Medicare Hospice Benefit Program Evaluation. Final Summary Report

摘要

In FY86, the hospice benefit payments of $20 million for about 10,500 Medicare beneficiaries who elected the benefit were less than one percent of the total Medicare Part A expenditures. Overall, the study found neither any significant increase in costs nor any significant savings to the Medicare program attributable to the Medicare hospice benefit during the 1984-1986 period. The only unambiguous finding of hospice cost savings is that for free-standing hospices, compared to net additional costs generated in the provider-based hospices. Analyses found no difference between conventional care patient costs and those of hospice benefit patients, that certified hospices are larger than are non-certified hospices, they have lower average daily costs than non-certified hospices and considerably lower costs per discharge than non-certified hospices. Certified hospices were generally able to earn positive net revenues while conforming to the reimbursement and inpatient day limits of the Medicare program. A simulation suggests that the sample of non-certified hospices also would have profited under the benefit, with 3/4 expected to have earned positive net revenues had they participated in the Medicare hospice benefit.