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Home Health & Hospice Week

Industry Note:

Study Points To Enrollment Policies As Factor In Hospice Underuse

Published on Thu Dec 06, 2012

Payment limitations may be more of a factor in hospice underuse than many providers think. So says a study in the most recent issue of the journal Health Affairs.

In a national survey of the enrollment policies of 591 hospices, researchers found that 78 percent of hospices had at least one enrollment policy that may restrict access to care for patients with potentially high-cost medical care needs, says the study's abstract. Such needs include chemotherapy or total parenteral nutrition, for example.

"Smaller hospices, for-profit hospices, and hospices in certain regions of the country consistently reported more limited enrollment policies," says the study headed up by Melissa D. Aldridge Carlson, an assistant professor of geriatrics and palliative medicine at the Mount Sinai School of Medicine, in New York City. "Hospice providers' own enrollment decisions may be an important contributor to previously observed underuse of hospice by patients and families."

Suggestions: Researchers call for Medicare to increase the hospice per diem rate for patients with complex needs. That suggestion likely dovetails with the Centers for Medicare & Medicaid Services plans to revamp the hospice payment system soon.

The abstract is online at http://content.healthaffairs.org/content/31/12/2690.abstract.

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