Racial Gap in Hospice Care Exacerbated by Misinformation

Today, we present to you this short interview with Dr. Kimberly Johnson, a Geriatric Medicine Specialist and professor at Duke University, and guest speaker at the upcoming Clinical Team Conference. Dr. Johnson discusses some of reasons for the low-levels of hospice utilization in the African-American community.

Dr. Johnson points out several reasons for this disparity, and highlights several misconceptions about hospice that were reported in a study on this topic. These issues included forgoing curative treatment, mistrust in the healthcare system as a whole, understanding suffering as a spiritual trial, and fear of the possible expense of hospice care.

At the upcoming Clinical Team Conference, one of the featured pre-conference seminars will touch on these issues:

  • 9603c11ac916382823befd2770913a992015 Clinical Team Conference and Pediatric Intensive
    Gaylord Texan Resort and Convention Center in Grapevine, Texas
    Wednesday, October 14, 2015, 9:00 am – 5:30 pm
    PC02 – Best Practices for Improving Access and Outreach to Communities of Color in End of Life Care
    Richard Payne, MD, Duke Divinity School, Durham, NC
    Kimberly S. Johnson, MD, MHS, Duke University, Durham, NC
    Corey Kennard, MS, KINGDOM Equipping Ministries, Detroit, MI

Education is the best way to combat misinformation, and as we highlighted previously, making sure that individuals with personal connections tell their story to their networks is a great way of building trust and breaking down barriers. The Moments of Life campaign is collecting  stories from willing patients and families who want to share the positive impact hospice has made in their lives, and how hospice has helped them enjoy more moments of life. They have a beautiful story about Willie Campbell, a 93-year old African-American great-great-great grandmother for whom hospice made a significant contribution to her quality of life.


Additionally, providing incentives for doctors and other medical personnel to have conversations with patients and families about their end-of-life options, and having a multi-disciplinary team that could include a spiritual advisor could help bridge this gap. That is why we continue to support and advocate for the Care Planning Act. What other ways can we ensure that understanding of and access to hospice care is equal for all parts of the community?

Highlighting the “P” in #HPM

#HPM chat this week focused on Palliative Care— an area that needs more attention than it gets. Hospice is type of palliative care, but palliative care has much wider application than just at the end-of-life.

Judith Skretny, Director of Palliative Care at NHPCO, is working in conjunction with the MJHS Institute for Innovation in Palliative Care to present a webinar series on palliative care that includes all members of the team and addresses some key issues. Webinars offer 1.0 AMA PRA Category 1 Credits™, 1.0 Nursing CE credits and/or its equivalent according to the discipline.

Additionally, HAN is monitoring the progress of the Palliative Care and Hospice Education and Training Act (H.R. 3119), also known as PCHETA. The bill was introduced by Rep. Eliot Engel, NY 16, and currently, it has 8 Cosponsors:

  1. Emanuel Cleaver, MD 05
  2. Tom Reed, NY 23
  3. Greg Walden, OR 02
  4. Reid Ribble, WI 08
  5. Matthew Cartwright, PA 17
  6. Mike Coffman, CO 06
  7. Christopher Gibson, NY 19
  8. Chellie Pingree, ME 01

Finally, at the upcoming Clinical Team Conference and Pediatric IntensiveNHPCO is offering two specific sessions on palliative care:

  1. Two Day Intensive Training: Pediatric Palliative Care Training
  2. Single Day Class: Leading the Way to Community-Based Palliative Care Success

We need to hear from you, our grassroots activists, about your needs in palliative care: Do you need training? Advocacy materials? What can we do for you in your palliative care programs? We are all ears, so please let us know in the comments!

End of Life Cartoons?

Noted editorial cartoonist Jack Ohman has been chronicling his father’s final months in a touching cartoon anthology.

Through the comforting and familiar vehicle of newspaper cartoon, Mr. Ohman addresses many of the challenges we hospice workers, volunteers, patients, and families see on a daily basis: denial, unpreparedness, caregiver exhaustion, fear, regret, resignation. By addressing such a difficult subject in a unique and accessible way, Mr. Ohman has touched a wide audience and helped foment thought and discussion around important end-of-life issues.

I recommend everyone view the entire anthology. After reading it, I was struck by the idea of how can we best communicate these difficult topics in a comfortable, accessible way? Newspaper cartoons are a part of millions of Americans’ childhood experiences, and could be a great vehicle for expressing the difficult emotions associated with end-of-life and bereavement issues. Have you seen or used cartoons like this before, whether for patient/family outreach or staff training? How about for advocacy? Could we draw some of our own cartoons and submit them to local newspapers? I am excited by the idea for using alternative methods of communication to bring more attention to hospice issues! Let me know what you think in the comments!


ICD-10 Countdown!

Who doesn’t love a good countdown clock, right? Even CMS has a countdown clock for the implementation date for ICD-10!

In case you don’t stay up late reading the latest medical billing news, here’s a quick recap of what’s going on with ICD-10. ICD-10, or the International Statistical Classification of Diseases and Related Health Problems (ICD), is a coding system composed of over 14,000 codes for diseases, injuries, and other factors influencing a patient’s health. These codes will replace the ICD-9 coding system, which is 36 years old.

All claims with dates of service of October 1, 2015 or later must be submitted with a valid ICD-10 code; ICD-9 codes will no longer be accepted for these dates of service. For hospice providers, this change most directly applies to diagnosis coding on claim forms. On October 1, 2015 and going forward, a claim cannot contain both ICD-9 codes and ICD-10 codes. Claims containing ICD-9 codes for services on or after October 1, 2015:

  • ​will be Returned to Provider (RTP) and not processed.
  • must be re-submitted by the provider with the appropriate ICD-10 code.

So there’s a lot depending on attention to detail and accuracy in utilizing ICD-10. Need some resources? Luckily for NHPCO members, our friends down the hall in the Regulatory Department have collected a wealth of information to help hospice providers transition to ICD-10. Check it out for all of your ICD-10 needs! The Regulatory team has also highlighted a webinar on transitioning to ICD-10, lead by NHPCO consultant Jean Acevedo, LHRM, CPC, CHC, CENTC. The webinar will be held this Thursday, September 17, 2015.

Advocacy Out West!

Oregon2 Oregon1

I’m out in Oregon today, speaking with awesome hospice providers at the Oregon Hospice Association’s Professional Practices Exchange conference. It’s been an invigorating time- I love anytime I can spend with hospice professionals. I took some time to give some legislative and policy context to the work they’re doing every day. We talked a little about the new routine home care rate, and about what the (foggy) crystal ball could tell us about what the future might hold for our community.

I presented right after NHPCO’s fantastic regulatory and compliance director Jennifer Kennedy (a tough act to follow!) It was helpful to give some context to her presentation around the FY2016 Final Rule. We also talked through some successful advocacy strategies, and the importance of the committee structure to the policy making process (and Oregon’s outsized role in that process).

HAN loves to travel- if you’re interested in us presenting in your state, or even hosting a custom webinar, drop us a line at info@nhpcohan.org. We’ll get you the resources you need to be the best possible advocates you can be!