Eli's Hospice Insider

The wheels of healthcare reform legislation are turning slowly, putting good news and bad news in motion.

As for the latter, the House's so-called tri-committee bill, crafted by three House committees of jurisdiction, calls for a "productivity adjustment" cut to hospice payments that would total $9.8 billion over 10 years.

Bright spot: The House tri-committee bill could include another oneyear moratorium on phase-out of the hospice budget neutrality adjustment factor (BNAF), the National Association for Home Care & Hospice reports. The House Ways and Means Committee included that provision in its version of the legislation.

Another piece of bad news in the House is that Democratic leadership is appeasing the so-called Blue Dog coalition of conservative Democrats by agreeing to give the Medicare Payment Advisory Commission (MedPAC), or at least another independent executive branch body, power to set Medicare rates independently, according to press reports. The MedPAC move got a boost from Health and Human Services Secretary Kathleen Sebelius on "Meet the Press," too.

Meantime, all eyes are on the Senate Finance legislation, which is expected to look the most like the final healthcare reform package, due to its support from lawmakers on both sides of the aisle -- if they can agree.

Resource: If you're looking for a hospice history and reimbursement refresher -- and a summary of MedPAC recommendations for changing hospice payment methodology -- check out, "A New Era of For-Profit Hospice Care -- The Medicare Benefit," in the June 25 issue of The New England Journal of Medicine In the article, author John K. Iglehart notes that "if Congress considers MedPAC's hospice recommendations ... it will probably do so this year, in the context of intensified efforts to slow Medicare spending -- rather than in the budget-neutral fashion recommended by both the commission and providers of hospice services."

Read the full article at http://content.nejm.org/cgi/content/full/360/26/2701.