. To facilitate an effective process, both Boards have decided to suspend elections for new Directors this year.

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About NAHC

The National Association for Home Care & Hospice (NAHC) is the voice of home care and hospice. NAHC represents the nation’s 33,000 home care and hospice providers, along with the more than two million nurses, therapists, and aides they employ. These caregivers provide vital services to Americans who are aged, disabled, and ill. Some 12 million patients depend on home care and hospice providers, who depend on NAHC for the best in advocacy, education, and information. NAHC is a nonprofit organization that helps its members maintain the highest standards of care. To learn more, visit nahc.org.

About NHPCO

For additional information, see the Frequently Asked Questions (NAHC website, NHPCO website).

Congressional Briefing Demonstrates the Value of the Medicare Hospice Benefit

For Immediate Release
July 28, 2023

New Research Shows Hospice Produces Better Outcomes, Lower Medicare Costs

(Washington, D.C. and Alexandria, VA) – On Thursday, July 27 a panel of healthcare experts presented groundbreaking new research at a Capitol Hill briefing for Congressional offices, showing that patient use of hospice contributed to $3.5 billion in Medicare savings in 2019, while also providing multiple benefits to patients, families, and caregivers.

The study, conducted by NORC at the University of Chicago, is one of the most comprehensive analyses of enrollment and administrative claims data for Medicare patients covered by Medicare Advantage and Traditional Medicare. The study was funded by the National Association for Home Care & Hospice (NAHC) and the National Hospice and Palliative Care Organization (NHPCO).

Panelists Dianne Munevar, VP of Health Care Strategy at NORC; Dr. Joseph Shega, Chief Medical Office at Vitas; and Susan Lloyd, CEO of Delaware Hospice, related their vast experience with hospice care, extolling its benefit for patients and their loved ones, and also shared findings which prove that longer hospice stays equate to greater savings for taxpayers and overall, better experiences for patients.

Susan Lloyd, CEO of Delaware Hospice shared her personal experience with her mother’s end of life care. “The full benefits of hospice care are realized when the patient and family have the opportunity to engage with the team who provides the support needed wherever [the patient] calls home. Hospice is not a place, it’s a way of caring for people and their loved ones as they are nearing the end of life,” said Lloyd. “One of the greatest blessings of my life was to be there when my mom died. She was not alone; she was surrounded by love. Hospice made that happen for mom, for me, and my family.”

“There’s a lot of myths and misperceptions about what hospice is and what hospice does because of short stays,” said Dr. Joseph Shega, Chief Medical Officer of VITAS. “So when you have a short stay, the hospice does incredible work to try to meet [patients] where they are to honor their wishes […] but if somebody would have that conversation four, five, six, months earlier, they could have an experience like what Jimmy Carter is experiencing now, where he’s chosen he wants to be at home and there’s no difference in life expectancy between those who enroll in hospice earlier vs. those who don’t. With hospice, you can provide that care at home.”

Key findings from the Value of Hospice study include the following:

- - NORC estimates that Medicare spending for those who received hospice care was $3.5 billion less than it would have been had they not received hospice care.
  - In the last year of life, the total costs of care to Medicare for beneficiaries who used hospice was 3.1 percent lower than for beneficiaries who did not use hospice.
  - Hospice is associated with lower Medicare end-of-life expenditures when hospice lengths of stay are 11 days or longer. In other words, earlier enrollment in hospice reduces Medicare spending even further.
  - Hospice stays of six months or more result savings for Medicare. For those who spent at least six months in hospice in the last year of their lives, spending was on average 11 percent lower than the adjusted spending of beneficiaries who did not use hospice.
  - At any length of stay, hospice care benefits patients, family members, and caregivers, including increased satisfaction and quality of life, improved pain control, reduced physical and emotional distress, and reduced prolonged grief and other emotional distress.

(Source: NORC at the University of Chicago)

“The longer the hospice stay, the more the potential savings,” said Dianne Munevar, Vice President of Health Care Strategy at NORC. “Even when hospice care is 89 percent of total cost, spending is still 12 percent lower compared to the non-hospice [patient]. That’s a huge difference and a huge value to Medicare.” Even when hospice stays exceed six months, Medicare still saves money. “The longer the stay across all disease groups…hospice spending was 11 percent lower than the non-hospice users,” explained Munevar.

