In a significant move towards enhancing end-of-life care for patients in need of palliative blood transfusions, Rep. Earl Blumenauer (D-OR-3) introduced H.R. 9803, the Hospice CARE Act of 2024. This bill expands access to palliative blood transfusions for individuals enrolled in the Medicare Hospice program, aiming to address a pressing gap in the current state of care.
Hospice care plays a vital role in end-of-life care. Unfortunately, many patients delay or forgo enrolling in hospice if they require blood transfusions for quality of life, such as those with blood cancers. Though the Centers for Medicare & Medicaid Services has explicitly recognized the ability of hospice providers to cover palliative blood transfusions, there are very few hospice programs that provide palliative transfusions since the reimbursement rate is inadequate to cover the cost. Instead, patients that rely on palliative transfusions choose not to enroll in hospice to continue to receive these essential blood transfusions.
Delayed enrollment in hospice has been shown to lead to a greater number of emergency room visits and hospital admissions in the last 30 days of life, with patients much more likely to die in the hospital or intensive care unit. The cost of these transfusion-dependent patients not meaningfully utilizing hospice dramatically lowers end-of-life quality measures at an increased cost to Medicare ($17,783 vs $7,662).
The Hospice CARE Act of 2024 would make important reforms to the Medicare Hospice program, including through providing reimbursement for blood tranfusions outside of the bundled rate structure. This adjustment is designed to more accurately reflect the real cost of blood transfusions in a hospice setting. By aligning reimbursement with the true expenses involved, the bill would increase access to palliative blood transfusions for patients rather than having them forgo or delay enrollment in the Hospice program.
America’s Blood Centers thanks Rep. Blumenauer for his leadership in introducing this bill. Individuals and organizations alike can show their support by submitting letters to their Members of Congress urging them to back this crucial legislation.
Work has also been done in the Senate to improve care for Hospice patients, with the introduction of S. 2186, Improving Access to Transfusion Care for Hospice Patients Act, introduced by Sen. Jacky Rosen (D-NV). This bill would require the Center for Medicare and Medicaid Innovation (CMMI) to establish and implement a model under which blood transfusions furnished to an individual receiving hospice care are paid separately from the Medicare Hospice benefit. Those interested in supporting Sen. Rosen’s bill and encouraging their Members of Congress to cosponsor it can do so here.
To learn more about how blood transfusions can enhance end-of-life care and ABC’s advocacy efforts to expand the availability of blood transfusions in Hospice, click here.