Recorded presentation

Beth Cameron Feldpush, MPH, Nancy A. Edwards, Joanna L. Hiatt, MA, and Gordon Richmond, MSPH. US General Accounting Office, 441 G. St., NW, Washington, DC 20548, 202-512-8428, feldpushb@gao.gov

The Medicare hospice program has grown steadily since its inception in 1983, with Medicare payment totaling approximately $4 billion in 2003, or 1.6 percent of total Medicare expenditures. Also, in recent years, the provision of hospice care has changed, as advances in medical technology have influenced the mix and intensity of hospice services provided, the average hospice length of stay has declined, and the number of patients with noncancer diagnoses has grown. In this session, the U.S. General Accounting Office (GAO) will discuss findings from our review of the Medicare hospice per diem payment structure. In this review we assessed the extent to which current Medicare payment for hospice services is adequate and appropriate and evaluated the current per diem payment methodology and hospice care categories. In this session, using data obtained from the Medicare hospice cost reports, we will assess providers’ costs compared to the current payment rates for all hospices and for hospices of different sizes and in rural and urban locations. We will also show the percentages of total costs made up by different cost factors, such as nursing and drug costs, and compare them to the cost allocations included in the original payment rates. Finally, we will present information on the quantity of services provided to patients at different points of time during a hospice stay and among the four different Medicare hospice care categories, as well as among patients with different terminal diagnoses and in different residential settings. See www.gao.gov for the full report.

Learning Objectives:

At the conclusion of the session, participants will be able to (
• compare hospice per diem costs to Medicare per diem payments; and (
• discuss potential modifications to the Medicare hospice payment system.

Keywords: End-of-Life Care, Medicare

Related Web page: www.gao.gov

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: U.S. General Accounting Office
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment

Recorded presentation