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When Hospice Patients Also Get Treatment, Payment Can Be A Problem

Seniors with terminal illnesses often face a tough choice: If they choose to get Medicare hospice benefits, they have to give up conventional medical treatments that aim to cure their disease.

As a result, many people forgo hospice care until the very latest stages of their illness, and less than 40 percent of people are in hospice when they die.

The federal law overhauling health care eliminates the need to make such difficult choices for some seniors cared for at 15 sites that will test an approach that allows terminally ill patients to receive hospice benefits and curative treatment at the same time.

But some hospice centers already offer concurrent care to Medicare patients. These "open access" centers cover the cost of conventional therapies if a patient wishes them, even though Medicare may not. Why take the financial risk? "Typically once hospice gets involved, people forgo often futile therapies,"says Jon Keyserling, vice president for public policy and counsel at the National Hospice and Palliative Care Organization.

In hospice, the emphasis is on quality of life rather than quantity. Instead of focusing on the next round of chemo, hospice workers help patients figure out how they can make the most of the weeks or months remaining to them, say experts. Ironically, a recent study found that patients who got palliative care not only said they had a better quality of life but they actually lived longer than those who got only standard treatment, with chemotherapy.

If you want to identify where to get concurrent care, your best bet is to call hospices your community and ask.