Proportion and Patterns of Hospice Discharges in Medicare Advantage Compared to Medicare Fee-for-Service

J Palliat Med. 2018 Mar;21(3):302-306. doi: 10.1089/jpm.2017.0046. Epub 2017 Sep 5.

Abstract

Background: When Medicare Advantage (MA) patients elect hospice, all covered services are reimbursed under the Medicare fee-for-service (FFS) program. This financial arrangement may incentivize MA plans to refer persons to hospice near end of life when costs of care typically rise.

Objective: To characterize hospice discharge patterns for MA versus FFS patients and examine whether patterns differ by MA concentration across hospital referral regions (HRRs).

Design and measurement: The rate and pattern of live discharges and length of stay (LOS) between FFS and MA patients were examined. A multivariate mixed-effects model examined whether hospice patients in MA versus FFS had differential patterns of discharges. In addition, we tested whether concentrations of MA hospice patients in a patient's HRR were associated with different patterns of discharges.

Results: In fiscal year 2014, there were 1,199,533 hospice discharges with 331,142 MA patients having a slightly higher live discharge rate (15.8%) compared to 868,391 FFS hospice discharges (15.4%). After controlling for patient characteristics, the adjusted odds ratio (AOR) was 1.01 (95% CI 0.99-1.02). MA patients were less likely to have early live discharges (AOR 0.87 95% CI 0.84-0.91) and burdensome transitions (AOR 0.61 95% CI 0.58-0.64) but did not differ in live discharges post 210 days. Among hospice deaths, MA hospice patients were less likely to have a three-day or less LOS (AOR 0.95 95% 0.94-0.96) and a LOS exceeding 180 days (AOR 0.97 95% 0.96-0.99). The concentration of MA patients in a HRR had minimal impact.

Conclusion: MA hospice patients' discharge patterns raised less concerns than FFS.

Keywords: Medicare Advantage; fee-for-service; hospice; live discharge.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Fee-for-Service Plans*
  • Female
  • Hospices*
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Medicare Part C*
  • Patient Discharge / statistics & numerical data*
  • United States