Eli's Hospice Insider

Published on Wed Jul 18, 2018 PDF

Medicare policy requiring beneficiaries to forego dialysis hampers usage.

Medicare patients on chronic kidney dialysis have “woefully poor access to hospice care,” says a study published by University of Washington School of Medicine researchers in Health Affairs.

Of the patients studied, “fewer than one in four patients enrolled in hospice, quite low compared with the almost 50 percent hospice-enrollment rate of Medicare’s overall population,” says a UW release about the study. “And in all four groups, patients spent a median of five to six days in hospice, far less than other Medicare beneficiaries.”

Medicare’s policy that most patients must stop dialysis to elect hospice contributes to the statistics, says study author and UW professor Ann O’Hare. Expanding Medicare’s concurrent care demonstration may help dialysis patients access the hospice benefit, she suggests, although unpredictable illness trajectories also play a part in the problem.

See the study abstract at www.healthaffairs.org/doi/abs/10.1377/hlthaff.2017.1181.