Palmetto GBA Regional and State-Level Non-Cancer Length of Stay (NCLOS) Rates: July 1, 2008 – December 31, 2008
Non-Cancer Length of Stay (NCLOS) Rates1 permit Palmetto GBA to characterize its entire hospice provider population using at least six months of claims data. This approach allows Palmetto GBA to document variations in the proportion of long-stay non-cancer patients (>210 days) at the regional, state and provider levels. While these quantitative data do not necessarily reflect the appropriate or inappropriate provision of hospice services under Medicare, they do allow for the identification of trends and possible educational opportunities.
Palmetto GBA's Regional Home Health and Hospice Intermediary’ (RHHI's) 16-state region may be divided geographically into four sub-regions: Southeast (Kentucky, North Carolina, South Carolina and Tennessee), Southwest (Arkansas, Louisiana, New Mexico, Oklahoma and Texas), Gulf Coast (Alabama, Florida, Georgia and Mississippi) and Midwest (Illinois, Indiana and Ohio). The data used to calculate the NCLOS Rates reported below were obtained from non-cancer claims paid during the period July 1, 2008 to December 31, 2008, and subject to Palmetto GBA's Hospice Local Coverage Determinations (LCDs).
The All Categories NCLOS Rates summarize the experience of hospice providers submitting non-cancer claims to Palmetto GBA, for all nine non-cancer diagnoses categories. The table below contains regional information, while the accompanying PDF files describes the frequency and distribution of the All Categories, Provider-specific NCLOS Rates, by state and by policy. To view these files, select the PDF files below.
Hospice providers submitting claims to Palmetto GBA may request their individual NCLOS Rate information, including the All Categories NCLOS rate, by submitting a written request, on their agency's letterhead, to:
Stacey V. Brennan, MD, FAAFP
Director, Part A Medical Affairs
Palmetto GBA - Mail Code: AG-300
P.O. Box 100238
Columbia, SC 29202-3238
In your request, please include the following information:
1. Contact Name
2. Telephone number and extension (if applicable)
3. Provider Number
4. Mailing Address to send the NCLOS rate information
1NCLOS Rate values may range from 0, no beneficiaries had lengths of stays > 210 days, to 1 all had stays > 210 days. The units are per 100 beneficiaries (e.g., a NCLOS Rate of 0.15 means that 15 beneficiaries out of 100 had stays > 210 days)
NCLOS Rates
|
Diagnosis Category
|
Southeast
|
Southwest
|
Gulf Coast
|
Midwest
|
All Regions
|
|
ALS
|
0.22
|
0.24
|
0.29
|
0.23
|
0.25
|
|
The Adult Failure to Thrive Syndrome
|
0.22
|
0.26
|
0.27
|
0.22
|
0.25
|
|
Alzheimer's Disease & Related Disorders
|
0.32
|
0.35
|
0.33
|
0.28
|
0.32
|
|
Heart Disease
|
0.2
|
0.24
|
0.24
|
0.17
|
0.22
|
|
HIV Disease
|
0.19
|
0.11
|
0.11
|
0.12
|
0.12
|
|
Liver Disease
|
0.08
|
0.1
|
0.08
|
0.06
|
0.08
|
|
Pulmonary Disease
|
0.21
|
0.23
|
0.23
|
0.16
|
0.21
|
|
Renal Disease
|
0.06
|
0.05
|
0.05
|
0.04
|
0.05
|
|
Stroke & Coma
|
0.16
|
0.18
|
0.16
|
0.11
|
0.16
|
|
All Categories
|
0.21
|
0.24
|
0.24
|
0.18
|
0.22
|