NewsLine - August 2012 - (Page 34)

Short Takes continued from previous page EHB Update: Now Up to the States—and a Local Advocacy Issue NHPCO Engages COS: Spring 2010 Upon passage of the ACA, NHPCO and HAN were immediately concerned that hospice care could be overlooked in what everyone thought would be a standard set of essential health benefits, especially since there wasn’t a clear place for hospice within the 10 specified categories. During meetings and discussions with NHPCO’s Council of States (COS), NHPCO presented on the topic to engage all state hospice organizations on this issue. The object was to lay the groundwork for multiple national groups to educate and advocate for inclusion of the strongest state hospice benefit in this standard set of essential health benefits. Several state organizations were proactive, assisting NHPCO in identifying Maine and California as the states with the best hospice coverage and the ones that should be promoted through HAN’s outreach to national stakeholders. Making the Case for Hospice During the remainder of 2010 and throughout 2011, NHPCO and HAN held a series of meetings with CMS, the HHS Office of Health Care Reform and the Office of the Assistant Secretary for Planning and Evaluation to make their case for inclusion of hospice coverage in the essential health benefits package. IOM Report: October 2011 The Institute of Medicine released an HHS-commissioned report on October 6, 2011, providing its recommendations on the approach and process the agency should follow concerning essential health benefits. It is also worth noting that hospice coverage was favorably presented in the report. “Essential health benefits” (EHB) are one of the requirements of the Affordable Care Act. They refer to a set of services that insurance companies must cover in the health insurance plans sold to individuals and small businesses, both within and outside the new state-based exchanges.1 These essential health benefits are a minimum set of services that fall into 10 broad categories, ranging from hospitalization, maternity and newborn care to ambulatory care and prescription drugs. When the ACA was signed into law, it was thought that the federal government would create a standard set of essential health benefits that private insurance plans in all states would be required to cover. In December of 2011, however, the U.S. Department of Health and Human Services (HHS) issued a Bulletin stating that it would defer to the states to develop their own benchmark plans, with their own set of essential health benefits. While managed care and private insurance represent just 7.9 percent of hospice revenue (per NHPCO’s latest Facts and Figures), NHPCO and the Hospice Action Network (HAN) have been monitoring this issue since the ACA took effect in March of 2010—and have taken action when appropriate. Here’s a brief recap of the key events to date, along with the recommended next steps for hospice advocates and supporters. 34 NewsLine http://www.nhpco.org/files/public/Statistics_Research/2011_Facts_Figures.pdf

Table of Contents for the Digital Edition of NewsLine - August 2012

Creating Opportunities Through Diagnosis-specific Programming
A Message From Don
Free Community Assessment Tool
Blogging for the Hospice Clinician
Custom-print Marketplace (display ad)
Hospice of Michigan’s @HOMe Support
The Voice of NCHPP
Managing Stress
Quality Reporting Deadlines Draw Near
A Hospice Nurse Offers a Lasting Gift
Essential Health Benefits Update
NHPCO Members Receive Health Care Innovation Awards
Add CGAs to Your Giving Menu (display ad)
Simione: Solving Your Hospice Challenges (display ad)
Compliance Tip of the Month
CTC 2012 (display ad)
Resource Links to Bookmark
Videos Worth Watching
News From FHSSA

NewsLine - August 2012