Posted on 11/27/2007 6:50:27 AM PST by shrinkermd
Hundreds of hospice providers across the country are facing the catastrophic financial consequence of what would otherwise seem a positive development: their patients are living longer than expected.
Over the last eight years, the refusal of patients to die according to actuarial schedules has led the federal government to demand that hospices exceeding reimbursement limits repay hundreds of millions of dollars to Medicare.
The charges are assessed retrospectively, so in most cases the money has long since been spent on salaries, medicine and supplies. After absorbing huge assessments for several years, often by borrowing at high rates, a number of hospice providers are bracing for a new round that they fear may shut their doors.
One is Hometown Hospice, which has been providing care here since 2003 to some of the most destitute residents of Wilcox County, the poorest place in Alabama.
The locally owned, for-profit agency, which serves about 60 patients, mostly in their homes, had to repay the government $900,000, or 27 percent of its revenues, from its first two years of operation, said Tanya O. Walker-Butts, a co-owner. Its profits were wiped out in the time it took to open the demand letters, Ms. Walker-Butts said.
Hometown paid its first assessment with a bank loan. When the bank declined credit for the second year, the hospice structured a five-year payment plan with the Centers for Medicare and Medicaid Services, the federal agency that administers the program, at 12.5 percent interest.
(Excerpt) Read more at nytimes.com ...
The inevitable result when the government is financing health care. Circumstances change too quickly for a lumbering bureaucracy to keep up.
Don’t worry. If HillaryCare ever gets into play, you’ll die when HillaryCare decides it’s time, if not before....
You’re doing too good a job. We must punish you.
Now will we have a duty to die?
Hillary has a plan for solving the problem:
SOYLENT GREEN!
Great news for Dr.’s who specialize in geriatrics though, the money has to go somewhere....
Now, here's the interesting part...HOSPICE IS A BUSINESS, like any other. They NEED CUSTOMERS. My mother was in the hospice system for three years.
That being said, I still think it saves Medicare money. My Mom was going to the hospital every other week it seemed and she was miserable. When she said, NO MORE HOSPITALS, her doctor was the one who suggested hospice. Like many other people, I though hospice was totally end of life. I had two experiences with hospice. One with my brother who died of cancer at a wonderful facility in Claremont, CA. His stay was about two weeks. and my Dad, who died at his home with hospice care. He had the service for less than a week.
My mom was one of these people they're talking about in the article. When recommended, the doc was sure she was end of life. But when she had this wonderful hospice service at my home, as she lived with me the last seven years of her life, she just kept getting better and happier.
I still believe it's cost effective. I believe one week of intense hospital care is more expensive than a whole year of hospice and not nearly as helpful. So it's up to the government (yea, sure), to tighten up the rules or realize that people want to be comfortable towards the end of their lives, they don't want to be in a cold hospital and linger indefinitely, if possible, they'd rather be at home for a shorter time with people who love them.
Sometimes it balances out...my husband was an out-patient for five weeks, then went on hospice and died a week later.
And when we do not do our duty, we will be "helped along".
By the way, IMO, hospice care is the best thing the medical community has come up with in a very long time. It needs to be refined and explained to people.
By the way, IMO, hospice care is the best thing the medical community has come up with in a very long time. It needs to be refined and explained to people.
And when we do not do our duty, we will be “helped along”.
IN my experience that is already occuring.
Yes. It is occurring and has been for a long time.
For me it is all about quality and not quantity. Some people are so afraid to pass on that they go to heroic measures costing hundreds of thousands of dollars to extend their life for a couple of months, instead of accepting what God has deemed and being with family and friends in quality time. I never want to be a burden on my family or society when it becomes obvious that the cost/comfort ratio becomes too one sided I will go in peace, with my family and friends with me.
I agree with you completely. As usual we see government policies far from solving anything, making things worse.
the whole concept of hospice was to remove the patient from a hospital setting to their home to die......AND save the government money in the process. so it didn’t work out that way?
Bring out your dead!
CUSTOMER:
Here’s one.
CART MASTER:
Ninepence.
DEAD PERSON:
I’m not dead!
CART MASTER:
What?
CUSTOMER:
Nothing. Here’s your ninepence.
DEAD PERSON:
I’m not dead!
CART MASTER:
‘Ere. He says he’s not dead!
CUSTOMER:
Yes, he is.
DEAD PERSON:
I’m not!
CART MASTER:
He isn’t?
CUSTOMER:
Well, he will be soon. He’s very ill.
DEAD PERSON:
I’m getting better!
CUSTOMER:
No, you’re not. You’ll be stone dead in a moment.
CART MASTER:
Oh, I can’t take him like that. It’s against regulations.
DEAD PERSON:
I don’t want to go on the cart!
CUSTOMER:
Oh, don’t be such a baby.
CART MASTER:
I can’t take him.
DEAD PERSON:
I feel fine!
CUSTOMER:
Well, do us a favour.
CART MASTER:
I can’t.
CUSTOMER:
Well, can you hang around a couple of minutes? He won’t be long.
CART MASTER:
No, I’ve got to go to the Robinsons’. They’ve lost nine today.
CUSTOMER:
Well, when’s your next round?
CART MASTER:
Thursday.
DEAD PERSON:
I think I’ll go for a walk.
CUSTOMER:
You’re not fooling anyone, you know. Look. Isn’t there something you can do?
DEAD PERSON: [singing]
I feel happy. I feel happy.
[whop]
CUSTOMER:
Ah, thanks very much.
CART MASTER:
Not at all. See you on Thursday.
My mom was 79 years old and in terrible health. He was so nice and was so sincere.
He told me age doesn't matter, he operates on people into their 90's. Think about that. There would have been families that would have said YES on the false hope that their loved one would have gotten miraculously better. Common sense tells you not to do brain surgery on an elderly person who is not in good health. Besides, the amount of her dementia was so minute...Why would I do that to my Mom?
Can you imagine how much brain surgery would cost Medicare? These are the problems we face. Just because we can, doesn't mean we should.
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