As Joe Biden prepares to launch his administration, hospice industry stakeholders are calling for stepped up vaccinations for staff, aid for additional personal protective equipment (PPE) and extension of regulatory flexibilities implemented during the COVID-19 pandemic.
The National Hospice & Palliative Care Organization (NHPCO) has written to Biden to push for hospice priorities as the pandemic continues into 2021. The hospice advocates also requested additional funding for bereavement care, flexibility on rules for respite care, suspension of audits during the public health emergency, as well as a community-based palliative care benefit and a delay for the value-based insurance design demonstration, often called the Medicare Advantage hospice carve-in.
As hospice providers care for an influx of COVID patients and seek great access to nursing homes, vaccines are the first items in the industry’s wish list.
“It is critical for hospice and palliative care providers, just like hospital staff, to be given priority access to COVID-19 vaccines,” NHPCO indicated in the letter. “This is not only for the safety of the interdisciplinary team but for the patients, families, and community members they encounter across every community in the United States every single day.”
Biden has given clues as to his administration’s health care priorities, many of which involve reversing Trump-era policies. Biden has pledged to strengthen the Affordable Care Act, lower the Medicare eligibility age to 60 and address high drug costs. But the president-elect has also identified distribution of more vaccine doses as an imperative for the early days of his administration.
While Biden’s team has not made any statements specific to hospice or palliative care. The incoming administration has floated a $1.9 trillion COVID-19 relief plan that includes $20 billion for a national vaccination program that would partner with state and local governments. The plan would establish community vaccination centers nationwide as well as mobile units to reach remote areas.
NHPCO also pushed for the administration to direct the Federal Emergency Management Agency to prioritize hospice and palliative care providers in its distributions of PPE, as well as COVID-19 testing supplies.
For a longer term goal, the industry group asked the administration to consider creating a community-based palliative care benefit within Medicare, through a Center for Medicare & Medicaid Innovation demonstration.
Currently Medicare reimburses for palliative care physician services through fee-for-service payment programs that do not sufficiently cover the full range of interdisciplinary care, but in calls grew louder during 2020 for Medicare to establish a dedicated palliative care benefit. This fall more than 60 organizations, including NHPCO and the National Association for Home Care & Hospice, wrote to federal health care officials requesting a palliative care demo.
Members of Congress also joined the call in 2020. Reps. Neal Dunn, M.D. (R-Fla), David Roe, M.D. (R-Tenn.), Jeff VanDrew (D-N.J.), and Sen.-Elect Roger Marshall (R-Kan.) wrote to CMS Administrator Seema Verma to advocate for a Medicare palliative care benefit demonstration.
“A community-based palliative care demonstration would enable access to a specially trained interdisciplinary clinical team providing relief from symptom distress while the patient continues to pursue curative treatment,” the NHPCO letter said. “This is especially important for seriously ill patients with comorbidities who are battling conditions such as COVID-19.”