A recording of the briefing is available.

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About NAHC
The National Association for Home Care & Hospice (NAHC) is the voice of home care and hospice. NAHC represents the nation’s 33,000 home care and hospice providers, along with the more than two million nurses, therapists, and aides they employ. These caregivers provide vital services to Americans who are aged, disabled, and ill. Some 12 million patients depend on home care and hospice providers, who depend on NAHC for the best in advocacy, education, and information. NAHC is a nonprofit organization that helps its members maintain the highest standards of care. To learn more, visit nahc.org.

About NHPCO
The National Hospice and Palliative Care Organization (NHPCO) is the nation’s largest and oldest membership association for providers who care for people affected by serious and life-limiting illness. Our members deliver and expand access to high-quality, person-centered interdisciplinary care to millions of Americans. NHPCO provides education and resources to support that mission. Together with our advocacy partner, the Hospice Action Network (HAN), we serve as the leading voice advancing public policy to improve serious-illness and end-of-life care, while our CaringInfo program provides free resources to educate and empower patients and caregivers. nhpco.org

Six Month Update on Hospice Program Integrity Recommendations

For Immediate Release
July 25, 2023

(Alexandria, VA) – In January of this year, NHPCO and other national stakeholder organizations submitted program integrity recommendations to Centers for Medicare and Medicaid (CMS) Administrator Chiquita Brooks-LaSure regarding ongoing efforts to stop fraudulent hospice activity, focused but not limited to bad actors operating in Arizona, California, Nevada, and Texas. In the six months since, CMS and the Office of Inspector General (OIG) for Health and Human Services have acted on 17 of those recommendations. These program integrity efforts include:

1. 1. Revocation of Medicare enrollment: CMS has identified fraud schemes and increased its operational ability to revoke Medicare enrollment more quickly.
  2. Organizational Deactivation: CMS proposes to revoke Medicare certification if a provider has not billed any claims within six months.
  3. Increased site visits for hospices suspected of being non-operational: CMS has initiated a National Site Visit Project to visit every Medicare certified hospice in the country and revoke Medicare Certification for non-operational hospices.
  4. Put certain new hospices into “high risk” survey category: CMS proposes moving initially enrolling hospices and those submitting applications with new ownership into the “high” level of categorical screening.
  5. Prohibit individuals with convictions for certain crimes from serving as hospice administrators or owners: CMS proposes to require all hospice owners with five percent, or greater, direct or indirect ownership to submit fingerprints for a criminal background check allowing CMS to detect parties potentially posing a risk of fraud, waste, or abuse before it begins.
  6. Ownership disclosure: If the company is not publicly traded, require disclosure of ownership and control, major investors over a certain threshold: CMS proposes modifying the provider enrollment application to collect additional information, including new categories of organization types and organizational ownership.
  7. Drive-by surveys to confirm operations: As previously mentioned, CMS has implemented a National Site Visit Project to visit every Medicare certified hospice in the country.
  8. Require a hospice agency to have specified personnel categories on a CCN application or revalidation and require the hospice agency to provide certain information for individuals in these types of positions: CMS proposes to add hospice administrator and hospice medical director to the definition of “managing employee” which requires hospices to report these roles.
  9. Require new hospices to undergo more frequent surveys: CMS announced enhanced oversight for newly enrolling hospices and hospices submitting a change of ownership, in Arizona, California, Nevada, and Texas.
  10. Care Compare Website: CMS proposes to post data about hospices in the Hospice Special Focus Program at least annually on a CMS public-facing website, increasing hospice transparency.
  11. Require an onsite survey within one year when there is a change in ownership: CMS announced enhanced oversight for hospices submitting a change of ownership, in Arizona, California, Nevada, and Texas.
  12. Prohibit sale or transfer of hospice certification number for specified timeframe: CMS proposes prohibiting sale or transfer of certification within 36 months of certification or most recent ownership change.
  13. Ensure survey oversight for ability to provide all 4 levels of care, including General Inpatient Care (GIP) and respite contracts, as well as provision of continuous home care (CHC) and afterhours care: CMS published a Request for Information (RFI) on Hospice Utilization; Non-Hospice Spending; Ownership Transparency; and Hospice Election Decision-Making. Through this RFI, CMS requested feedback on barriers to higher intensity levels of care.
  14. Presence of corporate compliance plan: OIG announced it would be modernizing its Compliance Program Guidance (CPGs), including the industry-specific CPGs (ICPGs) by the end of 2023.
  15. Hospice Special Focus Program: CMS proposed moving forward with the Special Focus Program targeted at poor performing hospices identified through surveys and quality metrics.
  16. State Operations Manual – Appendix M Hospice Guidance for Surveyors: CMS revised Appendix M to include guidance for surveyor training, accrediting organizations in surveyor training, and protocols for surveyor conflict of interest.
  17. Background Checks (Require background checks on hospice agency owners/administrators): CMS proposed newly enrolled hospices requiring all owners with five percent direct and indirect ownership to submit a criminal background check, including fingerprinting.

