Hospice Does its Part to Create Value for Medicare

Hospice of Siouxland is a mission-driven organization that provides compassionate care for individuals living with a life-limiting illness and their families through quality medical, emotional, spiritual and social support. Our commitment is first and foremost to the patients and families we serve.

But our constituencies extend even further, including to the community, our own staff and, yes, even the payors who make Hospice of Siouxland financially feasible. Being accountable to payors, including private insurance companies, Medicaid and Medicare, means Hospice of Siouxland must be committed to providing value; that is, quality care and efficient services at a fair cost.

My job as the administrator of Hospice of Siouxland is to provide leadership that ensures faithful adherence to our standards for high value. Expectations are growing for care providers, including Hospice of Siouxland, to make sure that reimbursement through entitlement programs such as Medicare and Medicaid are still adding value to the services they support.

For years the hospice and palliative care community has made the case that hospice enrollment creates cost savings for Medicare. A new report published in the March issue of Health Affairs indicates this to be true – that hospice patients have lower Medicare costs, reduced use of hospital services and that hospice care improves overall care quality.

The study was conducted by the Brookdale Department of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai. Researchers looked at the most common hospice enrollment periods and found that hospice patients had significantly lower rates of hospital and intensive care use, hospital readmissions and in-hospital death when compared to the matched non-hospice patients. The study also reveals that savings to Medicare are present for both cancer patients and non-cancer patients. Moreover, these savings appear to grow as the period of hospice enrollment lengthens.

Is saving money the goal of hospice? Of course not. The goal of everyone in health care is to provide the right care, at the right time and in the right place. Many people in Iowa and across the nation are learning that there is a time when aggressive treatment, intensive care and long hospital stays are no longer worth the toll they can take on quality of life. When that time comes, hospice is often the right care as it allows patients and their families the comfort and control we all want at the end of life.

Dollar savings is simply an offshoot of the public’s greater understanding of end of life and the role of hospice. But it is also a sign of a cultural shift in the medical world, moving toward patient-centered care and in support of quality of life, moving away from doing everything we can and moving toward doing everything we should – with patients firmly in control.

By living up to its mission and values, Hospice of Siouxland provides value to all of our constituencies.

Linda Todd

Executive Director

Hospice of Siouxland