Hospice Leaders Applaud Expanded

Access for Patients

Edo Banach, President and CEO, National Hospice and Palliative Care Organization

Medicare beneficiaries will enjoy easier access to hospice care thanks to recent legislation, according to the National Hospice and Palliative Care Organization (NHPCO), which applauded the change.

A provision to allow physician assistants (PAs) to serve as attending physicians for Medicare patients who want to receive hospice services was included in the recent two-year federal budget deal.

“This common sense, bipartisan legislation will go a long way to ensuring that patients can have their preferred care team at the end of life,” said NHPCO President and CEO Edo Banach.

Edo Banach, President and CEO, National Hospice and Palliative Care Organization

Currently, even though there is a shortage of hospice providers in many rural and underserved communities, Medicare lets only physicians and nurse practitioners serve patients who want to sign up for hospice.

This often forces people who receive primary care from a PA to give up that provider when they elect hospice. The Medicare Access to Hospice Act removes this barrier for patients and families and for hospice providers, NHPCO said.

“Hospice providers in communities across the country, especially those in rural and underserved areas, have a difficult time finding enough primary care providers to serve their patients,” Banach explained. “ Allowing PAs to serve as the attending physician will relieve the burden and allow for a more seamless delivery of care.”

A related proposal, The Rural Access to Hospice Act, was not included in the budget deal. It would eliminate the rule that restricts physicians at Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) from serving as hospice attending physicians.

Both FQHCs and RHCs play critical roles in ensuring access to healthcare for all Americans, regardless of where they live, NHPCO explained in a letter drafted for hospice advocates to use. “It is imperative that these clinics, who reach some of our most vulnerable neighbors, be able to continue serving their patients when they elect hospice,” the letter declares.


How Can We Remove Stigma from Hospice Use?

“We wish we had called hospice sooner.” That may be the most frequently expressed regret that hospice staff and volunteers hear.

In a recent op-ed essay, Tarrah Lowry-Schreiner of Sangre de Cristo Hospice & Palliative Care in Pueblo, CO, tried to address “what makes a [family] caregiver so reluctant to call in the hospice care cavalry for an ailing loved one at the end of life?”

Lowry-Schreiner listed common reasons for delay:

  • If you refuse to recognize that a loved one may be dying, maybe it won’t happen.
  • If you see hospice as a last resort, you reinforce the view that death means disease has defeated medicine.

The danger is, efforts to prolong life may end up prolonging pain and suffering instead, she wrote. [ Click here to read the full essay, which appeared in the Pueblo Chieftain.]

“ When people make the hospice decision, they are choosing to live out the rest of their lives with dignity,” Lowry-Schreiner declared.

“We truly can offer much-needed hope for people dealing with terminal illnesses because even when there’s no hope for a cure, there’s still hope for pain-free days and hope for more time with family and loved ones,” she concluded.

As part of our reinvigorated focus on encouraging the use of hospice services, the National Hospice Regatta Alliance will be sharing pro-hospice commentary with people involved in hospice regattas throughout 2018.

Do you have a video testimonial or written essay you would like to share? Please contact the Alliance today.