News From HospiceCare Inc. - Fall 2009

In this edition of News from HospiceCare:

Help Protect Us Against Medicare Cuts
Staff Prepares for a New Flu
Remembrance Programs
Charitable Giving at Year's End
Thanks for Supporting Our Events
Upcoming Events

Help Protect Us Against Medicare Cuts

Medicare, the insurer for most Americans 65 and older, is in trouble. Our news media is filled with stories about the debate surrounding universal healthcare. But that debate is crowding out the real story, which is that by someestimates, without major reform, rate cuts or tax increases, Medicare is expected to run out of money by 2016, a situation compounded by the passage of Medicare Part D (pharmaceuticals) in January 2006.

Nearly 70 percent of HospiceCare’s revenue comes from Medicare (see below). With that revenue and the support of the community, we’ve been able to realize our vision: To help build a community in which exceptional end-of-life care is accepted, expected and available to all. We’ve even managed to maintain a modest operating margin of 2 percent for the last four years, which has allowed us to build a reserve of two months of operating funds.1

Now, however, we’re facing cuts to our Medicare reimbursements by as much as 16 percent. Reductions of 5 percent over the next three years are a result of the elimination of the Budget Neutrality Adjustment Factor (BNAF).2 Another 11-plus percent in reductions may follow if current Congressional proposals pass.

Hospice is unfortunately lumped in with other Medicare-reimbursed services. Other healthcare providers are reimbursed by Medicare for each physician visit, treatment, test or pharmaceutical (fee-forservice), encouraging more care, not better care. In contrast, hospice is paid a flat daily rate, which must cover the cost for ALL staff, medications, supplies, equipment and inpatient care used in a single day, encouraging quality care.3

The question is: What can we do? Because of these anticipated revenue cuts, HospiceCare has begun the process of redesigning how we deliver our services, while maintaining the high quality of our care. We are committed to taking steps that ensure that we continue to serve our communities.

Here’s what you can do: Contact Congress today at http://ow.ly/tzX6 to let your senators and representatives know that “two cuts are too much” for hospice, and Americans are depending on them to protect high quality end-of-life care for future generations. It only takes two minutes. Take action today!

1 HospiceCare has been working toward a six-month reserve, which is standard for organizations that don’t have diversified revenue. This would enable us to make payroll for 540 employees on the rare occasions when Medicare reimbursement is delayed.

2 The Budget Neutrality Adjustment Factor (BNAF) was enacted in April 1995 to offset the disparity in wages from one geographical area to another. The three-year phase-out of BNAF will result in about a 4 percent cut in hospice reimbursement rates each year.

3 A study by the Dartmouth Institute for Health Policy and Clinical Practice estimates that each hospice patient saves Medicare about $2,300 by providing emergency care in homes versus emergency rooms or hospitals. For the complete study, go to hospicecareinc.com.

Staff Prepares for a New Flu

This flu season promises to be very different from past flu seasons because of the H1N1 virus. While no one knows how the flu season will play out, as a healthcare organization, HospiceCare Inc. is taking the necessary steps to prepare our staff and safeguard patients.

“Our first concern is the health of our patients,” says Jane Quinn, vice president of regional services, education and research, and the person leading HospiceCare’s preparations for the H1N1 flu. “Because of the disproportionate infection rate among younger populations, we have concentrated our efforts on educating our staff and ensuring that absences due to illness stay at a level that allows us to maintain the high quality service that our community has come to expect.”

In addition to educating our staff about signs, symptoms and prevention of the flu, we have launched an effort to vaccinate all employees. Staff and visitors are screened for flu symptoms, and clinical staff have the equipment to safely care for infected patients. Finally, we have created a plan for covering patient needs should a significant number of staff take ill.

We are also monitoring the spread of H1N1 so we can adjust our plan as necessary. “No matter how the situation changes,” adds Quinn, “our goal is to ensure consistent delivery of hospice care to all in our community who need our services.”

Remembrance Programs

For people who have recently lost a loved one, the holiday season can be a very difficult time. HospiceCare’s Holiday Remembrance Programs, held every November, can provide welcome support. These events offer survivors an opportunity to remember those who have died and to gain strength and comfort from others as the holiday season begins. Information on coping skills and how to create new holiday rituals provides practical guidance for those who are grieving. The programs are free and open to the public. The Janesville program will be held November 8 from 2:00 p.m. to 3:30 p.m. and the Madison program will be held November 15 from 2:00 p.m. to 3:30 p.m.

Charitable Giving at Year’s End

Today many donors are exploring alternative ways to fund their charitable gifts. Making charitable gifts of appreciated stock or mutual fund shares can be an excellent way to improve your financial situation and preserve your cash reserves while helping HospiceCare. A properly structured donation provides numerous benefits to both the donor and to HospiceCare, including:

• Fulfilling your wish to give back to HospiceCare. Donor Rick Ripp tells us, “We felt giving to HospiceCare would be a good way to honor a family friend, Vern Hellenbrand, who spent his final days at the HospiceCare Center.”

• Avoiding the potential tax liability of selling appreciated stock or mutual fund shares. Rick continues, “We give stock because we save the capital gains tax instead of selling the stock and giving cash, and it is easy.”

• Receiving an income tax deduction for a donation of stock or mutual fund shares held more than one year.

The deduction equals the fair market value of the stock gift, and you can avoid paying income tax on the appreciation of the stock’s value. As always, check with your financial advisor or tax professional to discuss specific issues as they pertain to your individual situation. For information on how to make a gift of appreciated assets, contact donor services at (608) 327-7143.

For example, Harry and Dorothy decided to give HospiceCare 100 shares of a stock they purchased in 2002 for $2,000 that today are valued at $5,000. If Harry and Dorothy sold the shares outright, they would have a $3,000 capital gain. By deciding to gift the appreciated shares to HospiceCare, they avoid paying capital gains tax on the sale, which will save them $597 in federal and Wisconsin income taxes. In addition, they receive a tax benefit for the full market value of the stock gift which, at a 42 percent rate (federal and state combined and assuming the maximum tax brackets), nets them a tax savings of $2,100. In other words, donating stock that cost them $2,000 gives them a tax benefit of $2,100!

Thanks for Supporting Our Events!

Above photo from the HospiceCare Butterfly Gala.

From the beginning, HospiceCare has been a community idea and a community effort. There’s no greater demonstration of this than the events that our community was willing to support on our behalf last summer

The Radiate Hope Foundation donated $10,000 to HospiceCare from their annual fundraiser! Community members flocked to the Capital Brewery on July 11 for a day filled with music, games and food.

In August, The Ladies of Harley and our friends at the Sun Prairie VFW each hosted poker runs and raised $11,000 for HospiceCare.

Nearly 300 guests filled the Overture Center for the HospiceCare Butterfly Gala on September 12. Guests danced the night away and generated more than $65,000 for HospiceCare. View more photos online.

Golf Events

More than 360 golfers hit the greens this summer to raise over $60,000 for HospiceCare.

The 8th annual Neumy Golf Outing was held in memory of Randi Neumeyer and Paul Peterson at the Lake Windsor Golf Club.

Stark Realty supported HospiceCare through their Community Classic Golf Outing at Bridges Golf Course. Thank you to all the sponsors and participants for making it possible for us to serve more uninsured and underinsured patients and families!

Golf enthusiasts filled Hawks Landing for our 14th Annual HospiceCare Golf Open.

(Left): Josh Evenson, Rob Schmidt, Mike Scholz and Doug Weisenberger from North Star Financial.

Events