This approach is core to NHPCO’s advocacy efforts. For high-quality hospice to continue to exist, hospice care needs to stay true to its core value. In protecting those values, the hospice national stakeholder groups must work together to weed out any bad actors and support the delivery of the highest quality of care.

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Press Contact
Madison Summers
NHPCO Communications
Ph: 571-412-3973

David Klementz and Chris Taelman Join the Hospice Action Network Board of Directors

For Immediate Release
July 24, 2023

(Alexandria, VA) – The Hospice Action Network (HAN), the advocacy affiliate of the National Hospice and Palliative Care Organization (NHPCO), is pleased to announce that Chris Taelman and David Klementz have joined its board of directors.

Klementz is President and CEO of Traditions Health, a nationally recognized leader in high-quality home health, hospice, and palliative care. Taelman joins HAN as a new board member representing the Center for Hospice Care where he serves as Chief Development Officer. The Center for Hospice Care is the largest non-profit provider in Indiana.

“The Hospice Action Network has a long history of members who are dedicated to advocating for the hospice benefit,” said HAN Board Chair, Susan Lloyd. “We’re excited to have David and Chris join our Board of Directors to fulfill our mission of speaking with one voice to ensure all Americans have access to quality hospice.”

“It’s wonderful to see individuals who are committed to supporting and advancing the hospice community. I am confident that the advocacy work of David and Chris with HAN will help raise awareness and foster innovation in end-of-life care,” said HAN Board Vice-Chair, Mark Slobodien.

HAN serves as the hospice community’s preeminent voice in Washington, DC by working directly with members of Congress and regulators, and through participation in the political process. HAN advocacy efforts are focused on policies which create equitable access to hospice and palliative care services serving millions of Americans. Additionally, HAN advocates for the hospice communities’ commitment to ongoing program integrity, and ensuring Congress gives appropriate funding to address the increased demand for a larger workforce, which is providing high-quality care to more hospice patients than ever before.

More information about HAN is available on the Hospice Action Network website. Those interested in learning more about grassroots advocacy efforts for the hospice and palliative care community are encouraged to register with HAN to receive periodic updates and calls to action.

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About HAN: The Hospice Action Network is the advocacy affiliate of NHPCO. HAN works with provider members, state organizations, national healthcare organizations and other relevant stakeholders to advance the NHPCO legislative and regulatory agenda. HAN advocates urge Congress and the Administration to support policies that promote equitable access to high-quality hospice and palliative care for patients and families.

