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New Medicare Program To Allow Some Hospice Patients More Treatment Choices

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A gap in the insured care available for people with terminal illnesses may be closing. Medicare announced last month that it would offer grants to 30 hospices across the country to test combining hospice care with so-called curative treatments, like radiation and blood transfusions.

In a series of reports on KPBS last year, inewsource reporter Joanne Faryon found that providing curative care to hospice patients could break a hospice providers budget. The reports also found that providing some curative care can give dying patients a few more good weeks or months.

William Mitchell, a medical oncologist and the director of palliative medicine at the UC San Diego Health System, said he routinely helps people facing the dilemma of choosing between hospice and curative care.

Mitchell said, they would like to continue a disease-focused treatment if there's a chance that will prolong their life, but they also need help at home with things that hospice care can help with.

He said, he finds that people are reluctant to accept help from hospice because they are still hoping that curative treatment can help them, and they can't have it both ways.

Mitchell said, as a palliative care physician and an oncologist, sometimes its hard to know which option would be better for patients. With Medicare's new model of care, he wouldn't have to make that choice.

A study of hospice care published by Aetna in 2009 found, offering more treatment options could "break down barriers to hospice use" and the study found the more liberal treatment model would not raise overall costs.

Suzy Johnson, Vice President of Sharp HospiceCare, said Sharp is well-positioned for a grant like this because they already have a similar program for patients enrolled in the Medicare Advantage program.

"Transitions Advanced Illness Management" is a home-based palliative care program. Patients in the program receive care to treat pain and other symptoms of their disease but can still get traditional treatment such as chemotherapy, and can be hospitalized if they want to be.

Sharp's report of the program found that patients participating in "Transitions" had 66 percent fewer hospitalizations, which translates to a reduction in costs.

Johnson said her organization is reviewing whether they will apply for the Medicare grant.


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