Uncharted Territories of Palliative and Hospice Care: Navigating Insurance and Ownership Realities
Amy Schiffman, MD, MHS, HMD
CEO AgeTech DC, CMO HealPros, Co-host of Mastering Medicare Podcast
Today's insight highlights the distinct roles of Palliative and Hospice Care in addressing the needs of patients with serious illnesses and those nearing the end of life. Palliative care focuses on alleviating the physical, emotional, and psychosocial burden of serious illnesses, allowing patients to pursue curative treatments. On the other hand, hospice care prioritizes comfort and symptom management for terminally ill individuals, foregoing curative measures. Both care types involve a multidisciplinary team and are generally covered by insurance and Medicare. Choosing between palliative and hospice care necessitates thoughtful consideration of personal values, prognosis, and insurance coverage.
A concerning trend in the American hospice care industry reveals a growing dominance of for-profit entities, accompanied by private equity firms entering the scene. This shift raises concerns about increasing costs, potential fraud, and compromised care quality. Issues such as fraudulent patient enrolment, improper categorization of care, and reduced care quality due to cost-cutting practices contribute to the concerns. Non-profit hospices are becoming less prevalent, influenced by financial constraints and heightened scrutiny. While some argue that consolidation and privatization can maintain quality, critics caution that it may compromise patient care. Additionally, there are proposed Medicare coverage changes, which might potentially integrate hospice into the Medicare Advantage program.
Furthermore, the insight highlights the significance of public reporting of hospice quality data to identify high-quality providers. A cross-sectional analysis of US hospice data indicates that family caregivers often report poorer care experiences at for-profit hospices compared to not-for-profit ones. However, there is variation in reported quality among both types. Dispelling misconceptions surrounding hospice care is crucial, as it serves various serious illnesses, offers symptom relief, and supports patients and their families. Hospice care can be initiated by anyone and is typically covered by insurance, making it accessible and easing the burden on those in need. Understanding these complexities is essential for informed decision-making about end-of-life care options.
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Read more: https://www.aginghere.com/p/july-28-2023-aginghere-compassion-commerce-navigating-complex-landscape-hospice-care-america