Overview of Hospice in WA State

1. Washington State Hospital AssociationTrustee BreakfastOctober 11, 2012The Emerging Paradigm for Palliative Care and Hospice Programs

2. Overview of Hospice in WA State • Hospice • Palliative (Comfort) care for those at the terminal stage of their disease with a life expectancy of 6 months or less if the disease follows it’s expected course. • Legislatively defined in statute at federal and state levels • Specific reimbursement tied to this model of care

3. Overview of Hospice in WA State • Hospice • WA state requires hospice licensure for use of word “hospice” • Federal and state regulations apply • Oversight by both CMS and Fiscal Intermediary • First hospice established in early 1970s as volunteer organization • Medicare Hospice legislation passed in 1983

4. Overview of Hospice in WA State • Hospice • 32 Medicare certified and 2 state licensed programs cover all WA counties • 16,119 Medicare hospice deaths – 2010 • CMS database • 42% WA Hospice Utilization • 41% National Hospice Utilization • 21,045 total hospice patients served – 2010 • WSHPCO membership database

6. Overview of Palliative Care in WA State • Palliative Care • Began in late 1980s as hospital based programs • CAPC is leader in in-patient PC program • No legislative definition • No federal regulations • Common element for eligibility is life expectancy of 2 -3 years, focus is more on palliative care than curative care • Only WA state regulations are Medicaid Pediatric Palliative Care

7. Overview of Palliative Care in WA State • Palliative Care • No payment mechanism • Multiple definitions and structures now • In-patient • Hospice and home health based • Clinic based • Difficult to determine actual number of programs • WSHPCO PC membership fluctuates between 9 – 14 programs each year

8. End of Life Continuum of Care Palliative Care and Hospice Model Treatment of Disease Treatment of Symptoms Palliative Care Hospice Bereavement Life Span of Person