Cuts in Medicare have dealt a blow to nonprofit providers

Joan Wickersham highlighted the exceptional services that hospice can offer. But her column should have come with a stark warning: Costs are increasing, access is decreasing, and Congress is ignoring the problem.

As a registered nurse, I find it disappointing that some have turned hospice care into a for profit-hustle. As chief executive of a nonprofit service provider, I am concerned that after years of underpayment, a new round of irresponsible Medicare cuts leaves many independent, nonprofit home care and hospice agencies facing a knockout blow.

Half of Medicare beneficiaries are enrolled in Medicare Advantage, a government-funded private insurance option. Medicare Advantage insurers are free to set significantly lower provider reimbursement rates. For many small, independent nonprofits that aren’t equipped to negotiate with them, rates are significantly lower than for-profits.

Post-pandemic, where two-thirds of states reported permanent closures of home community-based service providers, hospice and home health care continues to face increasing financial pressure. Inevitable closures will cause further consolidation. This will affect patient access, quality of care, and resources and force patients into emergency rooms and hospitals, further increasing overall costs and putting additional stress on the system.

RENEE MCINNES

Chief executive officer

NVNA and Hospice

Norwell

The writer also serves on the board of directors for both the Home Care Alliance of Massachusetts and the Visiting Nurse Association of New England.