Increased hospice enrollment would save Medicare millions each year, researchers find

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Increasing hospice enrollment would improve care for beneficiaries while saving the Medicare program millions of dollars annually, according to a study in the March issue of Health Affairs.

Researchers at the Icahn School of Medicine at Mount Sinai Medical Center in New York City looked at 2002-2008 survey data and Medicare claims of 3,069 people. Those who enrolled in hospice cost the Medicare program less than those who did not enroll in hospice, the researchers found.

The most savings occurred for Medicare when patients entered hospice 15-30 days prior to death, according to the report. If 1,000 additional beneficiaries enrolled in hospice during this window of time, the Medicare program would save about $6.4 million annually. Medicare would save more than $2.5 million annually if 1,000 additional people enrolled in hospice 53-105 days before death.

Increased hospice care would also lower 30-day hospital readmissions rates and positively impact quality of care measures, the researchers stated.

Based on these findings, the Centers for Medicare & Medicaid Services should increase access to Medicare-covered hospice care, the researchers proposed. A Medicare rule preventing simultaneous reimbursement for hospice and skilled nursing care may be leading to more aggressive care and increasing hospitalizations. The payment rule is being examined.