Hospice saves money. Why the time limit?

Hospice saves Medicare billions annually. This is the conclusion of research reported by author Jim Parker in Hospice News. One might argue these research conclusions are merely common sense observations. Think about it - if a patient selects hospice care they avoid much more expensive hospital care. The longer the patient is in hospice the greater the savings to Medicare. Yet the Office of Inspector General for the United States Department of Health and Human Services (OIG) considers stays of longer than 6 months in hospice to be grounds for fraud. Medicare and the OIG need to support hospice, not investigate it, if they wish to save billions for Medicare. Furthermore, Medicare should pay for hospice based on an hourly cost - and not pay hospice based on a complex coding system that encourages fraud and needless OIG oversight. To learn more details on these observations read The Journey’s End.

Solutions for avoiding aggressive EOL care

Many older patients today are not getting what they wanted. Instead, they are receiving invasive--and unproductive--care in the last month of their lives. As Paula Span eloquently explains in her The New York Times article, Aggressive Medical Care Remains Common at Life's End, elder care is fraught with these trials and tribulations. While the systemic reasons for these failures and frustrations would take an entire book to explain (trust me--my book is available April 4th), Span points to two potentially powerful solutions:

• Making more of an effort to offer patients Palliative Care Consults before offering aggressive end-of-life treatments like chemotherapy, dialysis, surgery, or a visit to the ICU.

• Allowing patients the option to continue curative treatment while in hospice. Reforming Medicare to allow this would benefit everyone. In fact, VA Insurance has found it beneficial to offer curative care in hospice. Even Medicare itself piloted a project showing that hospice with curative care improves experience and lowers costs.

If you found Span's article of interest, you might benefit from my book, The Journey’s End, which was written to help you avoid a similar fate at your life's end.

When you avoid dealing with a problem, it only gets worse

A general rule of life is that when you avoid dealing with a problem, it only gets worse.

Take the recent Wall Street Journal article "No Basis in Mathematical Reality" by James Freeman. It diagnoses one the most dire issues facing our nation - Medicare and Social Security's underfunded future.

In the article, Freeman focuses on cold, hard facts from a recent Congressional Budget Office (CBO) Report, citing what Brian Riedl of the Manhattan Institute wrote in the New York Times: “Over the next three decades, the Social Security system is scheduled to pay $21 trillion greater than its trust funds will collect…The Medicare system is projected to run a $48 trillion shortfall. These deficits are projected to, in turn, to produce $47 trillion in interest payments to the national debt.”

Of course, Congress is considering tax increases, but those new revenues would likely only cover 66 percent of the projected shortfall in funds. Clearly, some critical thinking is needed here. Fortunately, my forthcoming book, The Journey’s End, offers pragmatic reforms that could help make Medicare more affordable. Speaking of affordable, copies cost less than one trillionth of these projected shortfalls. But make sure to pre-order now...after all, when you avoid dealing with a problem, it only gets worse.