Hospital-Based Palliative Care with Medicare Claims: Evidence From Colorado.

BACKGROUND: The prevalence of hospital-based palliative care has been largely anecdotal as an increasing service being provided and there is a need to understand what trends can be analyzed with Medicare data. OBJECTIVE: To compare 2 methods of identifying hospital-based palliative care in the Medicare population in Colorado. STUDY DESIGN: Through Medicare claims data and phone surveys, we ascertained the presence of hospital-based palliative care services, number of patients receiving palliative care, and number of care visits provided during the previous year. DATA SOURCES/STUDY SETTING: Data were collected from every Medicare-certified hospital in Colorado during 2008 and 2013. MEASUREMENTS: We measured the presence of hospital-based palliative care teams and their average number of consultations through a phone survey and cross-referenced using a v-code modifier of Medicare claims indicating a palliative care consult visit. RESULTS: The number of hospital-based palliative care consultations increased five-fold from 2008-2013, and Medicare claims under-counted the number of these consultations compared to phone surveys. CONCLUSION: The systematic measurement of palliative care nationally is a key priority. More evidence is needed from other states to better understand the usefulness of Medicare claims in this effort.

Duke Scholars

Author Nrupen Bhavsar Surgery, Surgical Sciences

Author Donald H. Taylor Jr. Sanford School of Public Policy