Study: Medicare pay may cause hospices to discourage enrollment of high-cost patients

Many hospices may be discouraging enrollment for the highest cost treatments, and Medicare's way of paying them may be part of the problem, a new study finds.

Politico Pro: Hospices May Deter High-Cost Patients
For years, hospices have grappled with why many dying people don't seek out hospice care -- or why they get it for only the last days or weeks of their lives when they might have been helped by an earlier referral. But it turns out that hospices' own enrollment policies may be at least partly responsible, creating barriers to dying people with high-cost conditions. A study in Health Affairs on Monday, by Mt. Sinai School of Medicine's Melissa Carlson and colleagues at Yale and Johns Hopkins University, found that nearly eight in 10 hospices had at least one restrictive enrollment policy. Many had two or three such policies. These exclude people with particularly high cost treatment -- treatments like palliative radiation or transfusions that "may be prohibitively expensive for hospices to provide" (Kenen, 12/3).

Kaiser Health News: Capsules: Study: Hospice Rules May Keep Patients Away
Hospice is one of the fastest growing segments of Medicare, and many health policy experts laud it as a humane and cheaper way to care for people in the last half-year of life. But in surveying hospices, the new study warns Medicare's method of paying a fixed daily fee to hospices may be discouraging many from taking on patients with expensive needs (Rau, 12/3).