About NHPCO: The National Hospice and Palliative Care Organization is the nation’s largest and oldest membership association for providers who care for people affected by serious and life-limiting illness. Our members deliver and expand access to high-quality, person-centered interdisciplinary care to millions of Americans. NHPCO provides education and resources to support that mission. Together with our advocacy partner, the Hospice Action Network (HAN), we serve as the leading voice advancing public policy to improve serious-illness and end-of-life care, while our CaringInfo program provides free resources to educate and empower patients and caregivers. nhpco.org

Press Contact:
Madison Summers
NHPCO Communications
Ph: 571-412-3973

NHPCO Welcomes Congressional Reintroduction of the Palliative Care and Hospice Education and Training Act

For Immediate Release
July 12, 2023

(Alexandria, VA) – The National Hospice and Palliative Care Organization (NHPCO) and its advocacy affiliate, the Hospice Action Network (HAN) are pleased to support the reintroduction of the Palliative Care and Hospice Education and Training Act (PCHETA) in the U.S. Senate. This bipartisan legislation (S. 2243) would meet the growing demand for serious-illness care by investing in training, education, and research for the palliative care and hospice workforce.

The bill has been introduced by Senator Tammy Baldwin (D-WI) and Senator Shelley Moore Capito (R-WV). This bill is also co-sponsored by Senators Kyrsten Sinema (I-AZ), Lisa Murkowski (R-AK), Jeff Merkley (D-OR), Mike Rounds (R-SD), Jack Reed (D-RI), Cindy Hyde-Smith (R-MS), Kirsten Gillibrand (D-NY), Marsha Blackburn (R-TN), John Boozman (R-AR), Roger Marshall (R-KS), Maria Cantwell (D-WA), and Angus King (I-ME).

“Having served as my grandmother’s primary caregiver, I know the difference quality palliative and hospice care can make for a loved one who is battling a serious illness,” said Senator Baldwin. “Our bipartisan Palliative Care and Hospice Education and Training Act will make an overdue investment in education and research to ensure doctors, nurses, and health care professionals have the tools they need as they work tirelessly to keep patients with serious or life-threatening illnesses comfortable and safe. This legislation will help more Americans get the training they need to provide palliative care, help strengthen our health care workforce, and also ensure those with serious illness get the care they deserve.”

“The need for high quality palliative and hospice care services—which are vital for patients and their families—continues to grow, making passage of our bill needed now more than ever,” said Senator Capito. “As a caregiver for parents that suffered from Alzheimer’s disease, I saw firsthand just how valuable these services can be. In order to preserve access to this care, our bill would strengthen training and education opportunities for individuals working in these fields. I look forward to working with Senator Baldwin and my colleagues in the Senate to pass this legislation.”

Palliative and hospice care focus on improving patients’ quality of life and relieving suffering from serious illnesses and pain management. Findings from a recent study on the Value of Hospice Care, by NORC at the University of Chicago, show that at any length of stay, palliative and hospice care benefits patients, family members, and caregivers, including enhanced quality of life, increased satisfaction, reduced physical and emotional distress, improved pain control.

“Every American facing a serious or life-limiting illness deserves access to quality hospice and palliative care. We desperately need to train more professionals in the field of palliative medicine. Without efforts to address the existing workforce shortage, there will be only one palliative physician for every 26,000 seriously ill patients by 2030,” said COO and interim CEO of National Hospice and Palliative Care Organization, Ben Marcantonio. “Thank you to Senators Baldwin and Capito for your leadership in reintroducing the Palliative Care and Hospice Education and Training Act.”

PCHETA is a critical next step in training and education to address the healthcare workforce crisis as the American population continues to age.

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Press Contact:
Madison Summers
NHPCO Communications
Ph: 571-412-3973

NHPCO’s CaringInfo Program Releases New Resource: Finding Care Outside of the Home

For Immediate Release
July 10, 2023

(Alexandria, VA) – CaringInfo.org, a program of the National Hospice and Palliative Care Organization (NHPCO), is a consumer-focused website that offers information on a breadth of topics related to serious illness and end-of-life care. The mission of CaringInfo is to empower patients and caregivers to make decisions about the care and services they wish to receive.

While hospice and palliative care are often provided in the home, they can also be provided in many other settings, including assisted living facilities, nursing homes, and skilled nursing facilities. To help consumers navigate an often-complex care environment, CaringInfo now offers information on Finding Care Outside of the Home, a new resource that guides patients and families through the questions they should consider when choosing the care that is right for them.

