Ben Marcantonio speaks at the 2023 NHPCO Annual Leadership Conference Monday in Little Rock, AR.
Ben Marcantonio addresses the audience Monday at the national conference of the National Hospice and Palliative Care Organization. Credit: NHPCO

With growing awareness and use of hospice, the field has never been better. Still, bad actors permeating the sector, negative press, lagging reimbursement rates and the workforce shortage continue to pose problems, leaders of the National Hospice and Palliative Care Organization said during the opening keynote address of the association’s annual leadership conference in Little Rock, AR.

“In many ways, this is our time,” Ben Marcantonio, chief executive officer of NHPCO, said during the address Monday morning, adding, “We must be courageous about opening windows to new ways of thinking about serious-illness and end-of-life care, new ways of providing that care and new ways of resourcing the care in the decades ahead.”

One powerful spokesman for hospice is former president Jimmy Carter, who is in his seventh month of hospice care and turned 99 on Sunday.

“Let’s take inspiration from President Carter and his family, and the courage they have shown, by opening a window into hospice care that few others could do,” Marcantonio said. “By making their choice public and sharing parts of their journey, they have helped reshape the national conversation.”

Still, there are challenges ahead. Resourcing care will be key, as “reimbursement rates are not keeping up with the costs of providing care,” Marcantonio noted. Though a 2024 payment update will boost rates by 2.8%, this bump has been described as “skimpy” amid rising labor and inflation costs. Also, hospices that fail to meet quality standards under the rule could have their payment slashed by 4%, as part of continued scrutiny by the Centers for Medicare & Medicaid Services. 

And fraud continues to trail hospice. Earlier this year, CMS proposed a Special Focus Program for underperforming hospices. It also placed four states under “enhanced oversight” to curb fraud, waste and abuse concerns in the hospice industry. Marcantonio noted NHPCO’s work in guiding and refining CMS’ supervision of hospice providers.  

“In recent years, fraudulent actors have found ways to game the hospice payment system, mirroring fraud seen in other healthcare segments,”Marcantonio said. “I’m proud that NHPCO, collaborating with other national organizations, has made meaningful progress combating fraud by advocating for program integrity solutions to regulators and lawmakers.” 

With the amount of negative press about hospice, the field needs to come together — nonprofit and for-profit, urban and rural, small and large organizations, he stressed. 

“So my great hope for this conference is that we can all walk out of here resolved to put an end to division within our community,” Marcantonio said. 

Melinda Gruber, chair of the NHPCO board of directors, pointed out collaboration efforts between NHPCO and the National Association for Home Care & Hospice, which are exploring a possible merger.

“Work groups with members of both organizations are now looking at specific aspects of how the two organizations could be combined, including member benefits, dues structure, education and more,” she told the audience. “We are invested in this process, and we are committed to doing it right. We will continue to share updates as we move forward.”

The conference runs through Wednesday.