Mount Sinai Researchers Study Pathways to Hospice Care Among Medicare Enrollees

 

In an original investigation published today in JAMA Health Forum, Mount Sinai researchers describe how older adults with Medicare Advantage (MA) plans are more likely to enter hospice care from the community settings, versus inpatient stays in hospitals and nursing homes, than their counterparts enrolled in traditional Medicare (TM). In their national cross- sectional study of more than three million decedents, they found that those in MA plans were an adjusted 8 percentage points more likely than those enrolled in TM to be in the community setting prior to hospice. “The pathway to hospice is important to understand as our population ages and in light of a marked increase in hospice use since 2000. Twenty years ago, less than a quarter of dying patients received hospice, whereas today approximately one half of Medicare enrollees use hospice,” says first author Claire K. Ankuda, MD, MPH, Associate Professor of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai.

“We wanted to understand the pathway to hospice, as this may likely influence the timeliness of hospice treatment, which is critical for several reasons. Timely enrollment in hospice is important for patients and their families.  Late hospice referral is associated with unmet needs, lower patient satisfaction, and more hospitalizations and intensive care.”

An estimated half of all Medicare beneficiaries are enrolled in MA, says Dr. Ankuda, and for this reason, we need to keep a close eye  on how Advantage plans influence the quality of end-of-life care.