More insurers, programs offer 'open access' hospice care

Increasing numbers of hospice programs and private insurance companies are allowing patients to receive medical treatments while participating in hospice care, the New York Times reports.

Traditionally, patients who enter hospice programs must forgo additional medical care. As a result, many patients have been unwilling to enter hospice care and "instead opt for expensive hospital care that may end up costing Medicare and other insurers far more," the Times reports. Now, both Aetna and UnitedHealth, along with some of the nation's 4,200 hospice programs, have begun to allow patients to receive medical treatment while enrolled in hospice care -- an approach that supporters call "open access." Some doctors believe that the "either-or approach, if it ever made sense, is less valid now that continued advances in medicine can allow even patients with very advanced disease to benefit from new treatments," according to the Times. Some experts believe that if patients could enter hospice programs without forgoing medical treatment, it would limit expensive and lengthy end-of-life hospital trips, the Times reports. Aetna's experimental open access hospice program has shown that people are more likely to enroll in hospice care if they do not have to forgo medical treatment. Medicare still requires hospital patients to forgo medical treatment, and agency officials cite the growing popularity of hospice care as proof of the value of the current program, which began in the 1980s under the assumption that both hospice care and medical treatment would be unnecessarily expensive (Abelson [1], New York Times, 2/10).

Some Hospice Care Patients Outlive Predictions
The Times on Friday also examined cases in which patients who entered hospice care have survived longer than expected and in some instances have been discharged from hospice facilities (Abelson [2], New York Times, 2/10).