Medicare Hospice Benefit Program Evaluation: FY 1985 Summary Report

摘要

The interim report describes the overall Medicare Hospice Benefit Program Evaluation objectives, design, methodologies and data describing the first two years of experience of the Medicare hospice benefit. The Medicare hospice benefit went into effect 11/83 and became a permanent Medicare benefit in 4/86. The report provides background review of research literature on hospice care and describes the Medicare hospice benefit and puts it into context with the growth of the hospice movement in the United States. Descriptive statistics are presented about: (1) the 233 hospices which became Medicare certified providers under the hospice benefit; and (2) the over 8,000 Medicare beneficiaries who elected the hospice benefit during fiscal years 1984 and 1985. The utilization patterns of the Medicare hospice patients are presented. None of the certified hospices had difficulty operating within the Medicare reimbursement cap; and most of the certified hospices were generally in compliance with the 20% cap on hospice reimbursed inpatient days. Preliminary analyses are presented which estimate hospice 'savings' using both a comprehensive and a more generous set of assumptions regarding the way of estimating expenses which are offset by hospice care. The findings will be tested in the final report using both actuarial and statistical methodologies on three years of data.