Medicare patients enrolled in hospice receive better care at significantly lower costs than those who end up in a hospital or otherwise do not take advantage of the Medicare hospice benefit, new research shows.
The study, conducted by the Icahn School of Medicine at Mount Sinai, indicates the annual savings to Medicare could add up to $6.4 million, if 1,000 additional Medicare beneficiaries chose to enroll in hospice in the weeks prior to death.
Lead researcher Amy S. Kelley, M.D., an assistant professor of geriatrics and palliative medicine at Icahn School of Medicine, said the findings have significant implications for end-of-life patient care and healthcare costs.
"Considerable evidence supports that hospice significantly enhances quality of care for patients and their families near the end of life, but the impact of hospice on Medicare costs remains an ongoing debate," said Dr. Kelley, who detailed the study’s results in the journal Health Affairs. "Our study is the first to combine rich survey data and Medicare claims to demonstrate that an investment in the Medicare hospice benefit could translate into millions of dollars saved annually for the Medicare system and higher quality care for patients and families.”
For the study, researchers examined information from 3,069 participants in the long-running National Institute of Aging's Health and Retirement Study as well as their individual Medicare claims. They compared the Medicare costs of patients who received hospice care to those of patients who did not.
Researchers examined four different periods of hospice enrollment — 1-7, 8-14, and 15-30 days before death, as well as 53-105 days prior to death..
The results showed that if 1,000 additional beneficiaries enrolled in hospice 15 to 30 days prior to death, Medicare could save more than $6.4 million dollars annually, while those beneficiaries would be spared 4,100 hospital days. They also indicated if 1,000 additional beneficiaries enrolled in hospice 53 to 105 days before death, the overall savings to Medicare would be more than $2.5 million dollars.
Researchers also found that hospice enrollment was associated with significant reductions in admissions to hospital and intensive care units, days spent in a hospital, rates of 30-day readmissions and in-hospital death.
"To create the most value — both in terms of higher quality of care and lower cost — providers need to ensure that patients who could benefit from hospice know it's an available and accessible option," said Dr. Kelley.
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