NewsLine - April 2011 - (Page 4)

continued from page 2 per hospice were provided to patients living in a rural setting, the hospice was defined as urban. Hospices providing 50 percent or more of services to patients living in rural areas were classified as rural hospices and placed into one of two categories: moderately rural (50-74 percent of patient days in a rural county) or mostly rural (75-100 percent of patient days in a rural county). Calculation of Profit Margins The margin analysis discussed here is based entirely on Medicare margin per patient day. Note also that it relies on Medicare hospice cost reports which have never been audited or used in rate-setting and, as such, contain errors and variations in the completeness of reporting. Because hospice cost reports do not include reporting of revenues, claims were also used as a source of revenue data. The claims data are more accurate and complete than the cost data. By trimming cost report data, the most extreme values were eliminated, but the analysis presented still contains a high degree of variable quality in the cost portion of the analysis. Not accounted for are hospice repayments to Medicare associated with the “cap” policy. This was done for three reasons: (1) these repayments are associated with hospices concentrated in certain regions of the country; (2) they are retroactive, and (3) there is no accurate source of data to incorporate them into this analysis. Cost data were extracted from the 2008 Healthcare Cost Report Information System (HCRIS) and revenue data from 2008 hospice claims. Total cost per patient day was calculated as the total cost per patient day for services reimbursable through Medicare, plus the costs of statutorily required services (bereavement and volunteer services).3 Medicare revenues per patient day were calculated using claims data and selecting total payments paid through the Medicare program, as well as any co-insurance paid by the beneficiary for drugs furnished outside of the inpatient setting (maximum $5 per drug) or respite care (5 percent of respite care payment per day).4 Using these costs and revenue data, Medicare profit margins per patient day for each hospice were calculated as follows: Medicare Profit Margin = (Medicare revenue per patient day minus total reimbursable/ bereavement/volunteer costs per patient day) Medicare revenue per patient day Approximately 2,171 unique provider numbers were identified in the 2008 HCRIS database and 3,338 provider numbers were Protecting Hospice Rates: A Long-term, Multifaceted Strategy 2007 March: NHPCO forms the Alliance to aggressively lobby for hospice on Capitol Hill. 2008 February: Federal FY2009 Budget proposes BNAF phase-out. April: CMS issues Notice of Rulemaking to implement phase-out. May: Hospice Advocates respond, sending 4,400 messages to Congress. June: • 131 members of Congress request HWM Committee to halt phase-out. • Hospice Advocates flood the Hill with 17,000 messages. • Alliance launches media As we near the end of the line, let’s think about the stop before it. campaign to support the outreach. Hospice Sooner or later we’ll all arrive at the "end of the line." Sadly, hospice might get to the end of its line first. Without intervention from the White House or Congress by October 1st of this year, hospice programs will face drastic cuts and be forced to scale back services or close their doors permanently. Fact is, hospice is really health care that cares more and costs less. In 2007, an independent study by Duke University found that hospice saves Medicare more than $2 billion per year. Protect hospice before it gets to the end of the line. Death Protect hospice for America. Keep health care that cares more and costs less. For more information, visit www.nhpco.org/advocacy 4 NewsLine http://www.nhpco.org/advocacy

Table of Contents for the Digital Edition of NewsLine - April 2011

NewsLine - April 2011
Hospice Profit Margins in the Next Decade
A Message From Don
Protecting Hospice Rates Timeline
Sharp’s ACP Program
Experience the ACHC Difference (display ad)
Delaware Hospice’s Transitions Program
Recruiting Problems? HMR (display ad)
Hospice Executive Scholarship Program (display ad)
Voice of NCHPP: Volunteer/Volunteer Management Section
Volunteer Section Monthly Chats
Hospice Volunteer Program Resource Manual (display ad)
New National STAR Report – with Staff Compensation Data
Young Volunteers Learn About Hospice
One Bike, One Cause – One Uplifting Journey
Nurse’s Week Gift Ideas from Marketplace (display ad)
Members in the News
Upcoming Educational Offerings
Cover 2
NHF Quarterly

NewsLine - April 2011