What to Expect in 2018

It’s the second week of 2018 and both the House and Senate are back in action!  2018 is going to be a very busy year, and one of the first orders of business on the legislative calendar is completion of the FY 2018 budget.  Lawmakers must finalize the FY 2018 budget by Jan 19th or enact another continuing resolution to avoid a government shutdown.

Midterm elections are in November and all 435 seats in the United States House of Representatives and 33 of the 100 seats in the United States Senate are up for re-election.  It may be difficult to pass any significant legislation with control of the house and senate hanging in the balance, but NHPCO will continue to make the voices of hospice organizations heard on Capitol Hill and ensure that our priorities are protected.

Congress is also currently in the process of negotiating a package of Medicare-related legislation known as “Medicare extenders.”  Specifically, NHPCO is pushing for the inclusion of the Rural Access to Hospice Act in the Medicare Extenders Package.  This legislation would increase access to hospice care, especially in under served communities, by allowing clinicians at Rural Health Centers and Federally Qualified Health Centers to serve as the hospice attending physician.  YOU – YES YOU- can support the Rural Access to Hospice Act by contacting your member of Congress today!

Other important healthcare legislation NHPCO is actively supporting and working to bring to the forefront of the healthcare conversation this year include the Patient Choice and Quality Care Act (PCQCA), the Palliative Care and Hospice and Education and Training Act (PCHETA), and the Medicare Patient Access to Hospice Act.

So that’s about it for now! Check back regularly as we’ll be providing a more detailed video and podcast on what the hospice community can expect from NHPCO in 2018.

NHPCO Welcomes New Fullbright Fellow, Lenka Vanova!

Hello everyone, my name is Lenka Vanova and I come to NHPCO as a Fulbright Fellow for the next four months. My educational background is in humanities and cultural management, which I did for more than five years, organizing exhibitions and other cultural events. At the same time, however, I was interested in the ways architecture and design can help people to age in place (and thus lessen the burden on public finance) and devoted my Ph.D. thesis to this topic. After graduation I found a position combining all of my various interests and qualifications and I started to work for a major hospice (a mobile palliative care unit) in Prague, called Cesta domu, as a public affairs coordinator.

Cesta domu is one of the oldest and largest hospices in the Czech Republic and besides providing direct care services to patients, we publish books, run the only Czech public library specialized in palliative care and last but not least, advocate for hospices and palliative care on the national level. And advocacy is what I want to learn here at the NHPCO as I admire the consistent work and comprehensive tools and support it provides to the hospice community. In the Czech Republic, hospice care is only being started to be covered by the public health insurance (as of January 1, 2018, in fact). While this was a major success, plenty is yet to be done. I believe that with an experience from NHPCO, I will be able to help advocate for US policies, but then take that experience home to help the Czech hospice and palliative care community to achieve its goals.

-Lenka Vanova

Message from NHPCO CEO and President, Edo Banach, on Sunday’s New York Times Essay

In light of an essay recently featured in the New York Times, NHPCO President and CEO, Edo Banach, issued this response:

January 9, 2018

I’m sure that many providers have seen the essay that ran in The New York Times Sunday Review this past weekend, “This Was Not the Good Death We Were Promised.”  Journalist Karen Brown shared her family’s personal experience with hospice surrounding her father’s death.  For those who have not seen the opinion piece, the experience did not end well. Ms. Brown did acknowledge the good care that was provided while her father was stable; however, when her father’s condition suddenly took a turn for the worse and he was in great pain and actively dying, the hospice failed to provide the service that was promised and expected.

This is a situation where excuses will not change this family’s experience.  And I know that no provider would find the situation she described as acceptable.

As noted in the article, I spoke with Ms. Brown.  I let her know that the situation she described was not acceptable and I would not make excuses for it.  I also explained that her experience is not that of most patients and families.

Hospice has come a long way in the 35 years since the creation of the Medicare hospice benefit.  More people are accessing care, hospices are serving a wider range of patients with diagnoses beyond cancer, and there is a greater number of providers from which people can get care.  Yet, Ms. Brown’s story reminds us that we can never stop in our efforts to provide the highest quality care possible at all times.

There will always be experiences that do not go as planned, despite the best intention. We must make sure that we learn from situations that are below our standards and we necessary adjustments to ensure preventable problems don’t happen again. As an example from this experience, providers should ensure that on-call processes are well established and that necessary back-up plans are in place. No family should fail to get a timely returned call from a hospice and a prompt visit when indicated, especially during a crisis situation.

I was moved by the number of hospice professionals that posted responses to this essay on the NY Times website. They acknowledged this situation was a failure. Many readers also shared individual reflections on personal hospice experiences that were very positive; this high level of care is something that I have seen provided by so many of you all across the country.

As a provider community, we must be sure that we take this family’s experience and use it as a learning opportunity.  We must be careful that we don’t use this “hospice failure” to disparage other provider types. Ms. Brown made a specific choice not to share the name of the hospice.  So let us take this situation as an opportunity for all of us to remember our commitment to quality and excellence.



Edo Banach, JD

President and CEO



Support Rural Access to Hospice!

As the end of 2017 approaches, Congress is rushing to complete a package of healthcare reforms known as Medicare Extenders. Some of these proposals could negatively impact hospice referrals, so HAN is urging Congress to include the Rural Access to Hospice Act, which improves access to hospice care in rural and underserved areas, in the Medicare Extenders year-end package.  We need YOU – yes YOU – to reach out to your Members of Congress and encourage them to support the inclusion of the Rural Access to Hospice Act.

The Rural Access to Hospice Act would increase access to hospice care, especially in underserved communities, by allowing clinicians at Rural Health Centers and Federally Qualified Health Centers to serve as the hospice attending physician.  RHCs and FQHCs were created in response to a shortage of physicians serving Medicare patients in underserved rural and urban communities and are paid a fixed, all-inclusive payment for all of the services they provide.  Unfortunately, these health centers are not paid for providing hospice care.  If the Rural Access to Hospice Act is passed, RHCs and FQHCs would receive payment for serving as the hospice attending physician and more people would have access to the quality, end-of-life care that they deserve.

HAN and representatives from numerous hospice organizations have already started contacting Members of Congress regarding Medicare Extenders, but your help could make even more of an impact.  View our fact sheet for more information about the Rural Access to Hospice Act and visit our Rural Action Center to tell Congress to include the Rural Access to Hospice Act in any Medicare Extenders package. Take action today!

Hospice in the News!

On December 10th, The Washington Post published an article about the negative effects of deferring hospice care.  It includes information about a study conducted by Thomas Michael Gill, a professor of medicine, epidemiology and investigative medicine, at Yale University who agreed that the terminally ill are often referred to hospice later than they should.

The majority of hospice patients die within two weeks of receiving hospice care, not nearly enough time for patients or their family members to experience the substantial benefits of quality, end-of-life care.  NHPCO is continuously working to spread awareness about this issue through its advocacy efforts and we encourage you to join us by using our Advocacy Toolkit to contact your local representative.