CaringInfo currently provides information on topics including the services provided with hospice care, the differences between hospice and palliative care, the benefits of advance care planning and how to get started, and financial matters to consider and plan for at the end of life. CaringInfo also offers a regularly updated library of each state’s advance directives, including tips for completing each form.

“Serious-illness care continues to be a part of the national conversation, most recently with former President Jimmy Carter’s courageous decision to publicly share his end-of-life journey,” said NHPCO Interim CEO, Ben Marcantonio. “Even as ‘hospice’ becomes a more commonly understood term, there are still many misconceptions that exist. Where hospice and serious illness care is provided, and which services can be used with the hospice benefit, are among the most frequently asked questions from prospective patients and their families. ‘Finding Care Outside of the Home’ is a valuable resource that can be used in answering these questions and more.”

Visit CaringInfo.org, which is free and available to all, to explore the full site as well as the new content.

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About NHPCO

Press Contact:
Madison Summers
NHPCO Communications
571-412-3973

2023 NHPCO Pediatric Facts and Figures Report Released

For Immediate Release
June 28, 2023

(Alexandria, VA) – The National Hospice and Palliative Care Organization (NHPCO) has released the 2023 edition of the Pediatric Facts and Figures Report. The newest publication builds on previous versions and has been expanded with data obtained from a 2019-2020 national survey which includes a comprehensive view of pediatric hospice and palliative care across the United States, based on a wide-ranging needs assessment. Of note, section three includes a unique breakdown of service coverage by county and the type (non-metropolitan and metropolitan). This information can be valuable for program development, research, advocacy, and education.

“Pediatric palliative and hospice care in the United States started in the mid to late 1990s. Since then, providers have made much progress with expanding palliative care teams in most children’s hospitals and growing community-based programs in urban areas. However, there is still much to be done to afford children and their families equitable services and care,” said NHPCO’s Pediatric Facts & Figures Workgroup Chair, Dr. Christy Torkildson. “We hope this data will help stimulate a call to action for more research, education, and advocacy to afford children and their families the care and services they deserve when living with serious illness.”

“One key finding that stood out in this year’s report is that less than half of organizations who responded to the 2020 needs assessment have a dedicated pediatric team,” said NHPCO COO and interim CEO, Ben Marcantonio. “There is a wide-spread shortage of highly trained, pediatric palliative and hospice healthcare professionals in the workforce. This is a barrier to meeting the demands of the ever-growing pediatric palliative care needs. It is crucial to create both individual and group education opportunities to address any misperceptions about pediatric care.”

In total, over 481 hospice organizations from all 50 states plus Washington, DC and Puerto Rico contributed to the NHPCO Pediatric Facts and Figures Report, 2023 Edition from their responses to the 2020 needs assessment. Additionally, the Journal of Palliative Medicine recently published the article “State of the Service: Pediatric Palliative and Hospice Community-Based Service Coverage in the United States.” This is based on the 2020 NHPCO Pediatric Needs Assessment and is a product of the NHPCO Pediatric Advisory Council. The article highlights the hospice and palliative care services provided to children, including the staff who provide care and the scope of services. Additionally, a map highlighting service coverage by county across the United States is included. For more information on pediatric hospice and palliative care, see NHPCO’s pediatric pages.

On July 13, NHPCO will host a webinar on Perilous Pediatric Pathways: The Intersection of Adult Hospice and Children. Using a case-based format, the interdisciplinary team will explore the differences and similarities compared to adults.

The Pediatric Facts and Figures, 2023 edition is online and available to the public through NHPCO’s website under “Pediatrics Professional Resources”.

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Press Contact:
Madison Summers
NHPCO Communications
Ph: 571-412-3973

NHPCO Statement: Debunking Hospice Myths Propagated by Recent News Story

For Immediate Release
June 21, 2023

(Alexandria, VA) – The National Hospice and Palliative Care Organization (NHPCO) published the following statement in response to a recent NBC News story on HCA Healthcare hospitals, suggesting that HCA hospitals may be inappropriately pushing patients toward hospice care. NHPCO is not in a position to comment on HCA specifically. On behalf of our member hospices NHPCO has raised concerns about hospitals pressuring hospices to admit patients in the last hours of life. In a recent comment letter, NHPCO included examples of hospital pressures on hospices and recommended that the Centers for Medicare & Medicaid Services (CMS) or its contractors “should publish specific and accessible guidance about the hospital mortality metric specifically for hospitals and hospices.”

