In his opening address at the national conference Monday, Ben Marcantonio, interim CEO of the National Hospice and Palliative Care Organization, aptly characterized the current hospice era as a “pivotal time.” 

As he articulately explained, there are a lot of competing and contradictory storylines occurring simultaneously. For example, while Jimmy Carter’s election of hospice represents a heartwarming endorsement of the program he helped develop, the prolific fraud taking place in the sector casts a shadow on the benefit and its reputation.

“With all this opportunity and responsibility, we know we also face risk,” he told the audience in Little Rock, AR. “Hospice reimbursement rates are not keeping up with the costs of providing care. Workforce challenges make it hard to hire and retain talent. In recent years, fraudulent actors have found ways to game the hospice payment system, mirroring fraud seen in other healthcare segments.”

As if to punctuate his message, two developments — one highlighting the positive and one the negative — took place at the time of NHPCO’s conference this week. The first was the celebration of Carter’s 99th birthday, which took place last Sunday, the day before the annual conference. Carter, who celebrated six months in hospice in August, is approaching what is considered a long-stay hospice patient, which regulators have flagged. But a study commission by NHPCO and the National Association for Home Care & Hospice revealed substantial Medicare savings from longer length of stay.

The other hospice story that hit during the conference was the request by four U.S. representatives to improve the selection criteria for a proposed Special Focus Program for underperforming hospices. Specifically, they are concerned that the algorithm used to identify such settings will unfairly target the larger players and overlook those truly struggling with performance.

No question, the hospice benefit is weathering enormous change. But Marcantonio offered a salve for the hospice community: Stick together. No matter your size, region or financial affiliation, it’s important to be united.

“When we talk and act not as a community, but as competitors pitted against one another, we all lose,” he said.

Wise words.

Liza Berger is editor of McKnight’s Home Care. Email her at [email protected].