Hospice Care

Hospice Care in Mississippi

Mississippi

Hospice care is for terminally ill patients who expect to have six months or less to live. The most common primary diagnosis among Medicare-enrolled hospice decedents in 2020 was Alzheimer’s, Parkinson’s or other dementias, followed by circulatory or heart conditions and cancer. While standard medical care may focus on finding a cure, hospice care emphasizes pain control and emotional support for patients and their families. Hospice care is provided in a patient’s home — where most individuals prefer to die — or in a freestanding hospice facility, hospital or long-term care facility. Services provided by hospice care include:

• Pain management and symptom relief.
• Medication, medical supplies and equipment.
• Emotional and spiritual support for the patient through counseling or other therapies.
• Bereavement counseling and practical support for caregivers.

Medicare Part A covers hospice for patients with a life expectancy of six months or less; however, less than half of all eligible beneficiaries use it. 

Expenditures for the Medicare hospice benefit have rapidly increased over the past two decades, from $2.2 billion in 1998 to $22.4 billion in 2020. However, several studies have shown that hospice care results in savings for the Medicare program. Depending on the length of stay and patient characteristics, the Medicare hospice benefit can save between $2,309 and $17,903 per hospice patient.

The prevalence of hospice use among Medicare beneficiaries is higher among:

• Women compared with men. 
• Adults ages 85 and older.

White Medicare beneficiaries compared with those of other races and ethnicities. Studies show that Black adults are less likely to use hospice for reasons that include mistrust due to racism, fear that providers will deliver inadequate care and lack of knowledge about available hospice and palliative care services.

Current Medicare hospice policies require patients to forgo all medical treatment for their underlying disease to receive hospice benefits, which may deter individuals from transitioning to hospice. Allowing the continuation of curative treatments that help alleviate symptoms, such as blood transfusions, could increase the use of hospice care. The Centers for Medicare & Medicaid Services is currently testing the Medicare Care Choices Model, which allows Medicare beneficiaries to continue receiving care for their terminal condition while in hospice to see if it improves care outcomes.

For information and resources on hospice care, visit the National Hospice and Palliative Care Organization.

Abt Associates. “Evaluation of the Medicare Care Choices Model: Annual Report 3.” Rockville, MD: Centers for Medicare and Medicaid Services, October 2020. https://innovation.cms.gov/data-and-reports/2020/mccm-thirdannrpt.

Better Medicare Alliance. “Medicare Hospice Benefit and Key Considerations for Policy Changes in Medicare Advantage.” Issue Brief, February 2020. https://bettermedicarealliance.org/wp-content/uploads/2020/02/Hospice_IssueBrief.pdf.

Bogasky, Susan, Steven Sheingold, and Sally C. Stearns. “Medicare’s Hospice Benefit: Analysis of Utilization and Resource Use.” Medicare & Medicaid Research Review 4, no. 2 (2014): E1–14. http://dx.doi.org/10.5600/mmrr.004.02.b03.

DaVanzo, Joan E., Dorothy Chen, Jessica Greene, and Allen Dobson. “Hospice: Leading Interdisciplinary Care.” Vienna, VA: National Hospice and Palliative Care Organization, March 25, 2019. https://www.nhpco.org/wp-content/uploads/2019/05/Hospice_Policy_Brief.pdf.

Gomes, Barbara, Natalia Calanzani, Marjolein Gysels, Sue Hall, and Irene J. Higginson. “Heterogeneity and Changes in Preferences for Dying at Home: A Systematic Review.” BMC Palliative Care 12, no. 1 (December 2013): 7. https://doi.org/10.1186/1472-684X-12-7.

“NHPCO Facts and Figures: 2022 Edition.” Alexandria, VA: National Hospice and Palliative Care Organization, December 2022. https://www.nhpco.org/wp-content/uploads/NHPCO-Facts-Figures-2022.pdf.

Odejide, Oreofe O. “A Policy Prescription for Hospice Care.” JAMA 315, no. 3 (January 19, 2016): 257–58. https://doi.org/10.1001/jama.2015.18424.

Rhodes, Ramona L., Bryan Elwood, Simon C. Lee, Jasmin A. Tiro, Ethan A. Halm, and Celette S. Skinner. “The Desires of Their Hearts: The Multidisciplinary Perspectives of African Americans on End-of-Life Care in the African American Community.” American Journal of Hospice and Palliative Medicine 34, no. 6 (July 2017): 510–17. https://doi.org/10.1177/1049909116631776.