Fox & Friends allows Cassell to falsely claim health care reform “totally cuts” hospice care

From the April 5 edition of Fox News' Fox & Friends:

GRETCHEN CARLSON (co-host): I want to make sure I get this in. Because I'm listening to this interview, and I'm wondering how -- how is Obamacare going to affect your patients in a negative way?

CASSELL: Well, as of this next year, Medicare cuts are going to be huge. Did you have -- did you realize that hospice, you know, which is the end-of-life caring, that that's going to be totally cut in 2012? I mean, not only do they want you to die at a younger age, as they -- as they basically ratchet down care, but they want you to die a slow and painful death as well. I mean, this is -- it's horrible. And this timeline -- David Camp from Michigan did this timeline -- I mean, that's kind of when I kind of got on to this. I mean, obviously, if I saw this two months ago, I would have bolted into action sooner. But this actually tells, step by step -- we'll have it on the website -- how Medicare, ambulance services, diagnostic images, everything goes away.

In fact hospice “was not a major target of cuts”

National Association for Home Care & Hospice identifies productivity adjustment as cost. According to the National Association for Home Care & Hospice's "Comparison of Key Proposals for Hospice Payment and Regulatory Reform," the only significant provision in the health care bill which reduces payments to hospice providers “incorporate[s] annual productivity adjustment into market basket update beginning with FY 2013.” According to the Congressional Budget Office (CBO), “To the extent that providers increase their productivity over time,” the previous Medicare reimbursement system would “overstate actual increases in providers' costs.” CBO has stated that “a rationale for this option” is that "[i]mplementing this option would reinforce the incentives contained in Medicare's prospective payment systems for providers to deliver care efficiently." The National Hospice and Palliative Care Organization has said that the “impact of the cuts will be $6.8 billion.”

Final bill contained smaller cuts than bill passed by House. According to Inside CMS [accessed via Nexis]: “Home health and hospice facilities benefited from the House being forced to pass the Senate version of health reform, which included much smaller Medicare payment cuts to their facilities than the House had proposed.” Inside CMS also stated that "[t]he Senate bill also delays the cuts, which industry prefers. The delay reduces government savings over the next ten years." [Inside CMS, 4/1/10]

Hospices exempt from cost reductions proposed by advisory board through 2019. The Kaiser Family Foundation noted in its summary of the health care reform law that it establishes “an Independent Payment Advisory Board comprised of 15 members to submit legislative proposals containing recommendations to reduce the per capita rate of growth in Medicare spending if spending exceeds a target growth rate.” The document further notes that "[h]ospitals and hospices (through 2019) and clinical labs (for one year) will not be subject to cost reductions proposed by the Board."

Health care analyst: “Hospice was not a major target of cuts as a part of health care reform.” Michael Wiederhorn, a health care analyst with Oppenheimer & Co., reportedly stated in a recent research note that "[h]ospice was not a major target of cuts as a part of health care reform, but it also would not stand to benefit much from any of the changes."

Larry Beresford: “I think it's safe to conclude that America's providers of end-of-life care, on the whole, fared quite well.” Larry Beresford, health care journalist and author of The Hospice Handbook, wrote on April 2: “It wasn't long ago that opponents of health care reform were screaming about 'death panels' in a way that made it hard to think hospices weren't among those being targeted. Given what's in the health care reform bill that passed, I think it's safe to conclude that America's providers of end-of-life care, on the whole, fared quite well.”

Hospice care membership organization expressed support for health care reform provisions

National Hospice and Palliative Care Organization (NHPCO) has praised Concurrent Care Demonstration Program. NHPCO stated on March 26 that the Medicare Hospice Concurrent Care Demonstration Program in the health care reform law is an “exciting development” that “has been a NHPCO priority for some time.” The provision "[d]irects the HHS Secretary to establish a three-year demonstration program that would allow patients who are eligible for hospice care to also receive all other Medicare covered services while receiving hospice care."

NHPCO: Law “recognizes the unique characteristics of children at end of life.” Jonathan Keyserling, NHPCO's vice president of public policy, reportedly stated of the health care reform law: “There is a permanent change in the law that recognizes the unique characteristics of children at end of life. The pediatric palliative care model would permanently remove the requirement to forego the therapies. So, children under the Medicaid program would be able to receive a full range of conventional therapies as well as the supportive services that help their families.” Keyserling also stated that “Congress is recognizing the value of hospice as a quality end-of-life provider,” while expressing concern about “unintended consequences” that could arise from the health care reform law.

NHPCO expressed support for reduced payment cuts in Senate bill. In a December 19, 2009, letter to Senate Majority Leader Harry Reid, J. Donald Schumacher, president and CEO of NHPCO, expressed “strong support for the national effort to enact health care reform,” citing the Senate's “modification” to the “proposed reductions to the annual market basket increase.” From the NHPCO letter:

On behalf of hospice and palliative care providers and the more than 1.5 million patients, and their families, served by hospice each year, the National Hospice and Palliative Care Organization (NHPCO) would like to express our strong support for the national effort to enact health care reform. We acknowledge the enormity and complexity of the task facing Congress, and we applaud your recognition of the importance of preserving quality, compassionate and cost efficient end-of-life care as a critical component to the nation's health infrastructure.

NHPCO sincerely appreciates that the Senate leadership has responded to the concerns of the hospice community regarding proposed reductions to the annual market basket increase through the Manager's amendment to the Patient Protection and Affordable Care Act. We applaud this modification to the legislation and support the bill's progress with the amended hospice market basket language included. Minimizing the impact of these reductions is a necessary step to guaranteeing that all Americans retain access to compassionate, quality and cost effective end-of life care.