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Will Changes to Medicare Payment Rates Alter Hospice's Cost-Saving Ability?
Donald H Taylor, Nrupen A Bhavsar, Janet H Bull, Cordt T Kassner, Andrew Olson, Nathan A Boucher. Journal of palliative medicine, 2018-02-07
Topic: Health services, long-term care and technology
Medicare costs were reduced from hospice election until death using both 2009-2010 and new 2016 payment structures and rates. Mean cost savings were $1,527 with actual payment rates, and would have been $2,105 with the new payment rates (p < 0.001). Cost savings were confirmed by reducing the number of days used for cost comparison by three days for those with hospice stays of at least four days ($4,318 using 2009-2010 rates, $3,138 for 2016 rates: p < 0.001). Cost savings were greater for males ($3,393) versus females ($1,051) and greatest in cancer ($6,706) followed by debility and failure to thrive ($5,636) and congestive heart failure ($1,309); dementia patients had higher costs (+$1,880) (p < 0.001). When adding 3 days to the comparison period, hospice increased costs to Medicare. Medicare savings could continue with the 2016 payment rate change. Cost savings were found for all primary diagnoses analyzed except dementia.
Key findings
- Medicare costs were reduced from hospice election until death using both 2009-2010 and new 2016 payment structures and rates.
- Mean cost savings were $1,527 with actual payment rates, and would have been $2,105 with the new payment rates (p < 0.001).
- Cost savings were confirmed by reducing the number of days used for cost comparison by three days for those with hospice stays of at least four days ($4,318 using 2009-2010 rates, $3,138 for 2016 rates: p < 0.001).
- Cost savings were greater for males ($3,393) versus females ($1,051) and greatest in cancer ($6,706) followed by debility and failure to thrive ($5,636) and congestive heart failure ($1,309); dementia patients had higher costs (+$1,880) (p < 0.001).
- When adding 3 days to the comparison period, hospice increased costs to Medicare.
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Study details
- Evidence strengthLow
How this study scored 39/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record, multi-centre collaboration and free to read, so those were left out: it earned 22 of the 56 points we could judge it on, which is 39 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of palliative medicine) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2018 — within 10 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 29412764) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 22 / 56 | Scored on 10 of 20 parts. We have no data for the rest, so they are left out: 22 of the 56 points we could judge it on is 39 out of 100. |
| Total | 39 / 100 | — |
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
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APA 7th
Taylor, D. H., Bhavsar, N. A., Bull, J. H., Kassner, C. T., Olson, A., & Boucher, N. A. (2018). Will Changes to Medicare Payment Rates Alter Hospice's Cost-Saving Ability? Journal of palliative medicine. https://doi.org/10.1089/jpm.2017.0485
Vancouver
Taylor DH, Bhavsar NA, Bull JH, Kassner CT, Olson A, Boucher NA. Will Changes to Medicare Payment Rates Alter Hospice's Cost-Saving Ability? Journal of palliative medicine. 2018. doi:10.1089/jpm.2017.0485. PMID: 29412764.
BibTeX
@article{taylor2018-29412764,
author = {Taylor, Donald H and Bhavsar, Nrupen A and Bull, Janet H and Kassner, Cordt T and Olson, Andrew and Boucher, Nathan A},
title = {{Will Changes to Medicare Payment Rates Alter Hospice's Cost-Saving Ability?}},
journal = {Journal of palliative medicine},
year = {2018},
doi = {10.1089/jpm.2017.0485},
pmid = {29412764},
url = {https://doi.org/10.1089/jpm.2017.0485}
}
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