Repayments to Medicare May Be Too Much to Ask

Implications: The government has paid hundreds of millions less as a result of these measures. Now, the government has targeted the Hospice industry. Of course, there is no physician that can predict how long a patient will live. Physicians sign orders for Hospice patients that are terminal. The physician cannot know how many days of Hospice care will be provided. Much of the Hospice care is provided in a patient’s home and not in an acute care hospital or skilled nursing facility. Of course, there is no physician that can predict how long a patient will live. Physicians sign orders for Hospice patients that are terminal. The physician cannot know how many days of Hospice care will be provided. Much of the Hospice care is provided in a patient’s home and not in an acute care hospital or skilled nursing facility.

Analysis:  

The article stated that “Congress in 1998 removed limits on how long a person could receive Medicare hospice services but did not remove a cap on the aggregate amount that hospice could be reimbursed each year.” In other words, the pie has to be divided into smaller pieces. More and more patients receive hospice care. How much of this increase is due to the baby boom (aging population), people living longer with serious illness, or physicians and hospice agencies trying to include more types of patients in their hospice programs?

The physicians want the best care for their patients, even terminal cases. If Hospice is available in their area, they will find a way to ask for it. The Hospice agency is providing a valuable service within the Healthcare industry. My grandfather was care for by a Hospice agency. It fills a need within the range of Healthcare services. Hospitals cannot send nurses to the homes of hospice patients. Home Health agencies are not usually geared up in terms of personnel, supplies, drugs and protocols, to provide these services. What will be the impact if the Federal government runs 10% of the nation’s hospices out of business?

The government would like us to believe that mismanagement might be a greater issue than the reimbursement cap. If that is true, why focus on the Hospice industry? Or Home Health? Or Rehabilitation? Let’s be realistic. Whether the Hospice is mismanaged or not, somebody is going to lose an element of Healthcare or be significantly inconvenienced finding another. The mismanaged Hospices may be driven out of business. However, small rural not for profit Hospice care agencies could also be adversely impacted. It seems that if the reimbursement is too high for the government to pay, the reimbursement could be reduced. Asking organizations to repay funds which have already been spent seems a burden too costly to bear.