One might expect that hospice utilization would be unwavering or growing, given the country’s aging baby boomer population, as well as the growing awareness and universal availability of hospice services.

In reality, hospice utilization across the country has fallen for the first time in 10 years, according to Healthcare Market Resources.

The decline is only by 1%, but hospice has been at a pretty steady utilization rate of 2.6% to 2.7% for the past five years, the organization, which provides health care market intelligence reports, found. Healthcare Market Resources measured hospice utilization by dividing the number of hospice patients served by the total Medicare eligible population for each state. 

Only three states experienced hospice utilization growth in 2014, and that growth was only 0.1%. Meanwhile, eight states experienced utilization declines higher than 0.1% with the greatest decline at 0.3%. Fifteen states experienced no change in hospice utilization. The remaining 24 states experienced utilization declines of 0.1%.

Additional regulatory pressure and a new payment system that disincentivizes long-term patients could lead to lower hospice utilization rates, as length of stay shortens for these longer-stay patients. Meanwhile, the Senate Finance Committee’s proposal to transfer the hospice benefit into Medicare Advantage may very well mean fewer patients accessing the benefits, or stable patients being discharged more quickly, Healthcare Market Resources said.

“Overall, it’s a very flat market with no data to suggest any light at the end of the tunnel,” Healthcare Market Resources said. If the prospects for organic market growth are lousy, hospices can turn to geographic expansion, stealing market share from competitors or adding complimentary services to boost their revenues, the organization suggested.

Written by Mary Kate Nelson