When Medicare hospice eligibility criteria expand in 2011 as part of the Affordable Care Act of 2010, efforts to test whether palliative care and aggressive treatment provided concurrently will be judged based on costs. But a new JAMA article by David Casarett, MD, MA, Associate Professor in the Division of Geriatrics at the University of Pennsylvania School of Medicine, argues that the three-year Concurrent Care Demonstration Project should also examine the impact of new eligibility criteria on hospice access, quality and survival improvements.
“As Medicare tests new eligibility criteria, it is important to look beyond cost measures to see if this improves other important factors, so that patients are able to receive the right level of care at the right time,” said Dr. Casarett, who also serves as the national medical director for research and quality for the National Hospice and Palliative Care Organization. “Providing the appropriate level of care for our patients may mean that a combination of curative and palliative treatments is most appropriate.”
Current Medicare hospice eligibility criteria require patients to forgo aggressive treatment and only offer palliative care in the last six months of life. As a result, patients who do not want to stop aggressive treatment cannot receive pain and symptom management until they halt curative treatment attempts.
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