Encouraging Grassroots Outreach to Congress to Oppose Hospice Cap Cut

Now is the time to ask our congressional delegations to not make major cuts to the hospice aggregate cap in any end-of-year legislative package being negotiated. As is often the case with large, year-end spending bills, there are many programs and policies Congress wants to “stuff in” to an omnibus funding package before the close of the year. In order to pay for all these priorities, lawmakers must identify “offsets” to fund them. A significant reduction of the hospice aggregate cap, as has been recommended by MedPAC in the past, is being considered for one such “offset”.

The easiest thing you can do right now is to use NHPCO’s Hospice Action Network https://www.hospiceactionnetwork.org/take-action/#/ or NAHC's online grassroots campaign page https://p2a.co/mhu6Q52 to send our Senators and Representatives an email message and/or tweet asking them to oppose a cut.

It is always most impactful if you can personalize the pre-filled message language to talk about local impact. If you have good relationships with your members of congress' staff, please also consider reaching out to them directly to register your opposition.

HHAC is attaching a 2-pager background document that NHPCO and NAHC have prepared together. This document, and the talking points below, should help support any advocacy you may be able to engage in. Click here to access the 2-pager.  

• Patient access to care could be significantly reduced: a major cap cut would create disincentives to serve patients that have a more unpredictable disease trajectory, such as those with dementia and organ failure, thereby disenfranchising entire categories of patients’ access to the hospice benefit.

• It could further exacerbate health disparities in hospice access and utilization: The individuals most likely to have their access to hospice impacted by the cap reduction (those with dementia and other neurological diagnoses) are also more likely to be from medically underserved communities that already have lower rates of hospice utilization.

• It may result in increased overall spending by Medicare: Any proposal that could limit hospice use, such as the cap reduction, may result in increased overall spending for Medicare, as patients who might have been served by cost-saving hospice instead utilize more expensive and aggressive care such as hospital, ER, and skilled nursing facility services. Recent research has shown that hospice use by Medicare beneficiaries is associated with significantly lower total healthcare costs across all payers, including Medicare. 

Thanks so much for your help with this effort and for the work you are doing in the community. Please don't hesitate to reach out to HHAU with any questions.