walter russell mead peter berger lilia shevtsova adam garfinkle andrew a. michta
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Feds to Hospice: Your Patients Are Living Too Long

San Diego Hospice has just filled for bankruptcy in the face of a federal audit that could force the facility to pay back millions in Medicaid reimbursements. U-T San Diego reports:

Medicare pays San Diego Hospice $175 per day for each hospice patient it cares for. However, Medicare expects hospices to admit only patients who are likely to die within six months.

In some cases, [the hospice's CEO Kathleen] Pacurar has said, the hospice was too liberal with its admissions, continuing to claim reimbursement even though patients didn’t show continuing signs of decline.

Because of the audit, the hospice’s number of patients has declined dramatically, and it has already closed its in-patient hospital in Hillcrest.

We’re not in a position to judge the merits of the Medicare audit in this instance, and it’s important to note that Pacurar says the hospice was “too liberal” with its admissions. But it is always a shame when a community loses an institution like this. Hospice care has helped many thousands of patients die comfortably and with dignity since it first came to America in the 1970s. The in-patient and at-home palliative care it offers is often far more humane, and far less expensive, than dying in a hospital bed, hooked up to dozens of tubes, in pursuit of just a few extra days or weeks of life.

Improving hospice care and supporting those who choose it need to be a part of our health care policy mix going forward.

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