Hospice services Chapter summary

The Medicare hospice benefit covers palliative and support services for beneficiaries with a life expectancy of six months or less. Beneficiaries must “elect ” the Medicare hospice benefit; in so doing they agree to forgo Medicare coverage for intensive conventional treatment for their terminal condition. In 2010, more than 1.1 million Medicare beneficiaries received hospice services from more than 3,500 providers, and Medicare expenditures totaled about $13 billion. Assessment of payment adequacy The indicators of payment adequacy for hospices, discussed below, are generally positive. Beneficiaries ’ access to care—Hospice use among Medicare beneficiaries has grown substantially in recent years, suggesting greater awareness of and access to hospice services. In 2010, hospice use increased across all demographic and beneficiary groups examined. However, hospice use rates remained lower for racial and ethnic minorities than whites. • Capacity and supply of providers—The supply of hospices increased 53 percent between 2000 and 2010, with an increase of almost 3 percent in 2010. For-profit providers accounted for almost the entire increase in the number of hospices, both over the past decade and in the past year. In this chapter • Are Medicare payments adequate in 2012