Home Health & Hospice Week

Hint: It isn’t just California and Texas.

You can bet your law- and policy-makers will be poring over the statistics offered by the Medicare Payment Advisory Commission in its latest report to Congress — and that means you should too.

Take a look at the top figures MedPAC cites in its recent report, which are from 2022 unless otherwise indicated:

• Hospices had a Medicare aggregate profit margin of 13.3 percent in 2021, the most recent year with data available. (See more margin details in related story, p. 98.)
• The number of hospice providers increased by 10.1 percent to 5,899. “Market entry of for-profit, freestanding providers drove the growth in supply,” the report notes.
• Between 2021 and 2022, California gained 342 hospices and Texas gained 75 hospices. The next-closest states were Nevada with 24 new hospices, Arizona (15), Michigan (12), Virginia (10), Indiana (8), Ohio (7), and Oregon and Wisconsin (6 each).
• Medicare spent $23.7 billion on hospice, excluding Medicare Advantage. That compares to $12.9 billion in 2010.
• The share of decedents using hospice was 49.1 percent, up from 47.3 percent in 2021.
• On average, beneficiaries in hospice received 3.9 visits per week, up slightly from 3.8 visits per week in 2021.
• Medicare spent about $1.5 billion on services outside of the hospice benefit for hospice enrollees.
• Routine home care accounted for 98.8 percent of Medicare-covered hospice days.
• About 90 percent of Medicare hospice patients received at least one day of RHC, 16 percent received some General Inpatient Care, 3 percent received some Inpatient Respite Care, and 2 percent received some Continuous Home Care.
• In 2021, 18.9 percent of hospices exceeded the per patient cap. Those hospices provided care to about 5 percent of hospice patients.
• The ratio of decedents who used hospice at 49.1 percent is up from 2021 (47.3 percent), but still down from 2019 (51.6 percent).
• The average lifetime length of stay among decedents continues to rise, going from 92.1 days in 2021 to 95.3 days. Median LOS is 18 days, back up from 17 in the pandemic.
• The number of hospice users is 1.72 million, up from 1.71 million in 2021.
• In-person visits per week were up from 2021 at 3.9, but still below pre-pandemic levels (4.3 in 2019). Telehealth visits may affect the figure, MedPAC acknowledges.
• Nurse and social worker visits were “generally stable in 2022, but down from 2019 levels,” the report notes.
• Live discharges were 17.3 percent, close to the 2021 rate of 17.2 percent. “Hospices with very high live-discharge rates were disproportionately for profit and recent entrants to the Medicare program … and had an above-average rate of exceeding the aggregate payment cap,” the report highlights.
• In 2021, the live-discharge rate among cancer patients was 10 percent for below-cap hospices and 26 percent for above-cap hospices, MedPAC details. The live-discharge rate among heart failure patients was 19 percent for below-cap hospices and 57 percent for above-cap hospices.

Source: www.medpac.gov/wp-content/uploads/2024/03/Mar24_Ch9_MedPAC_Report_To_Congress_SEC.pdf.