title: Hospice care in a commercial preferred provider organization population in Tennessee.
abstract: This study was undertaken to examine two aspects of care at the end of life. First, we wanted to see whether the cost savings demonstrated repeatedly in the US Medicare hospice population would also be observed in a commercial population in Tennessee. They were. The second primary interest we had was whether there were certain medical services that seemed to presage death. We found four categories of services that profoundly increase in number as the end of life is approached: primary care, hospital-based specialist, non-hospital based specialist, and oncologist services. It is hoped that these findings could lead to a simple predictive model based on readily available claims data to help identify candidates for Hospice Care earlier.
authors.affiliation: BlueCross BlueShield of Tennessee Health Institute, Chattanooga, TN, USA.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Coulter
authors.affiliation: Hospice of Chattanooga, Chattanooga, TN, USA.
authors.forename: Terry
authors.initials: T
authors.lastname: Melvin
authors.affiliation: BlueCross BlueShield of Tennessee Health Institute, Chattanooga, TN, USA payne_carden@bcbst.com.
authors.forename: J Payne
authors.initials: JP
authors.lastname: Carden
authors.affiliation: BlueCross BlueShield of Tennessee Health Institute, Chattanooga, TN, USA.
authors.forename: Rick S
authors.initials: RS
authors.lastname: Mathis
mesh_terms: D017046:Cost Savings; D017048:Health Care Costs / Q000706:statistics & numerical data; D017051:Hospice Care / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D006278:Medicare / Q000191:economics; D015233:Models, Statistical; D011243:Preferred Provider Organizations / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D013714:Tennessee; D013727:Terminal Care / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D014481:United States
keywords: Tennessee; cancer; claims; commercial insurance; hospice/palliative medicine; predictive modeling