Top Lawmakers for Hospices to Watch in 2024

Hospice providers will be looking to Congress in 2024 to address issues related to program integrity, quality improvement, and industry-wide workforce pressures. As legislative efforts develop, hospices may want to focus their attention on a few key legislators. 

Though hospice is largely a community-based business, actions on the national level can have a huge impact. Congress has driven many of the changes that have occurred in the hospice space during the past several years. This includes the revamping of the hospice survey process and the establishment of a Special Focus Program (SFP) slated to begin in 2024, to name a few. 

Lawmakers have an essential role in ensuring the viability of the Medicare Hospice Benefit, according to Davis Baird, director of government affairs for hospice at the National Association of Home Care & Hospice (NAHC). 

“What we would love for our lawmakers to do is really champion the program as it exists and make sure it’s protected from threats to its payment system,” Baird told Hospice News. “But also we understand that there are areas where there needs to be more exploration for how the benefit can best support patients and families in 2024 and beyond. So, having those conversations about what those improvements would be is going to be an important exercise in 2024.”

One key priority for the hospice community is to secure updates to the algorithm that the U.S. Centers for Medicare & Medicaid Services (CMS) intends to use for identifying hospices for its forthcoming SFP. 

Many hospice stakeholders have expressed support for the SFP programs as a concept, but a vocal contingent has raised concerns that the agency’s methodology for selecting participants is deeply flawed. 

The nation’s four largest hospice industry groups, as well as some members of Congress themselves, have called on CMS to postpone the program and revise that algorithm. As of now, however, the agency intends to move forward with its current algorithm, as indicated in its 2024 home health final rule. 

Changes to the SFP will be the top priority for industry groups that will work with policymakers in the new year, according to Logan Hoover, vice president of policy and government relations at the National Hospice and Palliative Care Organization (NHPCO). 

“We are severely concerned with the direction that CMS has taken on this program. We don’t have confidence in the algorithm that they proposed. We don’t believe that it’s going to accurately identify the bottom 10% of hospices,” Hoover told Hospice News. “We feel that there are going to be hospices that are identified as a poor performing hospice that are not poor performing. And that’s going to have real ramifications for not just those providers, but the communities that they serve.”

In addition to these issues, the hospice community and some legislators will likely continue to seek action on bills that could bolster the industry’s dwindling workforce. 

For nearly a decade, stakeholders have sought passage of the Palliative Care and Hospice Education Training Act (PCHETA). 

If enacted, PCHETA would support hospice and palliative care training programs for physicians, nurses, pharmacists, social workers, and chaplains. The bill would also expand continuing education and career development programs and incentives in these fields. 

Amid the federal government’s many competing priorities, several lawmakers have emerged as champions for hospice and palliative care policies. While this list is by no means exhaustive, it represents a number of the key legislators that have sought to enact new hospice and palliative care policies as well as the integrity of the Medicare benefit. 

Also important to note is the role of congressional staff in crafting legislation and engaging with stakeholders. These professionals often play a crucial role in advancing public policy, including those who work specifically for the committees. 

“You’ve got good stuff on both sides [of the political parties] who we’ve had good conversations with,” Larry Atkins, chief officer for the National Partnership for Healthcare and Hospice Innovation (NPHI), told Hospice News. “The staff will continue to play a major role on these issues.”

To learn more about who in the congressional staff are champions for hospice and palliative care policies, click here