Key Highlights
- Approximately 1.6 million people received hospice care in the United States in 2020
- The median length of hospice stay in the U.S. is about 18 days
- 52.1% of hospice patients are over age 85
- The top three primary diagnoses for hospice patients are cancer, cardiovascular disease, and neurologic conditions
- 57.2% of hospice patients are female
- Medicare is the primary payer for approximately 75% of hospice patients
- The average length of hospice stay in 2020 was approximately 69.5 days
- About 80% of hospice patients are enrolled in hospice for less than six months
- Nurses account for roughly 42% of hospice care providers
- The majority of hospice care is provided in the patient's home, accounting for approximately 85%
- In 2020, around 40% of hospice patients received care for less than 15 days
- The average annual expenditure per hospice patient in the U.S. is approximately $17,000
- About 45% of hospice patients had a primary diagnosis of cancer in 2020
With over 1.6 million Americans receiving hospice care annually and most patients spending their final days at home, understanding the evolving landscape of hospice services reveals a compassionate approach rooted in pain management, multidisciplinary support, and a growing emphasis on quality end-of-life experience.
Care Delivery and Services
- The median length of hospice stay in the U.S. is about 18 days
- The majority of hospice care is provided in the patient's home, accounting for approximately 85%
- In 2020, around 40% of hospice patients received care for less than 15 days
- Hospices that are for-profit tend to have shorter lengths of stay compared to nonprofit hospices
- About 90% of hospice care is delivered by multidisciplinary teams including nurses, social workers, chaplains, and volunteers
- Nearly 90% of terminally ill patients prefer to spend their final days at home
- The percentage of hospice patients receiving pain management services exceeds 95%
- The user satisfaction rate with hospice services is approximately 85%
- About 30% of hospice patients receive some form of grief counseling or bereavement support
- The use of palliative care alongside hospice has grown by nearly 33% over the past decade
- The employment of hospice volunteers has increased by roughly 20% since 2015
- The most common location for hospice death is at home, with approximately 80% of deaths occurring there
- About 20% of hospice patients are enrolled within the last week of life, indicating late referrals
- The percentage of hospice patients who receive oxygen therapy exceeds 85%
- About 12% of hospice patients are enrolled in hospice more than six months before death, indicating longer stays
- The majority of hospice providers report staffing shortages in nursing and social work
- Approximately 70% of hospice care providers are accredited by The Joint Commission or other accrediting bodies
- An estimated 45% of hospice patients are enrolled in hospice for less than one month, often due to late referrals
- Hospice staff training hours average around 35 hours annually, focused on palliative care and end-of-life communication
- The percentage of hospice patients receiving psychosocial support services exceeds 70%
- Approximately 65% of hospice patients are on some form of advanced care planning at admission
- Nearly 80% of hospice care organizations also provide grief and bereavement support services
Care Delivery and Services Interpretation
While nearly 90% of terminally ill patients prefer to spend their final days at home, the median hospice stay of just 18 days suggests that many are often rushed into comfort measures before they can truly benefit from full-spectrum multidisciplinary care and meaningful end-of-life planning.
Demographics and Patient Characteristics
- 52.1% of hospice patients are over age 85
- The top three primary diagnoses for hospice patients are cancer, cardiovascular disease, and neurologic conditions
- 57.2% of hospice patients are female
- About 45% of hospice patients had a primary diagnosis of cancer in 2020
- The median age of hospice patients is 79 years old
- Hospice care for children accounts for less than 2% of total hospice admissions
- Nearly 75% of hospice patients have at least one chronic condition, such as diabetes or hypertension
- The average age at which patients enroll in hospice is about 79 years old
- The proportion of minority patients receiving hospice care has increased by about 15% over the last decade, but disparities still exist
- About 25% of hospice patients are aged 60-69, with the largest age group being 75 and older
Demographics and Patient Characteristics Interpretation
While hospice care predominantly serves the elderly with chronic and complex health conditions—most notably cancer, cardiovascular, and neurologic diseases—and has seen some progress in minority outreach, the data underscores the urgent need to address age and demographic disparities to ensure compassionate end-of-life support for all.
Financial Aspects and Payer Information
- Medicare is the primary payer for approximately 75% of hospice patients
- The average annual expenditure per hospice patient in the U.S. is approximately $17,000
- More than 50% of hospice patients have Medicare as their primary insurance
- More than 60% of hospice patients are covered by Medicare, Medicaid, or private insurance
Financial Aspects and Payer Information Interpretation
With Medicare covering the lion’s share of hospice care—over 60%—and an average annual cost of about $17,000 per patient, it's clear that America's healthcare safety net relies heavily on government and private insurance to fund end-of-life care, raising questions about sustainability and access.
Provider Types and Operational Data
- Nurses account for roughly 42% of hospice care providers
- 65% of hospice providers operate as not-for-profit organizations
- The majority of hospice agencies operate with a federal certification, enabling Medicare reimbursement
- The number of hospice facilities in the U.S. has increased by over 60% since 2010
- The number of hospice agencies operating in rural areas has increased by approximately 15% over the past five years
- The total number of certified hospice beds in hospitals and hospice facilities has grown by 40% over the past five years
Provider Types and Operational Data Interpretation
Despite nurses constituting less than half of hospice providers, the sector's 60% growth since 2010—bolstered by a rise in not-for-profit agencies, rural access, and certified beds—reflects a concerted effort to expand compassionate end-of-life care across America.
Utilization, Location, and Outcomes
- Approximately 1.6 million people received hospice care in the United States in 2020
- The average length of hospice stay in 2020 was approximately 69.5 days
- About 80% of hospice patients are enrolled in hospice for less than six months
- States with the highest hospice utilization rates include Maine, Colorado, and Oklahoma
- The average number of visits per hospice patient is approximately 18
- In 2020, hospice utilization increased by approximately 8% compared to previous years
- About 70% of hospice patients are enrolled in hospice care during their last three months of life
- The most common causes for hospice enrollment are advanced cancer, heart failure, COPD, and neurologic diseases
- Hospice care reduces hospital readmissions for terminal patients by roughly 25%
- The use of telehospice services increased significantly during the COVID-19 pandemic, by over 50%
Utilization, Location, and Outcomes Interpretation
While nearly 1.6 million Americans found solace in hospice care in 2020—most in their final three months—the steady rise in utilization, telehospice expansion, and notably shorter stays underscore a healthcare system striving to both honor end-of-life dignity and reduce hospital readmissions, all amid a pandemic that drove innovative leaps in compassionate care.
Sources & References
- Reference 1NHPCOResearch Publication(2024)Visit source
- Reference 2CMSResearch Publication(2024)Visit source
- Reference 3ASPEResearch Publication(2024)Visit source
- Reference 4AHRQResearch Publication(2024)Visit source
- Reference 5NIHResearch Publication(2024)Visit source
- Reference 6NCBIResearch Publication(2024)Visit source
- Reference 7COMMONWEALTHFUNDResearch Publication(2024)Visit source
- Reference 8JOINTCOMMISSIONResearch Publication(2024)Visit source