Medicare Hospice Cost Report 1999-2009

$79 / year

This dataset shows the top 20 hospice diagnoses, the number of patients, and average length of stay for calendar years 1999 to 2009.

Complexity

The dataset provides a summary of hospice data from 1998 to 2009, using calendar year data from Health Care Information System (HCIS). It shows the top 20 diagnoses for each year, based on the number of Medicare hospice patients with that diagnosis; the percentage of all Medicare patients for the year which that diagnosis represents; and the average length of stay for that diagnosis. To be eligible to elect the Medicare hospice benefit, beneficiaries must be certified by their attending physician (if any) and by the hospice physician as being terminally ill with a prognosis of 6 months or less to live, should the illness run its normal course. Expenditures for the Medicare hospice benefit have increased approximately $1 billion per year. In fiscal year 1998, expenditures for the Medicare hospice benefit were $2.2 billion, while in 2009, expenditures for the Medicare hospice benefit were $12.1 billion.

The frequency of some hospice terminal diagnoses has changed over time, with relatively fewer cancer patients and relatively more non-cancer patients as a percentage of total hospice patients. Lung cancer has been recognized as the most common diagnosis among Medicare hospice patients every year since 1998. By 2006 non-Alzheimer’s dementia became the most common diagnosis among Medicare hospice patients. The percentage of Medicare hospice patients with lung cancer dropped from 16% in 1998 to 9% in 2009. In addition, there is notable increase in the number of neurologically-based diagnoses. A marked increase in non-specific diagnoses such as “Debility, Not Otherwise Specified”, and “Adult Failure to Thrive” is also noted. Along with the shift in the mix of hospice patients, there exists a significant increase in the average length of stay (LOS) for hospice patients. In 1998, the average LOS for hospice patients was 48 days, but by 2006 it had risen to 73 days (a 52% increase). Since 2006, the average LOS has begun to decline slightly, dropping to 71 days in 2009, which is a 48% increase from 1998.

The average LOS varies by diagnosis. For the top twenty diagnoses in 2009, the average LOS ranged from 27 days for chronic kidney disease to 106 days for Alzheimer’s disease and other degenerative conditions. While the average LOS from 1998–2009 for hospice patients with diagnoses such as chronic kidney disease or cancers has remained relatively stable, the average LOS rose significantly for most other diagnoses, though it has recently begun to decline slightly. In the dataset, diagnoses that show no data for specific years were not in the top 20 diagnoses in that year. If no data in 1998, change is from the first year shown where data were available.

Date Created

2015-01-30

Last Modified

2015-01-30

Version

2015-01-30

Update Frequency

Irregular

Temporal Coverage

1998-2009

Spatial Coverage

United States

Source

John Snow Labs => Centers for Medicare and Medicaid Services

Source License URL

John Snow Labs Standard License

Source License Requirements

N/A

Source Citation

N/A

Keywords

Top 20 Hospice Diagnoses and Cost, Number Of Patients Availing Hospice Service, Average Length Of Stay

Other Titles

Medicare Hospice Cost Report by Diagnosis and Lenth of Stay 1999-2009, Medicare Hospice Payment Data 1999-2009

Name Description Type Constraints
DiagnosisTop 20 Diagnoses in 2009string-
Year_1998Average Length of Stay by Year, by Diagnosisnumberlevel : Ratio
Year_1999Average Length of Stay by Year, by Diagnosisnumberlevel : Ratio
Year_2000Average Length of Stay by Year, by Diagnosisnumberlevel : Ratio
Year_2001Average Length of Stay by Year, by Diagnosisnumberlevel : Ratio
Year_2002Average Length of Stay by Year, by Diagnosisnumberlevel : Ratio
Year_2003Average Length of Stay by Year, by Diagnosisnumberlevel : Ratio
Year_2004Average Length of Stay by Year, by Diagnosisnumberlevel : Ratio
Year_2005Average Length of Stay by Year, by Diagnosisnumberlevel : Ratio
Year_2006Average Length of Stay by Year, by Diagnosisnumberlevel : Ratio
Year_2007Average Length of Stay by Year, by Diagnosisnumberlevel : Ratio
Year_2008Average Length of Stay by Year, by Diagnosisnumberlevel : Ratio
Year_2009Average Length of Stay by Year, by Diagnosisnumberlevel : Ratio
Change_From_1998_In_DaysChange from average length of stay by Year, by Diagnosis to 2009. If no data in 1998, change is from first year shown where data were availablenumberlevel : Ratio
Percentage_ChangeChange in percent from average length of stay by Year, by Diagnosis to 2009. If no data in 1998, change is from first year shown where data were available.string-
DiagnosisYear_1998Year_1999Year_2000Year_2001Year_2002Year_2003Year_2004Year_2005Year_2006Year_2007Year_2008Year_2009Change_From_1998_In_DaysPercentage_Change
CHF5252545864727373837875732140.40%
Bladder CA373736413941414142513.50%
Lung CA43434243454846454646454524.70%
Liver CA35353536423838373839373725.70%
Breast CA56555556596060586162585935.40%
Pneumonias3736373739424341403633-4-10.80%
CVA/Stroke3636374143555353615653511541.70%
Prostate CA535352525455576058626059611.30%
Failure to thrive5063707678818382843468.00%
Debility NOS5150515659657073778283833262.70%
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