MOUNT VERNON — Hospice of Knox County is prepared to absorb possible funding cuts that may pass the U.S. Senate soon, but executive director Austin Swallow maintains hope that an agreement can be reached and present funding will remain in place.

According to Swallow, the federal budget that has been passed by the U.S. House for the next fiscal year has some cuts that would affect hospice funding throughout the nation. Swallow said that this has been done before, and that Congress has been able, with support from the hospice providers, “to beat this back.”

“I understand what the economists are doing,” said Swallow. “They see the growth in Medicare ... and they look at budget lines ... and they see lines that grow ... and they think, ‘can we cut these lines?’”

Swallow said that economists view the growth in the hospice benefit line item within the Medicare program as something that can be cut.

The proposed cuts would reduce the amount of hospice reimbursements by 1.44 percent for the first year; this would grow to a cut of 5.94 percent after three years. Swallow said the proposed cuts would be done by population, which would have a disproportionately negative effect in a rural area such as Knox County.

If the current budget is passed by the Senate, it would go into effect in October.

Swallow cited a study published by Duke University which showed that every patient served by hospice saves Medicare $2,300 on average.

“But those guys that write up the federal budget, they’re looking at the growth in the numbers,” said Swallow. “They’re not looking at the individual patient and realizing that even though there’s more acceptance of the hospice program, there’s more people now on the program they’re not looking at that; they’re looking at the number that’s affecting the Medicare bottom line.

“Proposing to cut the amount of reimbursement that they give to each hospice is one way that they are trying to be revenue neutral,” Swallow continued.

Swallow noted he has been in contact with U.S. Rep. Zack Space, who supported HR 5613, which is also known as the Protecting the Medicare Safety Net Act of 2008. The bill, passed in April, creates a moratorium on certain Medicare and Medicaid cuts until April 2009, including hospice programs, Swallow said.

“[This] is part of the typical, annual budget negotiations between the administration and the congress,” he said.

“We think that there is enough support in the Congress that they will not include this proposed legislation in the final budget act for the 2009 governmental budget. We hope so.”

Swallow said that if the current proposal passes as part of the 2009 budget, Hospice of Knox County will not cut its services.

“If it’s passed into law, and we have to deal with a 1.5 percent cut ... service would not be affected. There’s just no way that we’re going to allow service to our clients to be affected,” he said.

Swallow explained that one method for his organization to cut costs would be to look into some group-purchasing options.

“We’re looking for ways that we can work as an industry together,” said Swallow.

He also mentioned the possibility of eliminating some nonessential services, but said that hospice services themselves will not be affected.

“The nurses and the social workers and the aids, those guys are not going to be affected,” he said. “We ... just purchased a software system that we put into effect yesterday; that’s going to save us a lot of time and effort.”

Swallow explained that eliminating inefficient paperwork with the implementation of the new software system will allow hospice workers to spend more time with patients.

“We ... already had some things in action and in the planning stages to minimize the effects” of a potential budget cut, said Swallow, noting that he is always concerned about the prospect of a budget cut.

The hospice program was created 25 years ago and provides pain and symptom management care for people with terminal illnesses. Swallow said services can be provided for patients in their home or in a care facility. According to Swallow, hospice serves about 33 percent of all deaths in the country; in Knox County, this percentage rises to about 35 percent.