Medicare and Hospice

As a proponent of hospice philosophy and care — comfort and dignity at end of life — it was concerning to read the article, “Hospice and Its Costs,” http:/newoldage.blogs.nytimes.com/2011/06/27. According to the article, hospice costs have risen dramatically over the last 10 years. In these tough economic times, and with Medicare in the spotlight, it would be easy to see the benefit eventually being scaled back. This could hurt the people who really need it.  It’s one program that Medicare has done well and can have a tremendous impact on the physical and emotional well being of the terminally ill and their families. For one thing, hospice brings medical care providers to the patient where they can be tended to in their own environment and in the comfort of their own home. Perhaps there has been abuse of the Medicare benefit by some organizations. Perhaps patients are at times accepted into hospice too early with diagnoses such as dementia where it’s difficult to determine when they might die. The new requirement of “face-to-face” visits by physicians or nurse practitioners before a patient can be recertified to remain on hospice may be one way to identify those who should be discharged from the program and thereby bring Medicare costs down. But for those who truly have a limited life expectancy, hospice is an invaluable and needed service, especially for our elderly population and their families.

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