More on hospice reducing Medicare expenditures

Brad Flansbaum asks in the comments on yesterday’s post: “Can you give some examples? Lets say you extend a stay from 10 to 20 days. Utility gain, patient, provider, and family become grateful recipients of care, but how does the cost go down?”

The key (as always) is the counterfactual (as compared to what?). This paper we published in 2007 (this is an improved extension published in 2012 by Amy Kelley and colleagues) provides an estimate of cost savings by length of hospice use prior to death. I went back to the paper and dug up the estimated (cumulative) savings to Medicare of using hospice for the following periods of time before death:

  • 5 days $2,929
  • 10 days $4,037
  • 20 days $5,141
  • 30 days $6, 131

The last 5 day (or any other period) savings are estimated as follows: compare the cost to Medicare of a hospice user for the last 5 days of their life, to the Medicare financed cost of last 5 days of life for a matched control who did not use hospice (matches via propensity score matching; identifies a similar patient who did not use hospice). So, the savings quoted above are during the period of hospice use only.

The other questions Brad asks (precise estimate of increased benefit accrued to the patient of going from a 10 to a 20 day stay) are more difficult to answer, but I will give it a shot sometime next week.

The hospice tag will get you to many posts on this and related topics.

About Don Taylor
Professor of Public Policy at Duke University (with appointments in Business, Nursing, Community and Family Medicine, and the Duke Clinical Research Institute). I am one of the founding faculty of the Margolis Center for Health Policy, and currently serve as Chair of Duke's University Priorities Committee (UPC). My research focuses on improving care for persons who are dying, and I am co-PI of a CMMI award in Community Based Palliative Care. I teach both undergrads and grad students at Duke. On twitter @donaldhtaylorjr

3 Responses to More on hospice reducing Medicare expenditures

  1. Pingback: WaPo story on the Medicare hospice benefit | freeforall

  2. Pingback: WaPo Story on Medicare Hospice Benefit « The Reality-Based Community

  3. Pingback: Impact of hospice on costs for patients in Nursing Homes | freeforall

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