Palliative Care Issues

Here are the top issues at the state and federal levels for Ohio palliative care providers:

State

Medical Orders for Life Sustaining Treatment (MOLST): Ohio patients need a better way to communicate their wishes at end of life.  The Ohio Medical Orders for Life-Sustaining Treatment (MOLST) initiative, modeled after the national POLST paradigm (Physician's Orders for Life Sustaining Treatment) would allow patients, in conversation with their physician's, select from a range of end of life care wishes. 

Update the Definition of Palliative Care: Currently, the definition of Palliative Care in the state of Ohio is only located in the hospice licensure statute.  It states that palliative care is care provided to a "hospice patient," and there is increasing concern that, if interpreted verbatim, this may mean that hospices providing palliative care services to non-hospice patients are in violation of statute.  While no hospice has been penalized for violating this statute, OHPCO is acting preemptively to broaden the definition of palliative care, so that it is never interpreted to restrict patient care.

Federal

Create a Palliative Care Benefit: While hospice care is valuable at end of life, the benefit is limited by two eligibility criteria: first, that the patient have a prognosis of six months or less to live, and second, that the patient gives up all curative care related to his or her terminal illness.  For patients who have longer disease trajectories or who are simply not ready to give up treatment, hospice is not an option.  Palliative care, which offers similar services without the restrictive eligibility criteria, is currently unreimbursed under either the Medicare or Medicaid programs.  Palliative care programs have demonstrated their ability to reduce costs by controlling symptoms and clarifying treatment wishes, while also improving patients' and families' experiences of care.