The choice for end-of-life care is deeply personal and should be made by patients, in consultation with loved ones and medical personnel, with a thorough understanding of the prognosis, the various care options available, and the implications of each of those options.

Unfortunately, the NBC report works against the goal of public understanding of healthcare options by perpetuating myths about hospice. NHPCO seeks to clear up three of those myths here:

Myth: To discuss end-of-life needs or care is to “play God.”

Reality: Research consistently shows the vast majority of Americans would prefer to die at home. Yet, a large number don’t get that opportunity, because many medical professionals and systems are not adept at putting patient goals at the center of the care plan. Additionally, one of the main comments hospices receive from patients’ families is, “We only wish we had chosen hospice earlier.” Though the NBC News article never says directly that medical professionals should avoid talking with patients about end-of-life care options, it certainly risks putting a damper on those already very limited conversations, when in fact patients would benefit from the opposite. As a country, we should help medical professionals and facilities improve their capabilities for frank, open conversations with patients and their loved ones about prognosis and care options. By having those conversations effectively, and making referrals to community-based palliative care or hospice earlier, our health system could help more people spend their final days, weeks, or months at home, surrounded by loved ones, and achieving their goals. That is not playing God, it is giving patients what they deserve: complete information and the ability to make choices for themselves.

Myth: After entering end-of-life care, “patients don’t typically live long.”

Reality: The median length of stay in hospice care is 17 days and the average lifetime length of stay is 92.1 days, according to the Medicare Payment Advisory Commission. By sharing information about his personal end-of-life journey, former President Carter has helped Americans understand this reality. President Carter entered hospice care in February 2023 and as of today has been on hospice for more than 4 months. To qualify for hospice under Medicare, a patient must have a prognosis of six months or less to live if the disease runs its normal course. Some patients can and do outlive their prognosis, and in those cases the patient can be recertified for continued hospice care. Study after study after study have shown that hospice patients tend to live longer than patients with similar diagnoses who do not choose hospice care. Research also shows that hospice care—at any length of stay—benefits patients, family members, and caregivers, including increased satisfaction and quality of life, improved pain control, reduced physical and emotional distress, and reduced prolonged grief and other emotional distress.

Myth: “Patients in hospice typically receive only pain medication.”

Reality: While pain management and symptom control are core to hospice care, patients are offered so much more. By definition, statute, and regulation, hospices provide interdisciplinary care driven by patient goals. Hospice patients receive care from a team that includes doctors, nurses, hospice aides, social workers, spiritual care providers, bereavement care professionals, and trained volunteers. Many hospices also supplement those requirements with support from additional experts, such as speech, physical, occupational, music, or art therapists, and/or end-of-life doulas.

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Press Contact:
Madison Summers
NHPCO Communications
Ph: 571-412-3973

Hospice Advocates Bring their Voices to Washington, DC

For Immediate Release
June 16, 2023

NHPCO and HAN Help Ensure Provider Concerns are Heard on The Hill and at CMS

(Alexandria, VA) – More than 70 hospice and palliative care advocates from across the country met with over 130 congressional offices last week to discuss key legislative and regulatory priorities for ensuring and expanding access to hospice and palliative care. The meetings were part of Hospice Action Week, hosted in Washington, DC by the National Hospice and Palliative Care Organization (NHPCO) and its advocacy affiliate, the Hospice Action Network (HAN).

These congressional advocacy actions came a week after NHPCO filed detailed comments on the Centers for Medicare and Medicaid Services’ (CMS) Fiscal Year (FY) 2024 Hospice Wage Index and Quality Reporting Proposed Rule, demonstrating the importance of both legislative and regulatory advocacy for protecting and improving hospice and palliative care. In addition to the full comments, a summary of NHPCO’s recommendations on the proposed rule is available on its website.

