Hospice and Managed Care

SUMMARY

Managed care is having a significant effect on the delivery of hospice care. A primary concern facing hospices is that reimbursement rates will likely either remain stable or fall. This suggests that competition between health care networks will lead to mergers and the closing of some hospices. A second challenge is the immense pressure to make decisions based exclusively on the cost/benefit ratio of hospice in a context where managed care organizations seek to increase market share and improve profits. To foster good hospice care within a managed care environment, service providers need to be defined, criteria for referral to hospice programs must be crafted, payments should be based on a per diem method, benefit packages should identify a comprehensive package of services, and agreements between hospices and managed care organizations should allow for routine review and amendments to their contracts. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: [email protected]]

Additional information

Notes on contributors

John J. Mahoney

John J. Mahoney is the President of the National Hospice Organization.