NHPCO Comments on MedPAC’s Hospice Deliberations
For Immediate Release
January 12, 2024
MedPAC Commissioners Abandon their Previous Recommendation to Cut Payment Cap
(Alexandria, VA) – The National Hospice and Palliative Care Organization (NHPCO) today commented on the hospice implications of the public meeting of the Medicare Payment Advisory Commission (MedPAC) held yesterday, as well as MedPAC’s hospice workplan, which has been presented at previous MedPAC meetings.
During yesterday’s public meetings, the MedPAC Commissioners unanimously voted in favor of the Chair’s hospice recommendation, which will be included in the Commission’s report to Congress in March 2024. While MedPAC is not a policy-setting body, its recommendations do bear weight among policymakers and lawmakers. For the first time in five years, MedPAC will not recommend a cut to the hospice aggregate payment cap, which is a per-patient limit on the payments a hospice provider can receive for delivering care.
“MedPAC’s shift away from its previous recommendations to cut the aggregate payment cap is a win for hospices, patients, and families,” said NHPCO Interim CEO, Ben Marcantonio. “For nearly five years, NHPCO and our members have publicly and privately made it clear that cutting the hospice aggregate cap would likely reduce access to hospice care by forcing some providers to close and incentivizing hospices to discharge patients after 180 days of care. We are gratified that Congress never acted on the cap cut concept. Further, we appreciate that MedPAC has heard our concerns, and that its next report to Congress will not include the recommendation.”
On the other hand, NHPCO is disappointed by MedPAC’s recommendation to Congress that hospice reimbursement rates for patient care should not be updated in 2025, although by law hospice payment rates are pegged to the Centers for Medicare and Medicaid Services (CMS) inpatient hospital market basket rate. Hospices continue to face rising cost pressures, and NHPCO has previously advocated to update the market basket rate for hospices as these rates do not reflect the unique situation hospice providers are in.
Marcantonio commented, “At a time when costs have been increasing across the board and hospices are competing for a limited healthcare workforce, keeping hospice payments flat would put the squeeze on hospice providers even as patient demand for hospice care is expected to keep growing. In order to serve the American public, Congress should ensure hospice providers are reimbursed to provide the end-of-life care people want and deserve. We will continue working with MedPAC and Congressional leaders to ensure the hospice care model is not undermined by shortsighted recommendations.”
MedPAC’s hospice workplan outlines the work the Commission is doing to examine hospice spending, care delivery, and related topics now and in the years ahead. The plan cites important studies demonstrating the financial value of hospice care for Medicare, including the Value of Hospice research published in 2023 by NORC at the University of Chicago, which NHPCO discussed with Commissioners ahead of the publication of the workplan. NHPCO will continue to engage with Commissioners going forward on important topics in the workplan, including Medicare savings delivered by hospice care, addressing nonhospice spending for beneficiaries enrolled in hospice, and end-of-life care for beneficiaries with end-stage renal disease.
The National Hospice and Palliative Care Organization (NHPCO) is the nation’s largest and oldest membership association for providers who care for people affected by serious and life-limiting illness. Our members deliver and expand access to high-quality, person-centered interdisciplinary care to millions of Americans. NHPCO provides education and resources to support that mission. Together with our advocacy partner, the Hospice Action Network (HAN), we serve as the leading voice advancing public policy to improve serious-illness and end-of-life care, while our CaringInfo program provides free resources to educate and empower patients and caregivers. nhpco.org