Organizational Behavior: Hospice History of Term Paper

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Hospice affirms life and neither hastens nor postpones death" ("Preamble and Philosophy," NHPCO, 2010). The NHPCO formal mission statement is: "To lead and mobilize social change for improved care at the end of life" ("Mission & Vision," NHPCO, 2010).

Financial and economic statements

Hospices individually operate under a wide variety of financial models, including for-profit and not-for-profit systems. Most use "a managed-care model, with insurance companies providing per visit and per diem reimbursement" (Baxendale & Dornbusch 2000, p.1). "Hospices receive funds from government programs or private insurance, from donations made by the public or other corporations, and from grants donated by charitable foundations...Hospices are not reimbursed on a fee for service basis: rather, hospices are paid, on a basis of how many days the patient is enrolled in the program and received services…In return for payment, Medicare, Medicaid and private insurance companies expect the hospices to provide all services which the patient and family need which are related to the terminal illness"("Hospice Funding," Hospice Patient Alliance, 2001). "Shorter length of stays by patients closer to death and indigent care strain the managed-care model," given the expense of creating an initial pain management pain for the patient, which is necessary regardless of his or her length of the stay (Baxendale & Dornbusch, 2000, p.1).

Recently, the National Hospice and Palliative Care Organization survived what could have been a critical blow to its financial status.

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The American Recovery and Reinvestment Act of 2009 placed "a one-year moratorium on cuts in Medicare funding for the more than 4,700 hospice programs nationwide" (Perkins 2010). Medicare and Medicaid funding are one of the main sources of financing for hospice care. "A 2007 independent Duke University study found that hospice reduced Medicare costs by an average of $2,300 per hospice patient, amounting to a total of more than $2 billion in savings in a single year," but a 2008 regulation issued by the Centers for Medicare and Medicaid Services, would have eliminated "a key component of the Medicare hospice reimbursement formula known as the budget neutrality adjustment factor (BNAF)" (Perkins 2010).

Female role in the organization

Quite simply, without the commitment of women, hospice would not exist. Hospice was founded by a female physician, and upon the ideas of philosopher Elisabeth Kubler-Ross. Hospice volunteers tend to be disproportionately female. The chairperson of the NHPCO Board of Directors is female, as is the Vice Chair and many other members of the leadership organization. But more importantly, many would describe the overall philosophy of hospice as 'female' in nature, in the sense that it is accepting of death, and allows individuals to control their life journey, rather than the more directive approach of traditionally male-dominated Western medicine.

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