OIG study on hospice and assisted living

Categories: Policy.

The report, “Medicare Hospices Have Financial Incentives To Provide Care In Assisted Living Facilities,” released by the Department of Health and Human Services, Office of the Inspector General (OIG) examines the provision of hospice care to Medicare beneficiaries in assisted living facilities.

The OIG conducted this study as a part of the FY2014 OIG Workplan because Medicare payments for hospice care in ALFs have more than doubled in five years, totaling $2.1 billion in 2012.  All Medicare hospice claims from 2007 through 2012 were analyzed. 

Data on hospice patients in ALFs that was examined in the study included: Average length of service for patients on hospice; factors involving patients with long lengths of service; Medicare spending for hospice care in ALFs; diagnoses of patients; visit patterns; and volume of care for Medicare beneficiaries receiving hospice services in a ALF.

As part of the Centers for Medicare and Medicaid Services ongoing hospice reform efforts, the five recommendations were made:

  1. Reform payments to reduce the incentive for hospices to target beneficiaries with certain diagnoses and those likely to have long stays.
  2. Target certain hospices for review. 
  3. Develop and adopt claims-based measures of quality.
  4. Make hospice data publicly available for beneficiaries.
  5. Provide additional information to hospices to educate them about how they compare to their peers.

As an additional resource, the OIG published a podcast on this report that’s available on the OIG website. 

Members of the National Hospice and Palliative Care Organization will find a Regulatory Alert that looks at the data in detail and offers an assessment of the OIG study.

Leave a Reply

Your email address will not be published. Required fields are marked *