Home Health & Hospice Week

What does your live discharge rate suggest about your hospice?

A new study adds fuel to the feds’ fire for scrutinizing hospices’ live discharge rates. Researchers from the David A. Winston Health Policy Fellowship and the University of North Carolina used Medicare claims data from 2012 and 2013 and cost reports from 2011 to 2013 “to explore relationships between hospice-level financial margins and live discharge rates among freestanding hospices,” says the abstract for the study published in July’s issue of Health Affairs.

The results: “Adjusted analyses showed positive and significant associations between both operating and total margins and hospice-level rates of live discharge,” the abstract says. “One-unit increases in operating and total margin were associated with increases of 3 percent and 4 percent in expected hospice-level live discharge rates, respectively.”

In other words, the higher a hospice’s live discharge rate, the higher its Medicare profit margin.

“For more than a decade, hospices have steadily increased the rate at which they discharge patients before death,” the study authors say. “Although certain live discharges are consistent with high-quality care, regulators have expressed concern that some hospices’ desire to maximize profits drives them to inappropriately discharge patients.”

See the abstract at http://content.healthaffairs.org/content/36/7/1291.abstract.