Hospice Benefits Proven for a Variety of Lengths of Stay

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Karen Utterback By Karen Utterback 
Former Vice President, Product Marketing and Strategy, McKesson (Retired)

Hospice Benefits Proven for Varied Lengths of StayData has consistently shown that hospice improves quality of care and lowers costs, but until now, the benefits had only been proven for patients enrolled 53 to 105 days before death. A study released this spring proved the benefit is even greater for patients enrolled within 30 days of death.

Researchers at the Icahn School of Medicine at Mount Sinai Medical Center in New York City looked at Medicare claims of 3,069 people and 2002-2008 survey data, publishing their findings in a recent issue of Health Affairs.

For all the periods examined, hospice patients had lower rates of in-hospital death and hospital service use than the control group. The report said patients enrolled 15 to 30 days before death saved Medicare $6,430, those enrolled 8 to 14 days saved $5,040, and those enrolled one to seven days saved $2,650.

“Instead of attempting to limit Medicare hospice participation, the Centers for Medicare and Medicaid Services should focus on ensuring the timely enrollment of qualified patients who desire the benefit,” the authors wrote.

According to the National Hospice and Palliative Care Organization, the average length of service was 69.1 days, but the median (50th percentile) length of service in 2011 was 19.1 days. Based on the study data, for every 1,000 additional beneficiaries enrolled in hospice 15 to 30 days prior to death, Medicare could save more than $6.4 million dollars annually, and those beneficiaries would be spared 4,100 hospital days.

Perhaps more important than evidence of potential savings (with increased quality of care), this study underlines the value that hospice care helps provide. According to the CDC, one-third of all deaths occur in hospitals despite studies that show most Americans want to die in their own homes.

This is a story that both home health and hospice agencies should be telling their referring partners.

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