2024 NHPCO Facts and Figures Report Now Available

NHPCO

2022 Data Show First Increase in Hospice Utilization Rates Since COVID

(Alexandria, VA and Washington, DC) – The National Alliance for Care at Home (the Alliance) published the 2024 edition of National Hospice and Palliative Care Organization (NHPCO) Facts and Figures, an annual report on key data points related to the delivery of hospice care, including information on patient characteristics, location and level of care, Medicare hospice spending, and hospice providers. Facts and Figures – the leading resource for hospice providers and others interested in understanding the work of the community – has been published annually for over two decades by NHPCO. NHPCO is currently integrating into the Alliance, a newly-formed national organization that is combining the two leading organizations supporting the care-at-home community – NHPCO and the National Association for Home Care & Hospice (NAHC).

The findings in this report reflect patients who received care in Calendar Year (CY) 2022, or Fiscal Year (FY) 2022, provided by hospices certified by the Centers for Medicare and Medicaid Services (CMS) and reimbursed under the Medicare Hospice Benefit. This year COVID-19 continued to impact patient care as COVID-19 waivers were still in place through May 2023. These waivers included increased telehealth services. With 49.1% of all Medicare decedents in 2022 choosing hospice care, utilization of hospice increased in 2022 for the first time since 2019. The increase hints at a normalization of the utilization rates back to pre-COVID data. Hospice utilization rates increased across all race and ethnicity groups, with the largest increase among Hispanic Medicare beneficiaries seeing. The total number of beneficiaries enrolled in hospice care in 2022 was 1.72 million. Due to the unique impact of COVID-19 on 2020 data, those data are not included in many of the charts this year.

“The hospice Facts and Figures has been an important and impactful NHPCO publication. It is a great example of the type of data and high-quality information the newly formed National Alliance for Care at Home plans to provide the hospice and broader care-at-home community for years to come,” said Dr. Steve Landers, Chief Executive Officer for the Alliance.

Select findings from this year’s report include the following:   

  • 1.72 million Medicare beneficiaries were enrolled in hospice care for one day or more in calendar year (CY) 2022. This is a slight increase from 2021 but approximately equal to 2020.

  • Of all Medicare decedents in CY 2022, 49.1% received one day or more of hospice care and were enrolled in hospice at the time of death. This is the first increase in utilization since 2019. 

  • In CY 2022, Medicare Advantage (MA) continued growing into a larger portion of the Medicare population. A vast majority of MA beneficiaries shift to Traditional Medicare to utilize the Medicare Hospice Benefit. A small sect of beneficiaries who stay with MA for hospice care have value-based insurance design (VBID) plans.

  • In CY 2022, 51.6% of White Medicare decedents used the Medicare Hospice Benefit. 38.1% of Asian American Medicare decedents and 37.4% of Black Medicare decedents enrolled in hospice. 38.3% of Hispanic and 37.1% of North American Native Medicare decedents used hospice in 2022. In CY 2022, there was an increase in hospice utilizations by all race/ethnicity groups, with the largest increase among Hispanic beneficiaries. No group has returned to pre-COVID-19 utilization percentages.

  • The principal hospice diagnosis is the diagnosis, based on ICD-10 codes, determined to be the most contributory to the patient’s terminal prognosis. Alzheimer’s/nervous system disorders/organic psychosis, at 25%, is the top category of diagnosis for hospice beneficiaries and appears multiple times in the top diagnoses by, ICD-10 code. Cancer and circulatory diseases round out the top three diagnoses groups which account for nearly three-fourths of all hospice beneficiary diagnoses. 

  • Medicare paid hospice providers a total of $23.7 billion dollars for care provided in CY 2022, representing an increase of 2.7% over the previous year. This is slower growth compared to 2019-2021 but similar growth from 2020-2021.

  • In the most recently available data, 50.0% of participating providers received four or five stars on the CAHPS® (Consumer Assessment of Healthcare Providers and Systems) survey, which represents a 1% increase over the prior reporting period. However, Star Ratings were available for fewer than half of providers (2,046).

The 2024 Facts and Figures report is available to all on the NHPCO and Alliance websites.