Home Health & Hospice Week

Social worker visits remain virtually unchanged under SIA policy.

The jury is still out on whether Medicare's hospice payment reform model implemented last year is fixing the benefit's perceived problems, but the latest MedPAC report contains one encouraging statistic.

In 2016, Medicare paid hospice providers roughly $120 million for registered nurse and social worker visits in the last seven days of life, the Medicare Payment Advisory Commission notes in its annual report to Congress released March 15. Medicare makes those payments under the Service Intensity Addon provision that began in January 2016.

"The average number of nurse visits per day appears to have increased slightly (from 0.59 visits per day to 0.61 visits per day) during the last 7 days of life," the advisory body to Congress notes in the report.

Caveat: Nurse visits MedPAC used included both registered nurse and licensed practical nurse visits, the report explains. "Although the new payment system makes additional payments only for RN (not LPN) visits in the last days of life, we have included both types of visits in this chart because data specific to RNs are not available for 2015," the report says.

While nurse visits increased slightly, "at the same time, the average length of nurse visits during the last days of life appears to have declined slightly," from about 75 minutes to 72 minutes per visit, MedPAC points out.

"Social worker visits in the last days of life were less frequent and changed little during this period," MedPAC adds.