Replacing the Medicare Hospice Benefit
Rosemary Flanigan
January 22, 2010
Because of a query from a friend in Liberty, MO I have just read a Health Affairs article, “A New Medicare End-of-Life Benefit for Nursing Home Residents” by Haiden Huskamp, David Stevenson, et al. (29, No. 1 (2010): 130-135).
The authors allege that high-quality end-of-life care, which is an important component of the final days of many patients in nursing homes, would be better provided by removing the current Medicare hospice benefit and instituting a separate Medicare end-of-life care benefit which would not require that beneficiaries elect it nor would they have to forgo curative care; payment would be folded into the existing nursing home payment; and measurement of the quality of the care would be improved.
Oh, you wise ones out there, this new proposal sounds good to me, even with the potential drawbacks the authors point to. Has this issue come up in your practice?
January 22, 2010
Because of a query from a friend in Liberty, MO I have just read a Health Affairs article, “A New Medicare End-of-Life Benefit for Nursing Home Residents” by Haiden Huskamp, David Stevenson, et al. (29, No. 1 (2010): 130-135).The authors allege that high-quality end-of-life care, which is an important component of the final days of many patients in nursing homes, would be better provided by removing the current Medicare hospice benefit and instituting a separate Medicare end-of-life care benefit which would not require that beneficiaries elect it nor would they have to forgo curative care; payment would be folded into the existing nursing home payment; and measurement of the quality of the care would be improved.
Oh, you wise ones out there, this new proposal sounds good to me, even with the potential drawbacks the authors point to. Has this issue come up in your practice?
Labels: aging and end of life; hospice; bioethics; medical ethics
posted by Practical Bioethics at
12:09 PM
1 Comments:
I suspect this is a good idea. For one thing, everyone on medicare is either old or disabled - a prime population to be assured good end of life care. And, by allowing those nearing the end of life to remain within nursing home care would gradually train nursing home staff in good end of life care. Hospice staff would not be the only experts. the down side of all this - currently medicare pays for very little nursing home care - they would have to expand the length of time, and conditions for which they would authorize nursing home payment.
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