The Missouri Hospice and Palliative Care Association (MHPCA) Medicaid Project started in 2012. MHPCA worked closely with the Missouri MoHealthNet (Missouri’s Medicaid Division) to review the release of Medicaid data for Missouri Medicaid recipients who died in 2011.
Missouri is the first state in the nation to conduct this kind of study with a data release from a State Medicaid office.
It took a fair amount of time to coordinate the data collection and go through all the proper channels to access this information.
I met with the MoHealthNet director and staff to discuss the data use plan and procedures, making sure no personal information would be compromised. With their initial support, we completed an application to conduct research/study for the Missouri Department of Social Services. A panel for the department reviewed and supported our request, and the director agreed to the study before a letter of approval was issued.
In January 2013, MoHealthNet agreed to release the Medicaid data for MHPCA to complete the study. MHPCA worked with the state’s independent data provider to assure no recipient’s personal information was released, and that identifiers were assigned. Conference calls were conducted to determine data fields released.
MHPCA began the study with Dr. Cordt Kassner of Hospice Analytics. Dr. Kassner worked with MHPCA to receive and analyze the data. Dr. Don Taylor from Duke University also joined the study.
Up to May 2013, MHPCA was using general internal funds to pay for the data released from MoHealthNet, analysis, review and other costs. I began exploring grant possibilities to fund this study. We learned that the Medicaid Project was eligible for Missouri Foundation for Health’s (MFH) special projects grant. We submitted an application. We are thankful that they approved a two-year, $50,000 grant so we could complete the project.
MHPCA released the results for the long-awaited project in January 2014. We distributed the project brochure to all Missouri legislators. MHPCA followed up by meeting with key members of the Missouri State Legislature, including legislators on both the Senate and House budget committees. In addition, MHPCA organized a Hospice Day at the Capitol on Feb. 26, 2014, where more than 200 hospice staff shared the Medicaid Project booklet and talking points with their local legislators.
We are still hard at work sharing this information at various conferences and meetings, and with hospice groups.
What the data shows us: Hospice saves Missouri Medicaid money — end-of-life care costs 56 percent lower than Medicaid recipients who died in the hospital!
How does the study help our state Medicaid Hospice Benefit legislatively? Our project allows us to share evidence-based outcomes with legislators and the public regarding the important role hospices have in providing high-quality, end-of-life care at a lower cost. This message is important to communicate when funding for the Medicaid Hospice Benefit is examined every budget year. Also, this project assists other states in advocating for and protecting the Medicaid Hospice Benefit in their states.