How to improve hospice care
Hospice care is a beautiful thing. When patients are about to embark on their end-of-life journey, many seek comfort in professional hospice services. Throughout my career, I’ve seen firsthand how hospice has alleviated patients’ pain, provided spiritual strength, and helped families cope with losing a loved one.
Providing end-of-life care is a tremendous responsibility and an immense privilege. Like any patient, New Yorkers who choose to take advantage of the Medicare hospice benefit should be treated with dignity, compassion and respect. Through coordinated, personcentered care, we address each patient’s unique needs (physical, emotional, and spiritual), while also helping their families cope and find peace. As hospice professionals, we’re committed to ensuring that every patient and family we care for experiences the best of what humankind has to offer.
Unfortunately, a handful of hospice providers across the country have fallen short in their commitment to patients and their families. A recent report from the Office of the Inspector General detailed isolated incidents of substandard hospice care and neglect. The media coverage that followed largely focused on the terrible specifics of these incidents, all of which are unacceptable. There is no excuse for the horrendous care detailed in these case studies, but I want to stress that these instances do not represent the overwhelming majority of providers across the country or the values that define our philosophy of person- and family-centered care. I hope the content and angle of these news stories did not scare or discourage consumers from finding out more about hospice because that would be a disservice.
The report also outlined suggested reforms that the Centers for Medicare & Medicaid Services (CMS) should adopt to increase oversight, education and transparency of hospice providers. Hospice leaders with the National Hospice and Palliative Care Organization and the Hospice and Palliative Care Association of New York State support measures that will ensure patients always receive safe, professional and high-quality care. As the president and CEO of the Hospice and Palliative Care Association of New York State, I am proud to collaborate with NHPCO and policymakers in efforts to ensure hospice program integrity and stop cases of fraud and abuse before they occur.
The first step proposed by NHPCO in meeting this goal is expanded oversight of hospices. This means increased frequency in provider reviews, especially of new or recognized poor-performing hospices. CMS should also increase the penalty for hospice providers who choose not to participate in Medicare’s hospice quality reporting program.
Although improved oversight will increase the likelihood of identifying bad actors, the majority of mistakes made in hospice care stem from unintentional, clerical errors. To address these shortcomings, more training and education should be available for hospice providers as well as for the inspectors charged with reviewing them, so that evaluations are consistent and actionable.
What matters most to everyday consumers, however, is transparency. The decision to enter hospice care is emotionally charged and often overwhelming. CMS should do more to help consumers navigate their choices by providing survey reports and hospice accreditations. Improvements should also be made to the existing Hospice Compare tool.
When done right, hospice is indeed beautiful. The opportunity to transition from life to death with the love and support of experts should be available and provided to all who seek it, with the knowledge that the care provided will meet patient and family needs and be of the highest quality.