Obama talks about end-of-life planning as hospice providers lobby against funding cuts

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President Barack Obama suggested at a town hall meeting at the White House last Wednesday that some end-of-life education and planning could help save on medical expenses. A day later, hospice care organizations asked the president to halt funding cuts for their programs.

Hospice and palliative care organizations on Thursday sent the president a letter urging him to stop Bush Administration-approved cuts to Medicare hospice programs set to take effect on October 1. The more than 3,500 organizations pointed to a recent Robert Woods Johnson Foundation study that found hospice programs save $2,300 per patient for Medicare—up to $2 billion per year. The cuts in question would reduce hospice rates by eliminating a portion of the hospice wage index calculation called the Budget Neutrality Adjustment Factor (BNAF). The one-page letter was followed by 39 pages of signatures.

On Wednesday, the president recounted the story of his own grandmother, Madelyn Dunham, who succumbed to cancer two days before the presidential election. After breaking her hip in a fall, the president and his family struggled with a choice between hip replacement surgery and a more palliative approach. Obama suggested that families need more and better information to help make similar decisions under circumstances where evidence shows that additional expensive tests and treatments won't necessarily improve care.