Market Basket zeroed out in 2006 Budget… A rumor, yet to be confirmed, has the hospice market basket zeroed out in the Senate version of the budget blueprint for 2006. While it is only a rumor, it would mean that there would be no rate increase for 2006, and such whispered comments are swirling in Washington and whatever the truthfulness of the prediction, it only goes to show how important your advocacy efforts are at this point in time.
The Market Basket, in its most basic form, is the percent of pay raise that we can expect for the coming year. (That’s an oversimplification, but good enough for this post.) So what they are saying is that I should expect to be paid the exact same rates next year as I am getting this year which is big news because we always get a raise.
First, I’m not big on reporting rumors. Second, if NHPCO is going to report rumors could they at least let us know where they come from or how seriously I’m supposed to take them. Third, this is my great nightmare coming true.
I’ve posted a few times that I know that Medicare cuts or changes are coming and that I welcome them. I’m a good Republican and spend some time behind my desk conflicted at the waste of government money. The conflict comes because some of that money ends up in my bank account. So, here we go again, time to purify my soul.
Medicare needs to cut the payment rate for hospice patients that live in nursing homes. I’m talking about significant cuts, but only for those patients that live in nursing homes. Yes, the cuts will put some hospices out of business. Yes, they will mainly be the companies whos business practices make me throw up a little in the back of my mouth. Yes, since you asked, I have spent some time practicing my evil laugh for that day when the companies who have gotten into the hospice business for the sole purpose of taking care of nursing home patients because you can make a killing on them will crawl back into whatever vile soulless hole that they crawled out of.
Unfortunately for me, the same companies that hope to see ruined are the ones who have the money (money=power) to make sure that this kind of intelligent decision is not made in Washington. Instead something like freezing the Market Basket is going to happen which will allow inflation to reduce the massive profit on nursing home patients and make it even harder to break even on home patients. That decision will force people like me to focus my energy on the nursing home market in hopes of having enough big profit nursing home patients to finance my admirable but financially unsustainable home patient habit. The problem there is that most of the nursing home patients are taken by the nursing home owned hospices. Thus, people like me will go out of business and companies who don’t have to practice evil laughs because that is the way they laugh naturally will survive.
The person hurt the most? The home patient. When those of us who have no fear of daylight are gone and the nursing home owned hospices are all that are left, it will become very hard for a patient to die at home. I’d guess that if I sat down with my staff right now and told them that we want to discharge every home patient we can, we’d be able to find an excuse to discharge over 50% of them. It’s even easier to find a reason not to start caring for them. The reasons would be stupid, but you can always find an excuse to refuse a patient if you want to. Those of us with hearts don’t use those excuses. The day we don’t exist and hospice care is left only to corporate America, is going to be a sad day for the terminally ill of this nation.