Let's strengthen access to hospice care

While there is plenty to complain about when it comes to healthcare in our country, there is a bright spot that often goes unacknowledged. As Medicare’s first proven coordinated care model, hospice is an example of how patient-centered care can and should work.  It’s a model of care that reaches more than 47,000 New Yorkers each year as a team of compassionate and experienced caregivers come into a patient’s home and work to address all of their end-of-life needs- physical, spiritual and emotional.

Despite the critical role hospice and palliative care – often known as “comfort care” – play in the lives of individuals and families across the state, barriers to care still exist for patients and staffing challenges exist for hospice programs. The best way to address these obstacles to care is through smart, bipartisan public policy reforms, which I recently had the honor of discussing with Congressman Joe Morelle when he visited Lifetime Care Hospice for a roundtable discussion about the policy issues affecting palliative and hospice care.

First, there is a shortage of amply trained hospice and palliative care workers nationwide, in New York and in Monroe and its surrounding counties. At the existing rate, the number of workers receiving education and training will not be enough to meet the needs of the growing number of aging Americans who will require these services.

When meeting with Congressman Morelle,  local hospice and palliative care stakeholders shared their experiences and commended his support in co-sponsoring the Palliative Care and Hospice Training Act (PCHETA).  The bill, if passed, would work to reverse this workforce shortage trend by increasing the number of hospice and palliative care workers through expanded education programs, research funding and increased support for academic palliative medicine programs.

Second, rural New Yorkers are facing unnecessary difficulty when trying to access hospice care. When a Medicare beneficiary becomes eligible and elects to utilize hospice care, they must select a doctor or nurse practitioner to serve as their attending physician. Unfortunately, statutory barriers in federal law mean providers who work in Rural Health Centers (RHC) and Federal Qualified Health Centers (FQHC) cannot bill and be paid for hospice attending physician services. This restricts access to hospice for beneficiaries who want to enter hospice, but don’t want to lose the care of their trusted RHC or FQHC doctor. 

But a bipartisan legislative solution to this challenge also exists. The Rural Access to Hospice Act would allow RHCs and FQHCs to receive payment for serving as the hospice attending physician.

The good news is, these bipartisan, commonsense bills can ensure access to patient preferred palliative care across the Empire state. The truth is all patients deserve high-quality, person-centered hospice care.

Carla Braveman is president and CEO of the Hospice and Palliative Care Association of New York State.