Hospice Stats Say More about Care than Money

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Amy Shellhart By Amy Shellhart 
Director of Product Management, McKesson
Hospice Care Says More About Care

Hospice workers won’t be surprised at new research that reveals Medicaid patients dying in hospitals incur seven times the costs in the last month of life than those who die at home.

Dying while in an inpatient hospice facility cost roughly half of dying in a hospital ($32,379 versus $17,845), according to analysis from Arcadia Healthcare Solutions. Forty percent of patients were hospitalized at the time of death, compared to 7% using inpatient hospice and 42% who died at home. It’s also no surprise that those who died at home spent the least on healthcare in the last month of life, just $4,760.

The analytics firm studied Medicaid claims data for a private insurance company in one Western state, noting billable medical procedures in the patient’s last month of life and location of that care.

On the one hand, the story is purely about cost. But hospice workers and anyone who’s cared for a seriously ill family member or friend know that the underlying story is about the setting where one dies, notes Dr. Richard Parker, chief medical officer at Arcadia.

“In the end, everyone died. They all died,” Parker says in an NPR article about the study. “If we look at this retroactively, retrospectively—and we could go back and ask people—I bet most of them would say I’d rather be home with my family.”

Difficult, But Important, Conversations

Arcadia’s analysis is the latest of many recent reports that show the value of hospice or the need to have frank discussions about what can be a taboo topic.

The Institute of Medicine’s landmark report about dying showed that 90% of Americans believed it was important to have an end-of-life discussion with their family. But how many actually did it? Fewer than 30%.

Hospice organizations, however, should take care in admitting hospice patients—especially into inpatient settings. Analysis by the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services shows that three in 10 GIP admissions were not warranted for part or all of the stay. In fact, there was no evidence submitted at all that the patient had a terminal condition or elected hospice in 1% of patient stays. Having the proper documentation hospice software solution will help organizations ensure that every stay is justified.

As the healthcare industry collectively seeks to improve care quality while reducing its overall cost, we recognize the value of hospice in dollars-and-cents terms. But as people, as caregivers and as patients who will die someday, we also recognize hospice as a compassionate way to go.

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