According to a final regulation published Thursday, hospices serving Medicare beneficiaries will see an estimated 2.5 percent increase in their payments for 2009.
As part of the final rule, the Center for Medicaid & Medicare Services is phasing-out, over three years, the budget neutrality adjustment factor (BNAF) to the hospice wage index, beginning with a 25 percent reduction in 2009. The reduction to the wage index portion of hospice payments is partially offset by the annual market basket increase, which is 3.6 percent.
It is estimated that payments to hospices would decrease by approximately 1.1 percent for 2009.
CMS officials say phasing out the BNAF will save Medicare $2.18 billion over five years.
Hospice expenditures are estimated to be about $10.2 billion for 2007. The Medicare Payment Advisory Commission (MedPAC) reports that through 2015, hospice expenditures are projected to grow at a rate that outpaces those projected for hospitals, skilled nursing facilities, physician services and home healthcare.
But some say the cuts will force hospice providers to scale back care for terminally ill patients or close their doors all together.
"The government's reason for its decision that would effectively cut rates - the need to save money - simply isn't true," said Jonathan Keyserling, executive director of the Alliance for Care at the End of Life, an affiliate organization of the National Hospice and Palliative Care Organization. "Research has shown that hospice saves the Medicare system money, is highly rated by family members of hospice patients, and enables the patient to die at home in most cases."
"This rule defies logic and will have a direct, negative impact on care at the bedside," he added.
According to an independent 2007 Duke University study, hospice saves Medicare an average of $2,300 per patient, amounting to a total savings of about $2 billion a year.
"Let's be clear, the administration's cuts will seriously hurt the most vulnerable - the terminally ill," said J. Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization (NHPCO), which represents 4,000 hospices nationwide. "By issuing this rule, CMS is taking an end run around Congress and its longstanding role (of) protecting hospice."
Do you think that Congress needs to intervene and that hospice providers will be hit hard by this? E-mail Associate Editor Molly Merrill at molly.merrill@medtechpublishing.com.