2023 NHPCO Facts and Figures Report Now Available

For Immediate Release
December 13, 2023

Includes a special section on value-based insurance design hospice benefit

(Alexandria, Va) – The National Hospice and Palliative Care Organization (NHPCO) has published its 2023 edition of 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. NHPCO Facts and Figures is the leading resource for hospice providers and others interested in understanding the work of the community.

The findings in this report reflect patients who received care in Calendar Year (CY) 2021, or Fiscal Year (FY) 2021, provided by hospices certified by the Centers for Medicare and Medicaid Services (CMS) and reimbursed under the Medicare Hospice Benefit. The 2023 Facts and Figures report continues to see the impact of COVID-19 on patient care and the effect of the COVID-19 waivers to the traditional delivery of hospice care. However, this year started to see the return to pre COVID-19 levels in some areas.

“NHPCO Facts and Figures is an essential resource for the hospice community. Many of our members use it to benchmark their own programs as one of the most-cited annual reports on hospice care,” said Ben Marcantonio, Interim CEO of NHPCO. “These numbers represent over one million Americans who rely on person-centered, interdisciplinary care each year during a time of great need.”

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

- - Utilization of hospice care: 1.71 million Medicare beneficiaries were enrolled in hospice care for one day or more in 2021.
  - Decrease in percentage of eligible patients served: Of all Medicare decedents in CY 2021, 47.3% received one day or more of hospice care and were enrolled in hospice at the time of death. This continues the downward trend from 2020, likely due to deaths continuing to outpace the growth in hospice due to COVID-19.
  - Medicare Advantage enrollment: Medicare Advantage (MA) continued growing into a larger portion of the Medicare population. To access hospice, MA beneficiaries must be in a value-based insurance design (VBID) plan or shift to Traditional Medicare to utilize the Medicare Hospice Benefit. Most beneficiaries switch to Traditional Medicare.
  - Race and ethnicity of beneficiaries: In 2021, 50.0% of White, 36.3% of Asian American, 35.6% of Black, 34.3% of Hispanic, and 33.8% of North American Native Medicare decedents used hospice. 2021 saw an increase in hospice utilizations by all race and ethnicity groups except White beneficiaries, which saw a -0.8% decrease. Despite this rebound from the 2020 decrease, no group has returned to pre-COVID-19 utilization percentages.
  - Continued trends in principal diagnoses: While cancer is in the top 20 diagnoses twice, it is tied with Alzheimer’s/nervous system disorders/organic psychosis as the top category of diagnosis (24%). Although COVID-19 accounts for only 2% of primary diagnoses, it may still have been a secondary or contributory diagnosis.
  - Trends in quality of care: CY 2021 saw an increase in visits in the last days of life by both nurses and social workers after a decline in 2020.
  - Value-Based Insurance Design (VBID): From CY 2021 to 2022, there was an increase in both participating providers and beneficiaries as well as an increase in the percentage of use of in-network providers.

The 2023 NHPCO Facts and Figures report is available to all on the NHPCO website.

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About NHPCO:

The National Hospice and Palliative Care Organization (NHPCO) is the nation’s largest and oldest membership association for providers who care for people affected by serious and life-limiting illness. Our members deliver and expand access to high-quality, person-centered interdisciplinary care to millions of Americans. NHPCO provides education and resources to support that mission. Together with our advocacy partner, the Hospice Action Network (HAN), we serve as the leading voice advancing public policy to improve serious-illness and end-of-life care, while our CaringInfo program provides free resources to educate and empower patients and caregivers. nhpco.org

NHPCO Contact:
Madison Summers
571-412-3973