The congressional meetings and the FY 2024 comment letter addressed key issues impacting the hospice and palliative care community, including:

Reimbursement: For providers to continue delivering hospice care that Americans increasingly choose, and which has been recently demonstrated to improve patient and family outcomes while saving money, Medicare reimbursement must support delivery of those services. Reimbursement was a focus of both the comments on the FY 2024 Hospice Wage Index proposed rule and Hospice Action Week. Noting that the hospice market basket calculation used to predetermine hospice reimbursements ahead of each fiscal year has resulted in rates that have not kept up with actual market basket increases, NHPCO recommended that CMS use its special exception and adjustment authority to make a one-time retrospective adjustment of 3.7% for the combined FY 2021 and FY 2022 market baskets, in addition to the FY 2024 market basket adjustment of 2.8%, to ensure Medicare payments more accurately reflect the cost of providing hospice care today.

Program Integrity: In keeping with our longstanding efforts on program integrity, both NHPCO’s comments on the FY 2024 Hospice Wage Index proposed rule and the Hospice Action Week advocates’ meetings with congressional offices included a focus on hospice program integrity and fraud prevention. In the comment letter, NHPCO reiterated strong support for all efforts by CMS to address fraudulent behaviors that abuse the hospice Medicare benefit to defraud the system and harm patients. In Washington, hospice and palliative care advocates asked their Senators and Representatives to use their oversight authority to ensure CMS does everything possible to prevent fraud in the hospice system. We continue to advocate for 34 program integrity recommendations we made in January.

Workforce: As noted in the NHPCO comment letter, “Hospice providers are now seeing critical staffing shortages among nurses, social workers, aides, and other members of the interdisciplinary team…Providers report for 2022 nursing wages increased by as much as 23%, aide wages increased by as much as 12% and wages of other members of the interdisciplinary team increased by 5-6%… Hospices are not well positioned to compete with hospitals, staffing agencies, and other post-acute healthcare providers to recruit qualified care team members without significantly increasing their compensation costs.” These challenges speak to the need for reevaluating hospice reimbursement as outlined above. Additionally, advocates meeting with congressional offices recommended reintroduction of the Palliative Care & Hospice Education Training Act (PCHETA), a bill introduced in several recent congresses with broad, bipartisan support backed by NHPCO and HAN, which would establish a national approach to research and education to advance hospice and palliative care medicine.

Community-based Palliative Care: The hospice and palliative care advocates used congressional visits as an opportunity to discuss the importance of advancing a model of Community-based Palliative Care. Within days, U.S. Senators Jacky Rosen (D-NV), John Barrasso (R-WY), Tammy Baldwin (D-WI), and Deb Fischer (R-NE), co-chairs and co-founders of the bipartisan Senate Comprehensive Care Caucus, introduced the bipartisan Expanding Access to Palliative Care Act (S.1845), which would require the Center for Medicare and Medicaid Innovation (CMMI) to develop a Community-based Palliative Care demonstration.

CMS Requests for Information: NHPCO’s comment letter included detailed responses to two Requests for Information included by CMS in the FY 2024 Hospice Wage Index proposed rule, including recommendations related to:

- - Advancing health equity
  - Addressing the number of hospices that do not bill for the required four levels of care
  - Considering the issues with expensive end-of-life treatments, such as blood transfusions, palliative radiation and chemotherapy, and dialysis
  - Exploring options for concurrent curative and hospice care in specific patient situations
  - Improving available information from other Medicare providers about spending when the patient is enrolled in hospice
  - Adding codes to track the provision of services through telehealth and codes specifically for chaplain visits
  - Improving accuracy of ownership data in Care Compare and other government-run systems

Hospice Action Week also featured a meeting of the NHPCO Council of States, a network of leaders of state hospice and palliative care organizations from across the country. The Council of States discussed state and national policy issues of interest to hospice and palliative care providers and the role of state organizations in addressing the issues noted above.

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About NHPCO

NHPCO Contact:
Madison Summers
571-412-3973