October 7, 2016

New Medicare data: How much each state spent on hospice care

Daily Briefing

Medicare spent more than $15 billion on hospice care in 2014, according to new CMS data released Thursday.

The data were included in the Hospice Utilization and Payment Public Use File (Hospice PUF), which contains de-identified information on 4,025 hospice providers and 1.3 million beneficiaries. The dataset includes information on:

  • Diagnoses;
  • Hospice beneficiary demographics organized by provider and state;
  • Payments;
  • Submitted charges; and
  • Utilization.

CMS Chief Data Officer Niall Brennan said, "CMS believes that greater data transparency leads to a more effectively functioning health care system, which leads to better care and smarter spending."

Data details

In 2014, Medicare spent $15.1 billion on hospice care, an average of $11,393 per hospice beneficiary.

According to the data, southern states had the highest per-beneficiary spending. For example, the top three states by per-beneficiary spending were:

  • South Carolina, which spent $14,778 per beneficiary;
  • Alabama, which spent $14,361 per beneficiary; and
  • Mississippi, which spent $14,100 per beneficiary.

Wyoming spent the least—at $7,132 per beneficiary—followed by South Dakota ($7,252) and Alaska ($7,442).

In total, beneficiaries accumulated 92.3 million days of hospice care, or about 70 days per beneficiary. According to the data:

  • 33 percent of beneficiaries—or 433,000—spent more than 60 days in hospice care;
  • 27 percent of beneficiaries—or 354,000—spent 7 days or fewer in hospice care; and
  • 13 percent of beneficiaries—or 169,000—spent more than 180 days in hospice care.

About 11 percent—or 142,000 beneficiaries—were discharged before death. States in the South and Southwest had the highest rates of live discharges.

Many docs provide scant information about hospice patients' eligibility, OIG says

CMS released transparency tool

CMS also released the third iteration of its Market Saturation and Utilization Data Tool to help "increas[e] access to Medicare data and improving the flow of information," according to Brennan.

The tool includes data on national-, state-, and county-level provider services and utilization information for:

  • Ambulance services;
  • Home health services;
  • Hospice;
  • Independent diagnostic testing facilities for Part A and Part B; and
  • Skilled nursing facilities (SNF).

A new strategy to promote hospice access in SNFs

According to Health Data Management, the data can help demonstrate potential correlations between use of a particular service and the number of providers in a given area. CMS also can use the tool to track market saturation as a way to prevent fraud, waste, and abuse.

GAO: CMS should improve access to skilled nursing facility expenditure data

In related news, the Government Accountability Office (GAO) in a report released Thursday said CMS should improve access to and the reliability of expenditure data for SNFs.

In 2014, Medicare spent $28.6 billion on SNF services for 1.7 million beneficiaries.

However, the report said "CMS has not provided the data in a readily accessible format and has not posted the data in a place that is easy to find on its website," adding, "CMS does little to ensure the accuracy and completeness of the data" (Whitman, Modern Healthcare, 10/6; Bazzoli, Health Data Management, 10/6; CMS fact sheet, 10/6).

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More from today's Daily Briefing
  1. Current ArticleNew Medicare data: How much each state spent on hospice care

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