Changes in Medicare Costs with the Growth of Hospice Care in Nursing Homes

The use of hospice in nursing homes has increased substantially. In this analysis of Medicare expenditures in the last year of life for nursing home patients, hospice expansion between 2004 and 2009 was associated with a mean increase in Medicare spending of $6,800 per patient. Medicare expenditures...

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Bibliographic Details
Published in:The New England journal of medicine Vol. 372; no. 19; pp. 1823 - 1831
Main Authors: Gozalo, Pedro, Plotzke, Michael, Mor, Vincent, Miller, Susan C, Teno, Joan M
Format: Journal Article
Language:English
Published: United States Massachusetts Medical Society 07.05.2015
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ISSN:0028-4793, 1533-4406
Online Access:Get full text
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Summary:The use of hospice in nursing homes has increased substantially. In this analysis of Medicare expenditures in the last year of life for nursing home patients, hospice expansion between 2004 and 2009 was associated with a mean increase in Medicare spending of $6,800 per patient. Medicare expenditures for beneficiaries in their last year of life account for a quarter of the annual payments made by Medicare. 1 From its inception, hospice has been viewed as respecting patients’ goals of care with no resulting increase — or even with a resulting decrease — in health care expenditures. 2 – 4 Between 2000 and 2012, the percentage of Medicare decedents using hospice doubled (from 23% to 47%) 5 and hospice expenditures quintupled (from $2.9 billion to about $15.1 billion), 5 which raised budgetary concerns. 6 , 7 This increase was particularly large among persons with noncancer diagnoses and those residing in nursing homes. 8 The . . .
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ISSN:0028-4793
1533-4406
DOI:10.1056/NEJMsa1408705