Hospice of the West Cites Economic and Social Consequences of Over-Medicalization at End-of-Life

PHOENIX–(BUSINESS WIRE)–Hospice of the West (HOW), a leading community-based hospice and palliative care organization in Maricopa County, Arizona, points to the high cost of end-of-life care (EOL) on the healthcare system, highlights its devastating impact on patients and families, and offers solutions for easing the economic fall-out while improving quality and patient/caregiver satisfaction. As payers, policy makers and individuals cope with the impact of costly treatments for those with advanced chronic conditions or life limiting illnesses, HOW offers solutions to Medicare Advantage Plans and Accountable Care Organizations (ACOs) to alleviate this problematic situation.

“A staggering 30 percent of annual healthcare spending goes to unnecessary services,” says Dr. Ashish Sachdeva, associate physician, Hospice of the West. “Aggressive care during the last year of life, while well intentioned, may not lead to an improved quality of life.”

Dr. Sachdeva states that the overall economic burden is overwhelming, “Approximately 35 percent of Medicare fee-for-service spend occurs in the last year of life, and the second to last year of life represents 13 percent of the total fee-for-service Medicare spend.”

He adds that the burdens on patients and caregivers are equally daunting, “Medical costs are the leading cause of personal bankruptcy, a trend that will intensify as baby boomers transition into their Medicare years.”

Furthermore, patient/caregiver satisfaction is eroding as EOL care is rarely congruent with patients’ wishes.

“The medical system is inadvertently geared to provide aggressive interventions to patients with life-limiting illnesses, despite high cost or outcome,” explains Dr. Sachdeva. “This inclination, combined with patient/caregiver lack of understanding of prognosis, and reluctance to discuss if a test, procedure or treatment will improve quality of life or longevity, results in individuals with advanced illness receiving inappropriate or unwanted care.”

Dr. Antonio Uvas, associate physician, Hospice of the West, concludes that their model, which identifies and addresses issues earlier and improves care across the continuum, holds the key to resolving these issues.

“The process begins with earlier identification of advanced illness, which triggers the provision of home-based supportive palliative illness management (PIMTM) and the appropriate use of healthcare services during the last 12-14 months,” says Dr. Uvas. “This also results in a better patient/caregiver orientation and an earlier, more appropriate use of the Medicare Hospice Benefit.”


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