NHPCO Facts and Figures Report Shows Growing Number of Hospice Patients
For Immediate Release
December 15, 2022
(Alexandria, Va) – The National Hospice and Palliative Care Organization (NHPCO) published the 2022 edition of NHPCO 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 premier resource for hospice providers and others interested in understanding the work of the community.
Based on the most recent available data, which is from 2020, this is the first year in which NHPCO Facts and Figures includes information on COVID-19. Among Medicare hospice patients in 2020, 0.9% had a principal diagnosis of COVID-19. While COVID-19 may have contributed to the deaths of beneficiaries with other principal diagnoses, that would not show up in these data.
Select findings from this year’s report include the following:
- Growth in number of hospice patients: 1.72 million eligible Medicare beneficiaries chose hospice care in 2020. This is a 6.8% increase from 2019, representing the largest recent year-over-year increase in the number of Americans choosing hospice care, both in absolute numbers and as a percentage.
- Decrease in percentage of eligible patients served: In 2020, more Americans died than in any previous year on record, and the percentage change in the number of deaths was significantly higher than any time in the last decade. The number of deaths grew significantly faster than hospice enrollment, in large part because of COVID-19. After several years of growth, the percentage of Medicare decedents enrolled in hospice at the time of death (47.8% in 2020) dropped to the lowest number since 2013 (47.3%).
- Changes in race and ethnicity of hospice patients: White Medicare beneficiaries eligible for hospice care choose to enroll at higher rates than other Americans. Over the last two decades, there has been progress in the diversity of hospice patients, with more hospice-eligible Asian Americans, Black Americans, Hispanic Americans, and Native Americans choosing hospice care. However, the report shows that this year, fewer Asian, Black, Hispanic, and Native American chose hospice compared to the previous year.
- Continued trends in principal diagnoses: In the last 20 years, there has been a significant shift in the primary diagnoses of patients in hospice care. In 2002, cancer was the largest driver of hospice care. Since then, Alzheimer’s disease and other forms of dementia along with Parkinson’s disease have become the largest grouping of principal diagnoses. While the Alzheimer’s/dementias/Parkinson’s grouping declined slightly in 2020 compared to 2019, the overarching mix of diagnoses aligns to the trends of the last six years, which look different from the mix of the 2000s and early 2010s.
NHPCO COO and interim CEO, Ben Marcantonio, said, “I know providers who rely on NHPCO Facts and Figures to benchmark their own programs and it is one of the most-cited reports about hospice care. As the hospice community marks the 40th anniversary of the hospice benefit, it’s a natural time to look ahead to what hospice can and should be over the next 40 years. Facts and Figures is an essential resource for informing those conversations as we continue to strive to provide the best care to help patients live their final days to the fullest.”
The 2022 NHPCO Facts and Figures report is available on the NHPCO website.