In the September 21st New York Times article by Dr. Danielle Ofri “One last visit to see my patient” she describes how a family went from thinking of hospice about giving up to extolling its virtues. Many unfortunately still see hospice in the same way as this patient’s family and the recent 10 page document released by the National Hospice and Palliative Care Organization (NHPCO) highlights this. It provides a synopsis about hospice, who is receiving hospice in the US, how much care was received, how Medicare pays for hospice and who is providing hospice.
Some key facts and figures for 2015.
- > 1.3 million Medicare beneficiaries were enrolled in hospice care for 1 day or more
- 46% of all Medicare decedents received one day or more of hospice care with variation across states from 24% to 57%. (WI was in the 50-55% range)
- Most recipients were elderly (>84), white females, with cancer being the principal diagnosis (28%).
- 69.5 days and 23 days the average and median length of service for Medicare patients enrolled in hospice, respectively
- About 98% of days of care was at the Routine Home Care level with 56% of care being provided at home.
- $15.9 billion paid by Medicare
- $11,510.00, the average spending per Medicare hospice patient.
As a physician who takes care of patients with serious illness I have found out so far that the best ambassadors for hospice are usually those who describe their experience as ‘great’ with their loved one’s care on hospice. The opposite is also true, there are families that have had bad experiences with hospice which they hold on to and unfortunately prevents them from having their loved one experience what could be a peaceful and wonderful time on hospice. The numbers in this document can be used by Palliative care teams to guide discussions with patients with serious illness and their families who will benefit from hospice (See Fast Facts #82, 87 & 90 for more information about the Medicare Hospice benefit). Hopefully just as Dr. Ofri did, we can think of death also as a “moment of joy” when our patients and families enjoy and embrace the benefits they could derive from hospice care.