HOSPICE CARE: Serving More Patients, but Stays Are Shorter
While more terminally ill patients are seeking hospice care, they are doing so closer to the time of death, according to a General Accounting Office report to be released today. The Wall Street Journal reports that a GAO investigation found that the average length for hospice services fell to 54 days in 1998 from 74 days in 1992, with non-cancer patients accounting for the sharpest reductions (McGinley, 9/18). At the same time, the number of Medicare beneficiaries receiving hospice care jumped from 143,110 in 1992 to 358,949 in 1998. Sen. Charles Grassley (R-Iowa), chair of the Senate Special Committee on Aging, said, "Too few people use the hospice benefit for too little time. That has to change." Medicare patients may qualify for hospice care only if their physicians certify that their remaining life expectancy is six months or less. In cases where patients lived longer than six months, the government has been accused of coercing hospices to relinquish money they had received from Medicare. However, HCFA Administrator Nancy-Ann DeParle said there was "a disturbing misperception that hospices and beneficiaries will be penalized if a patient lives longer than six months." To clarify this misperception, DeParle distributed letters to 2,200 hospices participating in Medicare, which stated: "In no way are hospice beneficiaries restricted to six months of coverage. There is no limit on how long an individual beneficiary can receive hospice services, as long as they meet the eligibility criteria. As long as a physician continues to properly and conscientiously recertify the six-month prognosis, a beneficiary can continue to receive the hospice benefit." Grassley called the clarification "overdue" (Pear, New York Times, 9/18). The GAO report did not explain the reason for the decline in number of days spent in hospice care, but noted that increased federal scrutiny "may have contributed" to the trend (Wall Street Journal, 9/18).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.