New CMS Report Contains Wealth of Hospice Information
October 13, 2016 09:36 AM
A new report from the Centers for Medicare and Medicaid Services (CMS) details the different levels of hospice spending in states around the country.
The release is part of the Obama Administration’s efforts for greater transparency in healthcare. The Hospice PUF contains information on utilization, payment, submitted charges, primary diagnoses, sites of service, and hospice beneficiary demographics organized by CMS Certification Number (6-digit provider identification number), and state. This represents some of the most detailed hospice data available to the public. Although the Hospice PUF has a wealth of payment and utilization information about hospice services, the data set also has a number of limitations. For instance, there is no information on levels of care other than routine home care (RHC) and there is no quality data. Additionally, the data are not risk adjusted and thus do not account for differences in patient populations. Providers may be interested in viewing the methodology document.
The report, The Hospice Utilization and Payment Public Use File (or Hospice PUF), contains information on 4025 hospice providers, 1.3 million hospice beneficiaries and over $15 billion in Medicare payments from 2014.
Medicare spent an average of $11,393 per hospice beneficiary for an average of 70 days of care in 2014. Eleven percent of the 1.3 million hospice beneficiaries that year had a live discharge from care. Meanwhile, 33 percent of beneficiaries spent more than 60 days in hospice care and 13 percent spent more than 180 days in hospice care.
Southern states spent the most per beneficiary, with South Carolina in first place, spending $14,778, followed closely by Alabama at $14,361 and Mississippi at $14,100 per beneficiary.
The three states with the lowest spending per hospice beneficiary were Wyoming ($7132), South Dakota ($7252) and Alaska ($7442).
Southern and southwestern states led the way with the highest percentages of live discharge from hospice care. (A live discharge from hospice care may be due to a change in the terminal prognosis, to resume treatment or to change hospice providers.) Mississippi had the highest rate of live discharge, at 20.6 percent. South Carolina followed close behind at 18.3 percent. The lowest rate for live discharge was in Kentucky (7.1 percent), with Illinois, Ohio and North Dakota not far behind.
Southern states also tended to have a higher percentage of hospice beneficiaries receiving more than six months of hospice care in 2014. The highest rates of six or more months of hospice care were in Alabama (18.4 percent), South Carolina (18.1 percent) and Mississippi (17.2 percent). The lowest rates of six or more months of hospice care in 2014 were Wyoming (5.4 percent), South Dakota (5.8 percent) and Alaska (6.6 percent). The Medicare hospice benefit is designed for beneficiaries with a terminal medical prognosis of six months or less.
In all, there were 92.3 million hospice care days in 2014. There were 142,000 live discharges, about 11 percent of the total number of beneficiaries. Twenty-seven percent of hospice beneficiaries spent seven or fewer days in hospice care, about 354,000. The largest group of hospice beneficiaries was those who spent between 60 and 180 days in hospice care – about one-third of all beneficiaries.