ASH Backs the Use of Palliative Blood Transfusions During Hospice Care for Symptom Improvement
The American Society of Hematology (ASH) has announced its support of palliative blood transfusions during end-of-life care in a recent policy statement.
The Medicare hospice benefit for patients undergoing end-of-life care focuses on maximizing quality of life by providing comfort and support services while forgoing coverage related to conventional treatment. As part of this arrangement, hospice facilities receive a daily payment for each patient, then are responsible for covering service and medication costs, including blood transfusions. While blood transfusions can be offered during hospice care, they often are not because of the high cost.
As a result, patients with hematologic malignancies who require blood transfusions to ease their symptoms are less likely to use hospice services than patients with other types of cancers. This is particularly troubling, as patients with hematologic malignancies have a greater number of emergency room visits, hospital admissions, hospital deaths, and deaths in the intensive care unit in the last 30 days of life compared with patients with solid tumors.
The benefits of blood transfusions for patients undergoing palliative care are significant and can improve several symptoms, including breathlessness, bothersome bleeding, and profound fatigue.
ASH has several recommendations to increase access to blood product support for patients receiving hospice care:
- The Centers for Medicare and Medicaid Services (CMS) should work with hospice agencies and administrators to clarify that palliative transfusions are a covered benefit and should be symptom-based and performed in collaboration with hematologic oncologists.
- CMS should work with hospice agencies to create innovative reimbursement models to promote the provision of palliative transfusions, such as allowing for separate payment under Medicare Part B.
- CMS should work with hospice providers and other stakeholders to explore novel ways to access transfusions, such as at-home transfusions.
Learn more about ASH's advocacy efforts at hematology.org/advocacy.
Announcing the 2019 Honorific and Mentor Award Recipients
ASH will recognize these distinguished leaders in hematology through awards and special lectures at the 61st ASH Annual Meeting and Exposition in Orlando.
Wallace H. Coulter Award for Lifetime Achievement in Hematology
Richard Aster, MD, of the Medical College of Wisconsin and Versiti Blood Center of Wisconsin in Milwaukee, for his significant contributions to hematology in research, mentorship, and education throughout his 62-year career.
Ernest Beutler Lecture and Prize
Sriram Krishnaswamy, PhD, of the Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania and Jeffrey I. Weitz, MD, of McMaster University in Hamilton, Ontario, for their significant research contributions to the understanding and treatment of blood clots.
Mentor Awards
Leonard Zon, MD, of Harvard Medical School and Boston Children's Hospital and Michael R. DeBaun, MD, of Vanderbilt University School of Medicine in Nashville for their sustained, outstanding commitment to the training and career development of early-career hematologists.
William Dameshek Prize
Emmanuelle Passegué, PhD, of Columbia University Irving Medical Center in New York City for her outstanding contributions to the understanding of hematopoietic stem cells.
Leadership in Promoting Diversity
Griffin Rodgers, MD, of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH) for his extraordinary commitment to diversity and inclusion in hematology.
E. Donnall Thomas Lecture and Prize
Philip Greenberg, MD, of Fred Hutchinson Cancer Research Center and the University of Washington in Seattle for his outstanding contributions to the field of immunotherapy.
Henry M. Stratton Medal
William Eaton, MD, PhD, of NIDDK and Richard A. Larson, MD, of the University of Chicago for their seminal contributions to basic and clinical/translational hematology research, respectively.
Please visit hematology.org/Awards to learn more about ASH's awards program.
Accolades Abound for ASH Clinical News
ASH Clinical News (ACN) is proud to be the recipient of two Communicator Awards – an Award of Excellence and an Award of Distinction – from the Academy of Interactive and Visual Arts, a silver Excel Award from Association Media & Publishing, and a bronze ASHPE award from the American Society of Healthcare Publication Editors.
The Communicator Award of Excellence was presented for the November 2018 feature article "Rethinking Burnout," which looked at the epidemic of physician burnout and the shifting approaches to its prevention and management. The article, by freelance writer Emma Yasinski, stressed the importance of individualizing organizational approaches to the problem and reasserting the values important to physicians.
The Award of Distinction was given to an editorial by ACN associate editor David Steensma, MD, called "Draining the Email Swamp." In this Editor's Corner, Dr. Steensma, whose term as editor-in-chief of the publication begins in January 2020, offers advice for handling the daily deluge of emails.
A silver Excel Award was granted to another ACN associate editor, Alice Ma, MD, for her March 2018 Editor's Corner, "Not What I Signed Up For." In this editorial, Dr. Ma discussed her experience dealing with a patient who threatened physical violence.
Last, but not least, is a 2019 bronze ASHPE award for "Best Legislative or Government Article." This distinction went to the October 2018 cover story, "Realities of Right to Try," by freelance writer Leah Lawrence. In the article, experts expressed their opinions about increasing patients' access to experimental therapies.
These achievements are due in large part to readers' enthusiastic response to the content we provide. Thank you for your continued engagement and support of the publication!
