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Study: Per Capita End of Life Care Spending is Falling Rapidly

Posted on Friday, May 25, 2018 11:25 AM

It has been widely thought that end-of-life spending is one of the major reasons why there is a rapid increase in overall health care spending in the United States, but a new study is challenging that belief. 

“The findings from Dartmouth College and Dartmouth-Hitchcock researchers and published in the May 2018 edition of the Journal of the American Medical Association overturn years of assumption about end-of-life care and what is driving health care cost increases in the U.S. The study covered the years 2004 to 2014 and analyzed the Medicare Part A and B population, a group of 25-27 million people in those years.”

The researchers used data on Medicare beneficiaries ages 65 to 69 and calculated per capita spending based on six categories: home health, hospice, physician, outpatient, durable medical equipment and inpatient.  They then calculated the year-to-year changes in Medicare expenditures to changes in intensity of practice and the number of deaths or survivors. 

“Contrary to other studies, we found that per-capita end-of-life spending is decreasing and appreciably contributing to overall per-capita Medicare spending growth moderation,” wrote William Weeks, the lead author of the research team.

Per capita Medicare spending increased from about $9,100 in 2004 to $10,500 in 2009, but then decreased sharply to $9,600 in 2014.

While a mere 4.3 percent of Medicare beneficiaries died between 2010 and 2014, they accounted for 54.6 percent of all reductions in Medicare spending related to changes in practices, according to the researchers.

The findings “warrant further investigation into why end-of-life care intensity is changing, and, particularly, how those changes influence end-of-life care quality,” wrote the researchers in their paper.

Source: NAHC Report


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