Medicare beneficiaries on hemodialysis face poor hospice access

Medicare beneficiaries on hemodialysis often are not given access to hospice care, according to a June 4, 2018 study published in Health Affairs. During the last year of life, patients only about 20% enrolled in hospice, and they only spent five or six days in hospice care. The study found that the findings “signal the need for greater flexibility in the provision of end-of-life care in this population.”

Researchers studied a national registry of end-stage renal disease consisting of 640,000 patients who died between 2000 and 2014. The amount enrolled in hospice is about 30% lower than Medicare’s overall population.

Of course, patients who enroll in hospice must stop curative treatments, including dialysis (unless they have a more primary terminal illness, such as lung cancer). CMS Innovation is testing other care models that might be more flexible, according to researcher Ann O’Hare in a UW Medicine news release.

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