NCPA - National Center for Policy Analysis

Approaching Death, Many Patients Delay Entering Hospice Program

September 18, 2000

More terminally ill patients covered by Medicare are entering its hospice program -- but they are delaying entry for significantly longer periods, according to a General Accounting Office report.

  • The number of people receiving hospice care increased to 358,949 in 1998 -- from 143,110 in 1992.
  • Patients in the hospice program received an average of 59 days of care in 1998 -- down 20 percent from an average of 74 days in 1992.
  • In fact, 28 percent of all Medicare beneficiaries in the hospice program received care for one week or less.
  • In 1992, more than 75 percent of Medicare hospice patients had cancer -- but the number with other chronic diseases has been increasing rapidly in recent years, to the point where patients with other conditions and diseases now account for 43 percent of hospice patients.

Under Medicare, a hospice typically provides doctors' services, nursing care, the services of home health aides, medical supplies and equipment and pain-control medications.

Patients can qualify for hospice care under Medicare only if their doctors certify they are expected to live for six months or less. When some patients lived longer than six months, the government at one point tried to force hospices to pay back some of the money they received from Medicare. But officials now say there is no limit on how long an individual beneficiary can receive hospice services, so long as they meet the eligibility criteria.

Source: Robert Pear, "More Patients in Hospice Care, But for Far Fewer Final Days," New York Times, September 18, 2000.


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