office of inspector general

Thursday, December 20, 2007

Office of Inspector General Hospice/Nursing Home Report

The OIG released the first of two reports today looking at the differences between hospice care provided in nursing homes and hospice care provided somewhere else. (Thanks to NHPCO for pointing this report out to its members.)

The basic conclusion reads:

In our comparison of Medicare hospice beneficiaries who reside in nursing facilities to hospice beneficiaries who reside in other settings, we found that beneficiaries in nursing facilities tended to be older and more likely to have ill-defined conditions. Also, their time in care was longer and more costly. A second study will assess the appropriateness of payments for hospice care for beneficiaries in nursing facilities.

I hope “appropriateness of payments for hospice care” means they will assess the differences between the care provided to a home patient and a nursing home patient. If that is the case, I think the second report could change the hospice world. I have long said that, in general, nursing home patients are easier (cheaper) to care for than home patients. I have also advocated for a payment system that reflects this. In a game of follow the money, all you have to do is look to see how many of the large nursing home chains have started their own hospices to care for their patients. This is because nursing home patients take less effort and are therefore more profitable. We’ll have to wait and see if this is really what the study is all about, but I sure hope it is.

NHPCO has also promised some reaction to part one of the study tomorrow. I’ll post anything interesting when I can. My schedule will be a bit hectic with the holidays.

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