Affirming the Importance of Hospice Providers Thinking in Terms of Terminal Prognosis
NHPCO Offers Video Examining the Issue of Terminal Prognosis for Providers
ALEXANDRIA, Va., March 30, 2015 /PRNewswire/ -- Determining what aspects of care hospice providers are responsible for has become an issue of growing importance in recent months. National Hospice and Palliative Care Organization is working to help hospice providers with resources that will clarify what many considered a complex issue.
As part of NHPCO's efforts to help providers understand the issue involving terminal prognosis, the organization has created an online video that discusses the topic in an engaging format that will appeal to all hospice staff. The 10-minute video covers key points that are helpful to hospice providers.
"As providers of hospice care, we must properly frame the way we think about and characterize our patients and the scope of our responsibility in providing care to them, providing a comprehensive and accurate picture that validates each patient's eligibility for hospice care by focusing on the basis for their terminal prognosis," said J. Donald Schumacher, NHPCO president and CEO.
Ever since the Medicare hospice benefit was established, "terminally ill" has been defined as "having a medical prognosis that the individual's life expectancy is six months or less." Eligibility for the hospice benefit has always hinged on the patient having a terminal prognosis, regardless of the underlying cause or causes.
There is significant concern from regulators and on Capitol Hill that some providers may be relying on a single diagnosis, thereby defining their scope of responsibility too narrowly, ultimately failing to provide and coordinate all the care and services that they should.
While CMS does require a principal diagnosis on the claim form, the principal diagnosis often is only part of what should be reported to provide the more comprehensive portrayal of the reason for the patient's terminal prognosis.
As Schumacher explains, "The question can be asked, 'Does this diagnosis or condition contribute to or influence the patient's terminal prognosis?' If so, then it is our responsibility."
NHPCO acknowledges that this is likely to increase a hospice provider's responsibilities in a number of ways, but it is the right thing to do.
NHPCO strongly believes that no professionals are more skilled or have greater expertise at managing comorbidities than our nation's hospice and palliative care community and it is the hospice physician who can, and must, be the one to provide the most accurate and timely clinical picture of the individuals receiving hospice care.
"CMS has been very receptive to the proactive steps taken by the hospice community to paint a more comprehensive picture of our patients," noted Jonathan Keyserling, NHPCO senior vice president for health policy.
Eighteen months ago, NHPCO created the Relatedness Workgroup – made up of hospice physicians, clinicians and hospice administrators – who have been discussing the hospice's responsibility and the process a hospice would use to determine which of the patient's diagnoses and conditions would be related.
Tools created by this workgroup are available to NHPCO members in the Regulatory Section of NHPCO's website that includes the "Determining Relatedness to the Terminal Prognosis Process Flow Chart."
Contact:
Anita Brikman
Senior Vice President, Strategic Communications
Ph: 703-837-3154
NHPCO is the oldest and largest nonprofit leadership organization representing hospice and palliative care programs and professionals in the United States. NHPCO's mission is to lead and mobilize social change for improved care at the end of life.
Video - https://youtu.be/wbTSmZe_bFE
Logo - http://photos.prnewswire.com/prnh/20110105/DC25260LOGO
SOURCE National Hospice and Palliative Care Organization
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