Abstract
The Office of the Assistant Secretary for Planning and Evaluation (ASPE) of the U.S. Department of Health and Human Services (DHHS) commissioned this Medicare Hospice Benefit study to provide information on the role of the Medicare hospice benefit and more specific information about how end of life care is provided to institutionalized beneficiaries.
This report presents information on Medicare's hospice benefit, who is using it, how it is being used, what costs are associated with its use, what costs precede hospice enrollment and how these vary by type of enrollee. This information will be important for understanding the role of Medicare's hospice benefit in the context of the other benefits Medicare provides to one of the program's most expensive populations, the terminally ill, and understanding whether the current policies meet the needs of the population enrolling in hospice. Also included are snapshot contrasts of two groups of enrollees, those who were enrolled in HMOs or on Medicaid at least once during the 12 months between July 1995 and July 1996.
This report is intended to provide background information on the overall Medicare hospice population. The office of the Department of Health and Human Services (DHHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) initiated this study to better understand the use of hospice by dually-covered hospice enrollees in nursing facilities and this report provides the contrast for the nursing facility-based enrollee discussed in the two next reports in this study. Questions have been raised about whether hospice patients who live in nursing facilities are on the benefit for a longer time, receive different services, or otherwise use it differently than those residing in the community. This report describes the benefit's use by all enrollees in 1996.