ABCD Exchange : June - July 2000 : QuickScan - News in Brief

Upfront - Senate Special Committee on Aging Hearing
Letter - Changes at ABCD
Research - Healing Children's Grief
Lunch Bunch - Spring Events
On the Hill - Medicare Prespcription Drugs

News and Notes on End-of-Life Care

Washington, DC — Fast on the heels of HCFA’s report on potential best practices in coordinated care (which can be dowloaded from www.hcfa.gov/ord/coorcare.htm), the administration has released a request for proposals. The initial study looked at both non-disease specific programs (case management programs) and disease-specific programs (disease management programs). Of the 157 programs that volunteered to participate, a subset of 24 was selected for further analysis. This analysis makes up the bulk of the report. The new Medicare Coordinated Care Demonstration Program will "test the cost-effectiveness of paying for case management and disease management." HCFA wants selected projects to "demonstrate that, for chronically ill beneficiaries, these interventions supplement their physicians’ routine care." Deadline for submission of proposals is October 11, 2000, with awards to be announced by early 2001. For more information, contact Catherine Jansto, HCFA Project Officer at 410.786.7762 or at Cjansto@hcfa.gov. The RAND Center to Improve Care of the Dying is willing to help interested providers in applying – contact cicd@rand.org.

Washington, DC - Harvard researchers Haiden Huskamp and Joe Newhouse, and RAND researcher Melinda Beewoukes Buntin have completed a survey of people who work with dying patients nationwide. They presented preliminary findings at a congressional briefing in early July. The widespread sense of respondents that hospice needed to be more widely available will feed interest in the upcoming General Accounting Office report on the Hospice Medicare Benefit, which is likely to be released at a Senate Aging Committee meeting in September.

Alexandria, VA — Early results from a hospice cost study show that current Medicare reimbursement is inadequate to cover the costs of care for these patients. The study, conducted by an independent research and actuarial firm, looked at expenses and reimbursements incurred by hospice programs. Study author Bruce Pyenson, FSA, said, "For our 1998-1999 study sample, we noted that the current Medicare reimbursement for routine home care, which accounts for 95 percent of hospice care, does not cover the costs incurred by hospice organizations to deliver this service. The study suggests that two factors driving hospice financial losses: the short length of patient stay (an average length of stay is now 40 days), and new technologies that have driven the average costs of prescription drugs from $1 per day to $16 per day in a decade. The study is analyzing data from 10,000 patients. Final data will be forthcoming. For more information, contact Angela Thimas at the National Hospice and Palliative Care Organization at 703.837.3129 or athimis@nhpco.org

New York — In a fourth grantmaking cycle for funding arts and humanities, the Project On Death In America (PDIA) awarded $137,350 to three artists. "By supporting these fellowships in photojournalism, art, and literature, PDIA hopes to evoke and deepen our understanding of the meaning and experience of suffering, dying, and bereavement," said David Rothman, Ph.D., program director of the arts and humanities initiatives. PDIA has committed one million to this ongoing project. Current grantees include filmmaker Thomas Cole for Anatomy & Humanity: Conversations with Donors and Dissectors; photographer Meryl Levin for Anatomy of Anatomy, a book and traveling exhibition; and filmmaker Eugene Richards for two films, Long as I Remember and All That’s Sacred. For more information, visit PDIA on the web at www.soros.org/death

Boulder, CO - A former hospice president and CEO has turned his attention to publishing, and is soliciting stories for a collection called Lessons At the Gate. Editor Jacob Blass intends to showcase essays from clinicians, health care practitioners, professional writers, hospice volunteers, and others, all focusing on a "first-hand, life-changing lesson" they learned from a dying person. Blass said, "The stories should contain a clearly articulated lesson learned either directly from a dying person or from the circumstances of someone’s death. I hope the book will profoundly affect as many people as possible to live their lives more fully and purposefully." To date, contributors include Marilyn Webb, Bernie Siegel, Bill T. Jones, Jack Canfield, Stephen Levine, Joan Borysenko, and Rachel Naomi Remen. To request submission guidelines, e-mail Blass at Lessons4@aol.com

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This content is provided by Americans for Better Care of the Dying. For more information, visit www.abcd-caring.org.