Medicare Now Offering Some Patients at Select Hospices the Option of Receiving Palliative and Curative Care Concurrently

Credit: medicinenet.com

Medicare recently announced that 141 hospices will be allowed to have its patients participate in receiving both palliative and curative care simultaneously as part of a new initiative. This new initiative, the “Medicare Care Choices Model,” plans to evaluate whether letting patients with life-limiting illnesses opt for both types of care will “Increase access to supportive care services provided by hospice, improve quality of life and patient/family satisfaction, and inform new payment systems for the Medicare and Medicaid programs.” Contrastingly, the current system forces Medicare patients “to forgo curative care in order to receive services under the Medicare or Medicaid Hospice Benefit.”

Firstly, there is a limited amount of hospices that are allowed to work under this model. In addition, the restrictions surrounding participation involve not having used the hospice benefit within the last month before beginning the new model. Indeed, it is noted as being open to “beneficiaries with advanced cancers, chronic obstructive pulmonary disease, congestive heart failure and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS).”

The 141 hospices chosen
(Credit: innovation.cms.gov)

Interestingly enough, due to the high interest in Medicare’s decision to invest more attention in studying the benefits of allowing patients both types of treatment, this model grew from its initial plan of 30 hospices with a three-year duration to one of over 140 hospices with a five-year duration. The model will be divided into two phases with some hospices beginning on January 1, 2016 and the others starting in January 2018.

“And this matters because death is relational. It leaves an emotional legacy.”

This promising program offers so much hope for the terminally ill and their loved ones when it comes to facing difficult end-of-life decisions. As Katy Butler, author of Knocking on Heaven’s Door: The Path to a Better Way of Death, best put it in her recent New York Times op-ed piece, this type of program might be one stepping stone to “start to reduce the widely recognized problem of overly aggressive medical treatment, and attendant suffering, near the end of life.

Studies have found that about a third of Medicare patients have surgery in their last year of life, and 17 percent die in an intensive care unit or shortly after a stay. Too many families have cursed, in hindsight, the false hopes, unheld conversations and rushed medical decisions that led them there. And this matters because death is relational. It leaves an emotional legacy. Everything we do affects those we love, including the manner of our dying. Witnessing death in an intensive care unit often leaves family members with depression, anxiety and complicated grief. So does taking one’s life without saying goodbye.” We can only hope that better options will permanently exist sooner rather than later so that both the dying and their loved ones can truly rest in peace when the end comes.