End-of-Life Care Membership Organizations React to MedPAC Hospice Recommendations

Last fall, the Medicare Payment Advisory Commission (MedPAC) released draft recommendations to the Centers for Medicaid & Medicare Services (CMS) for modifications in the payment system, accountability measures, and data collection of the Medicare hospice benefit. The final recommendations are expected shortly. Yesterday, several national end-of-life care organizations that are concerned with legislative matters released a consensus statement on the protection of the Medicare hospice benefit.

This joint statement addresses MedPAC's draft recommendations directly.

Over the past several years, MedPAC has undertaken a review of the Medicare hospice benefit. While specific reforms and enhanced accountability measures are laudable and should be encouraged, those changes should be framed in the context of a comprehensive review of the various and complex components of end of life care and how the continuum of care can be expanded to increase access for patients and families. Included in this comprehensive review of hospice should be payment methodologies, fiscal constraints review, alternative eligibility criteria, and testing of new models of care, as well as any number of other issues. The hospice community is committed to work toward these goals.

Guiding this review ought to be several clear principles. Among them are:

• Advancing hospice and palliative care providers as the recognized providers of end of life care.


• Preserving and enhancing the Medicare Hospice Benefit.


• Recognizing high quality as the standard to which all providers must subscribe


• Ensuring accountability through transparency and fair regulatory scrutiny


• Promoting increased access through expansion and collaboration