Home Health & Hospice Week

Get ready to defend your claims for patients in nursing homes, thanks to new OIG report.

The cost of hospice care is squarely on the feds' radar screens--and there's a new report to prove it.

In a report released Dec. 20, the HHS Office of Inspector General notes that hospice care provided in nursing facilities costs Medicare significantly more on average than hospice care offered in other settings.

Slightly more than a quarter of Medicare hospice beneficiaries resided in nursing homes in 2005, the year analyzed by the OIG.

And hospice care continues to be on the rise, the study shows. In fiscal year 2001, 580,000 Medicare beneficiaries received hospice care costing $3.6 billion. By 2006, the number of beneficiaries served in hospice had jumped to 934,000, with costs reaching $9.2 billion, according to the report.

More scrutiny: The OIG plans further analysis of hospice services in nursing facilities, to get a better read on the appropriateness of the costs in that setting.

Hospice care provided in nursing facilities cost Medicare 25 percent more than hospice beneficiaries in other settings, according to the report. On average, Medicare paid $10,631 per beneficiary for hospice care for individuals in nursing facilities, compared with $8,500 per beneficiary for patients in other settings.

Medicare payments for hospice beneficiaries in nursing facilities were $2.55 billion. The program paid $5.37 billion for the 72 percent of hospice beneficiaries in other settings.

For more information: To read the report, go to www.oig.hhs.gov/oei/reports/oei-02-06-00220.pdf.