Hospice care scrutinized

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Medicare would increase hospice reimbursements by 1.3% in fiscal year 2015 under a payment rate proposed in May. This would be a $230 million boost, according to the Centers for Medicare & Medicaid Services.

This welcome news for providers came one day before the Washington Post published an article claiming that a significant number of hospices are skimping on care.

About 1 in 6 hospice agencies did not bill for any continuous home nursing care or inpatient care in 2012, according to a Post analysis of “millions” of Medicare records. Continuous care is supposed to be provided for patients requiring constant skilled nursing services, as they might when near death or when their condition worsens.

Payment policy might be to blame, the Post suggested. Medicare reimburses at a higher rate for continuous care than routine care, but providing constant nursing — whether in a patient's home or in a skilled nursing facility — still can cut into bottom lines, some hospice owners told the newspaper. 

The proposed 2015 rates put continuous care at $930 a day and routine home care at $160.

Any providers that neglect to provide continuous care do not represent “the hospice community as a whole,” said J. Donald Schumacher, president of the National Hospice and Palliative Care Organization.