continued from previous page FIGURE 2. GEOGRAPHIC VARIATION IN THE PROPORTION OF MEDICARE DECEDENTS WHO DIED WHILE RECEIVING HOSPICE CARE IN 2015 What proportion of Medicare decedents were served by hospice in 2015? Of all Medicare decedents in 2015, 46% received one day or more of hospice care and were enrolled in hospice at the time of death. As illustrated in Figure 2, the proportion of Medicare decedents enrolled in hospice at the time of death varied across states from a low of 24% to a high of 57%. Principal Diagnosis TABLE 3. PERCENTAGE OF PATIENTS BY PRINCIPAL DIAGNOSIS Principal Diagnosis Percentage The principal hospice diagnosis is the diagnosis that has been determined to be the most contributory to the patient's terminal prognosis. In 2015 more Medicare hospice patients had a principal diagnosis of cancer than any other disease. Cancer 27.7 % Cardiac and Circulatory 19.3 % HOW MUCH CARE IS RECEIVED? Dementia 16.5 % Days of Care* Respiratory 10.9 % In 2015 hospice patients received a total of 96,052,577 days of care paid for by Medicare. Stroke 8.8 % Other 16.7 % TABLE 4. DAYS OF CARE BY PRINCIPAL DIAGNOSIS Principal Diagnosis Mean # Days of Care Median # Days of Care Cancer 47 days 19 days Cardiac and Circulatory 76 days 28 days Dementia 105 days 56 days Respiratory 69 days 19 days Stroke 77 days 20 days Other 61 days 16 days *These values are computed using only days of care that occurred in 2015. Days of care in 2014 and/or 2016 are not included for patients who received care in those years as well. Days of care have been combined for patients who had multiple episodes of care in 2015. 16 NHPCO NewsLine | Winter 2017 In 2015, on average, patients with a principal diagnosis of dementia received the largest number of days of care. Length of Service* The average length of service (ALOS) for Medicare patients enrolled in hospice in 2015 was 69.5 days. The median length of service (MLOS) was 23 days. A larger proportion of Medicare patients (28.2%) were enrolled in hospice a total of seven days or fewer compared to all other length of service categories. In 2015 close to 30% of patients were enrolled in hospice for 7 days or less.