NHPCO NewsLine Spring 2020 - 12

continued

...when we point out
a hospice with a
high rate of live
discharges, or a
long length of stay,
what we're pointing
out more often
than naught are
limitations in the
system itself.

fact that people were and still are
dying in pain, dying isolated, or
dying unnecessarily in an
unnecessarily medicated way.
And that is something that we
still we've got a ways to go in
terms of making more progress.

Journalist: There seems to be a

contradiction in how it works and
how it should work.

Edo Banach: Yes. Journalists

a little bit against the thought
that hospice doesn't save money.
It all depends on what your lens is.
If your lens is as opposed to what
the status quo would be for a
similarly situated individual who
avails themselves of expensive,
extensive inpatient care, I would
argue hospice does save money.

are writing stories about how we
should be getting more
interdisciplinary, less medical care.
Zeke Emanuel writes an op-ed
about how his own father was
over medicalized and it really took
a feat, a real effort by him, to
reduce the medicalization and
provide more nonmedical
supports and services. And we
point out, that's what we do.
We're not a medical inpatient
model. We're a primarily homebased nonmedical model. I would
argue that hospice does so much
of what we want the health care
system to do. And when we point
out a hospice with a high rate of
live discharges, or a long length of
stay, what we're pointing out
more often than naught are
limitations in the system itself.

If you're comparing hospice to
nothing at all, then clearly it
doesn't save money. But I think
that is an unfair comparison. In
terms of what hospice was
established to do, which was
really to take care of people who
are suffering at the end of life
unnecessarily, hospice does save
money, but the whole point was
not only to save money. It was the

Dementia is the perfect example.
You have hospices who feel like
criminals when they provide care
to people for eight, nine, or ten
months because hospice is
supposed to be a benefit that's a
six-month benefit. But if you
think about the alternative, it's
discharging Mrs. Jones, allowing
her to decline, into and out of a
nursing home, then into hospice

Edo Banach: I would push back

12

Newsline / Spring 2020

anyway at the end of life. And
what we've done is we've cost the
system a ton more money and
we've cost the family a lot of grief
and I find myself thinking, why
are we doing that?

Journalist: Investors are
obviously enthusiastic about
hospice. Do you have any concerns
about how much money people
are making in this sector at the
moment?
Edo Banach: My key concern is

making sure that people get the
best quality of care possible. And
I'm no defender of any particular
sector, but I think that when we
argue about anything other than
quality of care, we're missing the
point. I want to make sure that
people are getting the best care
possible, that must be the
primary focus.
I think that anybody who's in
business, the business of hospice
care, purely as a business in order
to make a profit and isn't
committed to the interdisciplinary
model, isn't committed to all of
the ancillary services and benefits
that I talked about, isn't
committed to the highest quality
care possible, they should be doing
something else. I believe that very
strongly. I want to focus on the
quality of care above all else.
And we didn't even get into a
discussion about palliative care,
so please let's find time to talk
about that in the future. I have
lots of thoughts about
community-based palliative care
that i would love to share.
NHPCO NewsLine Spring 2020

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