title: Hospital-Based Palliative Care with Medicare Claims: Evidence From Colorado.
abstract: 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.
  
  
  METHODS
  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.
  
  
  METHODS
  Data were collected from every Medicare-certified hospital in Colorado during 2008 and 2013.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 1 Hospice Analytics, Colorado Springs, CO, USA.
authors.forename: Cordt T
authors.initials: CT
authors.lastname: Kassner
authors.affiliation: 2 Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Nrupen A
authors.initials: NA
authors.lastname: Bhavsar
authors.affiliation: 3 Duke Clinical Research Institute, Durham, NC, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Harker
authors.affiliation: 4 Four Seasons Compassion for Life, Flat Rock, NC, USA.
authors.forename: Janet
authors.initials: J
authors.lastname: Bull
authors.affiliation: 5 The Sanford School of Public Policy, Duke University, Durham, NC, USA.|6 Margolis Center for Health Policy, Durham, NC, USA.
authors.forename: Donald H
authors.initials: DH
authors.lastname: Taylor
mesh_terms: D003120:Colorado; D003625:Data Collection / Q000379:methods*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007345:Insurance Claim Review; D006278:Medicare / Q000706:statistics & numerical data*; D010166:Palliative Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013689:Telephone; D014481:United States
keywords: Medicare claims; hospital palliative care