Medicaid hospice cut will not save a dime
October 29, 2010 · 9:37 AM
Governor Chrisitine Gregoire plans to eliminate all Medicaid funding for adult Hospice care in WA State as of January 1, 2011. This cut is supposed to save the state budget $4.6 million. The savings from the elimination of hospice end-of-life care for the most needy of our neighbors totally ignores the increased costs which Medicaid will endure from those individuals who will wind up in hospital emergency rooms and will be charging Medicaid for all of their medications which Hospice would have paid for. It will result in a net cost increase to the state.
I'm confused by how our governor and legislature could consider cutting hospice benefits as a means to save money. Numerous studies continue to demonstrate that hospice care actually saves money at an average of $2,309 per hospice patient. Hospice agencies are paid the same small set amount for each patient from which the Hospice provides all professional clinical care including medications, labs, needed treatments, equipment in the home, respite services and counseling when and if needed for the patient and family for over a year following the death of the patient. Think about that. Without the Medicaid Hospice benefit, those patients will bill their medications directly to Medicaid and will wind up in hospital emergency rooms, not receive the extra end-of-life pain and symptom management that Hospice provides, and in most cases die in the hospital at a huge cost to the state. Even if the Hospice provides care on a charity basis, the medications and hospital emergency room visits will still be billed directly to the state through Medicaid. The bill the hospital will send the state for their care will be much higher than that which would have been incurred through hospice. When a hospice patient is covered by Medicaid, the state eliminates all costs for that patient beyond the small set daily rate paid to the hospice for providing comprehensive care and medications. Rocket science?
The lead author of a study at Duke University showing the cost effectiveness of hospice, Don H. Taylor, Jr. has said, "Given that hospice has been widely demonstrated to improve quality of life of patients and families ... the Medicare program appears to have a rare situation whereby something that improves quality of life also appears to reduce costs." Since the Medicare and Medicaid hospice benefits are identical, hospice also saves state-sponsored Medicaid programs money as well.
Do we really want to force our neighbors to suffer at the end of their lives with no support, or be forced to die in a hospital just to receive pain and symptom management? The people most affected by this cut will be low-income (or no-income) people between the ages of 18 and 65. Hospice cares for many young people in this category who need end-of-life care. This attempt to cut the budget is a poor financial choice which will result in higher costs to Medicaid (not lower) and will result in pain and suffering of many dying Washington state citizens.
Naturally, legislators "regret" having to make this sort of "difficult" decision in a time of economic crisis. Well, guess what legislators...You don't!
Please speak up about this issue. Contact your legislators and make sure that Hospice is a benefit that stays. It saves us all money and provides wonderful end of life care to those who need it.
Executive Director, Hospice of Kitsap County