Krista Harrison Peers Into the Intersection of Hospice, Dementia & Care Quality
06/14/22 • 26 min
The concepts that underlie hospice were introduced a few centuries ago but, the modern hospice movement began in London in 1967.
In 1982 hospice was added as a Medicare benefit. Today, half of all Medicare decedents enroll in hospice, at a total cost of $20.9 billion to Medicare in 2019.
Hospice has a strong evidence base for improving end-of-life experiences for the recipient and the recipient's family. But there's limited evidence regarding the effects of hospice for people with dementia.
This is a critical knowledge gap given that one in three adults aged 85 and older has dementia.
Krista Harrison from University of California San Francisco joins A Health Podyssey to discuss how well hospice works for people with dementia.
Harrison and coauthors published a paper in the June 2022 issue of Health Affairs assessing the relationship between hospice enrollment and last month of life care quality for Medicare enrollees living with dementia.
They found that hospice-enrolled people living with dementia had higher quality last month of life care than people who are not enrolled in hospice, with quality levels similar to people without dementia.
Order the June 2022 issue of Health Affairs for research on costs, care delivery, COVID-19, and more.
Subscribe: RSS | Apple Podcasts | Spotify | Stitcher | Google Podcasts
The concepts that underlie hospice were introduced a few centuries ago but, the modern hospice movement began in London in 1967.
In 1982 hospice was added as a Medicare benefit. Today, half of all Medicare decedents enroll in hospice, at a total cost of $20.9 billion to Medicare in 2019.
Hospice has a strong evidence base for improving end-of-life experiences for the recipient and the recipient's family. But there's limited evidence regarding the effects of hospice for people with dementia.
This is a critical knowledge gap given that one in three adults aged 85 and older has dementia.
Krista Harrison from University of California San Francisco joins A Health Podyssey to discuss how well hospice works for people with dementia.
Harrison and coauthors published a paper in the June 2022 issue of Health Affairs assessing the relationship between hospice enrollment and last month of life care quality for Medicare enrollees living with dementia.
They found that hospice-enrolled people living with dementia had higher quality last month of life care than people who are not enrolled in hospice, with quality levels similar to people without dementia.
Order the June 2022 issue of Health Affairs for research on costs, care delivery, COVID-19, and more.
Subscribe: RSS | Apple Podcasts | Spotify | Stitcher | Google Podcasts
Previous Episode
Ateev Mehrotra Shines a Light on Indirect Billing
Recently, there's been dramatic growth in the number of nurse practitioners (NPs) and physician assistants (PAs). The number of NPs has more than tripled in the last decade while the number of PAs has almost doubled.
Yet, due to particular billing practices in Medicare, it can be difficult to know how care these clinicians are providing. That means there's a lot we don't know about access and quality related to this critical part of the health care workforce.
Ateev Mehrotra from Harvard Medical School and Beth Israel Deaconess Medical Center joins A Health Podyssey to discuss how we bill for nurse practitioner and physician assistant services and the implications of those practices.
Mehrotra and colleagues published a paper in the June 2022 issue of Health Affairs examining the prevalence of "indirect billing," where care provided by a PA or NP is billed under the supervising physician.
They found about 11 million instances of Medicare indirect billing in 2010 and 30 million in 2018 and estimate that eliminating indirect billing would have saved Medicare more than $190 million.
Order the June 2022 issue of Health Affairs for research on costs, care delivery, COVID-19, and more.
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Next Episode
Excursion: Andy Slavitt
Listen to Health Affairs Editor-in-Chief Alan Weil interview Andy Slavitt, co-founder of both United States of Care and Town Hall Ventures and former administrator of the Centers for Medicare and Medicaid Services.
Andy is the host of the podcast In The Bubble with Andy Slavitt and recently published the book, "Preventable: The Inside Story of How Leadership Failures, Politics, and Selfishness Doomed the U.S. Coronavirus Response."
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