TEMPLE TERRACE — The parent company of LifePath Hospice eliminated 89 jobs this week, citing declining government reimbursements, costly regulatory changes and uncertainty amid expected changes to the hospice payment system.
The eliminated positions, 64 of which were filled and the rest vacant, were distributed across Chapters Health System and its affiliated companies, including LifePath and Good Shepherd Hospice, spokeswoman Jenna Paladino said.
She emphasized that the layoffs had nothing to do with performance.
"These challenges are also facing the hospice industry both nationwide and across the state," Paladino said.
Chapters Health, a nonprofit, has more than 1,000 employees providing services to more than 1,700 hospice patients daily and 1,813 palliative care patients annually. LifePath serves Hillsborough County, while Good Shepherd serves Polk, Highlands and Hardee counties.
Hospice Action Network, the lobbying affiliate of the National Hospice and Palliative Care Organization, predicted in a recent report a "perfect storm" of Medicare cuts and expensive regulatory changes that could spell trouble for hospices.
Typically, well over 90 percent of hospice patients are enrolled in Medicare and Medicaid. Medicare spending on hospice is expected to reach $17 billion next year and increase to $37 billion by 2024, according to a Medicare report last year.
Like all health care providers, hospices get mandatory 2 percent cuts to Medicare rates from automatic budget cuts known as sequesters, said Jon Radulovic, spokesman for the national hospice group. In addition, he noted, hospices could be subject to more cuts based on new quality reports they must file.
What's more, the Centers for Medicare and Medicaid has added more rigorous standards to get patients qualified for the hospice benefit. And the federal health care law calls for change to how hospices are paid, creating uncertainty in the industry.
"More and more is expected from hospice providers," Radulovic said.
Hospices run a 4 to 6 percent profit margin, he said. But that's before the mandatory 2 percent cut or the required services, such as bereavement counseling, that aren't reimbursable.
Four years ago, HPH Hospice, formerly Hernando-Pasco Hospice, laid off 19 continuous care nurses and seven support staffers. Spokeswoman Robin Kocher said her organization is better positioned now to deal with the financial issues facing hospices.
"All hospices are dealing with this, definitely," she said.
Recent national news reports have suggested that many of the big players in the hospice industry are doing fine financially. Stories in the Washington Post and Huffington Post found hospice organizations, most often for-profit companies, are boosting revenue by overbilling for care, refusing to discharge patients who are improving and enrolling people who aren't dying.
Contact Jodie Tillman at jtillman@tampabay or (813) 226-3374. Follow @JTillmanTimes.