Hospice Care in Louisiana and Mississippi

Hospice care is becoming the standard end-of-life medical intervention in the United States and over the last few years it has been expanding at a very rapid rate. Utilization of hospice care varies widely by cause of death and by geographic location of the facilities. Hospice utilization rates are higher in the South and Southwest compared to the rates in the Midwest and Northeast. In 2005, Mississippi had an average length of stay of 122 days while the national average was only 67 days. Louisiana has implemented a moratorium on the issuance of licenses for the period July 1, 2007 to December 31, 2008, apparently to address the problem of uncontrolled growth in the number of providers and Medicaid expenditures in Hospice care. This study examines the utilization of hospice by analyzing the organizational data voluntarily submitted by members of Louisiana and Mississippi hospice state organization for the years 2004 to 2006. More than half of the agencies providing hospice care were freestanding. Among those agencies reporting, three-quarters of the hospices are for profit. More than 85% of the agencies were Medicare-certified, and more than 80% of patients served by agencies are Medicare beneficiaries. Approximately 50% of hospice patients are 75 years old or older. The average length of stay was about 60 days; the median was about 30 days. The percentage of patients who died within 7 days of entering hospice was about 28%, while approximately 18% patients died in more than 180 days after entering hospice.