Hospital-Based Palliative Care with Medicare Claims: Evidence From Colorado

Background: The prevalence of hospital-based palliative care has been largely anecdotal as an increasing service being provided and there is a need to understand what trends can be analyzed with Medicare data. Objective: To compare 2 methods of identifying hospital-based palliative care in the Medicare population in Colorado. Study Design: Through Medicare claims data and phone surveys, we ascertained the presence of hospital-based palliative care services, number of patients receiving palliative care, and number of care visits provided during the previous year. Data Sources/Study Setting: Data were collected from every Medicare-certified hospital in Colorado during 2008 and 2013. Measurements: We measured the presence of hospital-based palliative care teams and their average number of consultations through a phone survey and cross-referenced using a v-code modifier of Medicare claims indicating a palliative care consult visit. Results: The number of hospital-based palliative care consultations increased five-fold from 2008-2013, and Medicare claims under-counted the number of these consultations compared to phone surveys. Conclusion: The systematic measurement of palliative care nationally is a key priority. More evidence is needed from other states to better understand the usefulness of Medicare claims in this effort.