Delaware Hospice set to test new model for care

Life-threatening illnesses force patients and their families to make difficult decisions.

At Delaware Hospice in Milford, a new national program will allow the center's staff to test a model that gives Medicare patients more flexibility when choosing care options.

Medicare rules require patients to choose between curative care or end-of-life hospice care. But under the new pilot program from the Centers for Medicare & Medicaid Services, Medicare beneficiaries have the option to receive hospice support services while still receiving treatment services for a serious illness. The Medicare Care Choices Model program will start in Kent County in January 2016, Delaware Hospice President and CEO Susan Lloyd said, and will expand to Sussex County in January 2018.

Participation in the program, which is intended to gauge the success of simultaneously receiving curative care and hospice support services, is limited to beneficiaries with advanced cancers, chronic obstructive pulmonary disease, congestive heart failure, HIV and AIDS, according to the Centers for Medicare & Medicaid Services.

Lloyd said participation will allow Delaware Hospice staff to engage with patients sooner, providing hospice support services that were previously unavailable to Medicare beneficiaries already receiving curative services, such as physical or occupational therapy.

Democratic U.S. Sen. Tom Carper visited Delaware Hospice for a brief tour Aug. 24 and shared his story about the difficulties of facing hospice care when his mother became ill.

“My mother, in the last year or so of her life, was living in another state … and hospice care was called in to help her,” he said. “She bounced right back. She lived for another year and had a pretty good quality of life. A lot of times people have this misperception about hospice care – just the last days, maybe the last weeks of a person's life, but that doesn't have to be the case at all.”

Lloyd said the new program is a way to move a national discussion about end-of-life care forward by allowing centers, such as Delaware Hospice, to test-drive a model intended to measure the quality of care and cost-effectiveness of combining services for patients and families facing life-limiting illness. Delaware Hospice is one of 141 organizations nationwide selected to participate in the Medicare Care Choices Model.

Medicare reimbursement practices for hospice centers tightened in 2013, after the Medicare Payment Advisory Commission found that long-term hospice stays were becoming very profitable for providers, and in some cases may have led to inappropriate use of the Medicare benefits.

The Medicare Care Choices Model program aims to determine whether the quality of care and life is improved for patients facing life-threatening illness if they're able to receive both curative services as well as palliative, or hospice-related support services, such as nutritional support and nursing.

“One of the hardest things for us to deal with is the loss of our loved ones and the idea that someone can be here, the family can be here and be involved, is enormously comforting to all of us,” Carper said. “Delaware Hospice has been invited to really provide an opportunity to try something new and different in order to get even better care, more thoughtful care, kinder care and do that in a cost-effective way.”

For more information about Delaware Hospice, go to www.delawarehospice.org.