New Policy Agenda Pushes for Hospice, Palliative Care Reform

The National Coalition for Hospice and Palliative Care (NCHPC) recently unveiled new policy guidelines aimed at improving equitable serious illness care access and quality.

The coalition’s newly released Public Policy Agenda was developed in collaboration with multiple organizations, including the Center to Advance Palliative Care (CAPC) and the National Alliance for Care at Home (Alliance). The agenda addressed six priority policy changes related to access, reimbursement, quality and equity, education and workforce training, program integrity and research.

The organizations joined forces to build a “roadmap” to strengthen sustainable patient- and family-centered hospice and palliative care delivery, according to NCHPC CEO Jessica Hausauer.

“The agenda itself is grounded in shared principles,” Hausauer told Hospice News. “The goal is to help improve coordination across our organizations representing providers and consumers and reduce fragmentation to maximize our impact together. Rooted in this agenda are priorities to protect and improve the Medicare Hospice Benefit including opportunities to improve payment for palliative care … and ensuring effective oversight.”

The Public Policy Agenda is a consensus-based framework that includes insights from hospice and palliative care providers across the nation. The new initiative is part of efforts to update the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care.

The agenda includes policy changes that directed at:

• Expanding access to adult and pediatric palliative and hospice care services 

• Improving quality and equity  

• Supporting program integrity and sustainability alongside value-based palliative care and hospice growth 

• Raising public awareness and knowledge 

• Strengthening workforce and increasing education and training opportunities 

• Integrating hospice and palliative care principles, practices and policy priorities across the healthcare and human services continuum  

The agenda is aimed at guiding policy reform and improving hospice and palliative care advocacy at a time of increasing demand and complexity, according to committee chairs Allison Silvers, chief health care transformation officer at CAPC, and Logan Hoover, vice president of policy and government affairs at the Alliance.

Workforce development is a significant priority outlined in the agenda, which includes policy recommendations to increase education and training opportunities in hospice and palliative care. The agenda addresses a variety of clinical and non-clinical staffing challenges.

“There is definitely a palliative care and hospice workforce shortage,” Silvers told Hospice News. “So, we’re focusing on education and getting the right skills out to the broader healthcare universe so that patients and families can benefit from palliative approaches. It’s about how we move forward, and I think workforce is bubbling up as a big priority.”

Program integrity issues plaguing the hospice space also represent a policy priority, Silvers indicated. Regulatory agencies and policymakers have increasingly examined ways to combat fraud, waste and abuse.

The agenda outlines program integrity imperatives such as ensuring effective oversight of the Medicare Hospice Benefit program, protecting patients’ safety and developing targeted actions that identify and hold fraudulent operators accountable. The agenda also addresses a need to ensure that Special Focus Program (SFP) methodologies accurately identify hospices in need of enhanced oversight and provide adequate support for quality improvement.

Rising interest in the hospice space has come with a greater need for stronger, more responsive regulatory oversight, Hoover indicated. Hospice and palliative care providers need more coordinated avenues to advocate for policy changes that directly impact their sustainability, he stated.

The new agenda allows for greater cohesive collaboration among providers working to address similar challenges such as program diversification and development, staff recruitment and retention, as well as financial and operational growth, according to Hoover.

“Increased interest in our industry … has only enhanced the need for greater responsiveness and greater collaboration between folks in our community,” Hoover said. “From desires to expand the pediatric space and program integrity, the most helpful thing that we can be is unified in responding to policymakers. Through the public policy documents, it allows us to really meet at the table and share perspectives and find what the common ground is that we can really advance the field in a meaningful way.”