The Medicare Dilemma: Choosing Between Treatment or Hospice

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Back to Blog shutterstock 466547960 The Medicare Dilemma: Choosing Between Treatment or Hospice Medicare Long Term Care Hospice Family End of life care end of life planning

Did you know that seriously ill Medicare patients must discontinue treatments for their illness before they’re eligible to receive hospice benefits?
It can be an extremely difficult choice to make for any sick person. Thankfully a change in policy is underway through a new project called the Medicare Care Choices Model that will give some 30,000 Medicare patients permission to receive both treatment and hospice care.

“I think it’s a recognition (that) this forced choice between palliative care and life-prolonging treatment is irrational,” said Dr. Diane Meier, director of the Center to Advance Palliative Care.

In the current Medicare program, hospice benefits are only available if doctors can prove a patient has less than six months to live, and if the patient agrees to cease curative treatment. Faced with the ‘either-or’ choice, many patients choose to skip hospice care to treat the illness, with the vast majority only entering hospice in their final days.

Studies have shown patients who receive both palliative care and disease treatment live longer than those who receive treatment alone.

“It makes sense,” said Meier. If you enter into a hospice program earlier in your treatment cycle, “People aren’t in excruciating pain; they’re not (as) depressed. And if people are able to avoid the very real risks of hospitals, it’s no surprise that they live longer.”

One example of how treatments can help with pain reduction is a Medicare patient enrolled in the new program can receive chemotherapy to treat a tumor that’s causing pain. “So it treats their cancer but it also makes them feel better,” said Meier.

Dr. Meier goes on to explain how hospice and palliative care serve similar roles. “All hospice care is palliative care, but not all palliative care is hospice. The comforts of palliative care not only focus on treating the pain and symptoms, but they help maximize the quality of life for people at any stage of illness,” said Meier.

Dr. Meier believes giving people the option to receive both types of care may save money. “My prediction is it will actually be less expensive to provide both approaches at the same time,” Meier said, “precisely because it will lead to less need for costly emergency and crisis care.”

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