After 39 years of existence, the Hospice of Martha’s Vineyard (HMV) has initiated the process to acquire Medicare certification. This move will expand services and help the hospice better fulfill its mission and vision to provide care for the Island community.
HMV was one among a handful of hospices across the country operating solely on community funding, without ties to the government health program, according to HMV executive director Tom Hallahan. HMV first adopted this funding strategy with the aim of providing the hospice increased flexibility on guidelines regarding who can or cannot be admitted to the hospice, thereby enhancing the quality of care it could provide. “That has always been a wonderful privilege to have that flexibility,” Hallahan said.
And yet, over the years, HMV found itself having to redirect some patients away from its care toward the services of the Island’s Medicare hospice. This is because despite the fact that HMV is committed to providing palliative care and bereavement counseling free of charge, some patients, due to specific medical needs and insurance statuses, would be faced with unaffordable co-pays if admitted at HMV. Such costs were often associated with certain pharmacy bills or durable medical equipment.
Hallahan stressed that the Medicare hospice was a wonderful partner to have on the Island, but having to recommend some people seeking HMV’s services find care elsewhere struck him and HMV’s staff as jarringly in conflict with their mission and vision. On its website, HMV is described as a hospice that “will be the Island’s resource for end-of-life care available to our entire community.”
HMV was therefore confronted with a defining decision. It would either have to change its vision and mission, or implement real changes to fully realize its aspirations. A conversation with a friend who runs a hospice in Pittsburgh reassured Hallahan that seeking Medicare certification would not take anything away from the services HMV already provides, but instead simply improve the quality of care they would be able to offer Island residents. “We look at this as expanding and enhancing our services so we can truly meet the end-of-life needs of the entire Island community,” Hallahan said.
HMV will continue offering palliative care and bereavement counseling free of charge. In fact, Hallahan said that obtaining Medicare certification will help cover the cost of certain services, This will in turn help HMV become better stewards of their donors’ money by adding new services free of charge, such as acupuncture, music, and art therapy.
Though some steps have already been taken, the road to certification is a long one. After a year of deliberations and the completion of a feasibility study, HMV’s board voted to proceed with the certification back in July. HMV is currently working with an external hospice advisor, and already hired an internal project manager. And yet Hallahan said the hospice had completed just 3 percent of what needs to be accomplished: “This is going to be very labor-intensive, because we are going literally line by line through the policies for patient care, human resources, and administration.”
Hallahan projects achieving certification by the end of 2021 or the beginning of 2022.
Much work remains to be done before HMV can call itself Medicare-certified, but the prospect of being able to finally offer end-of-life care to the whole Island community is what makes the effort all worthwhile.
“We are excited. Our patients and their families will not really notice a difference, except those that have called us in the past that we have pointed to the Medicare hospice,” Hallahan said. “We don’t have to do that anymore. And that’s cool.”