2010 to 2019 Saw Early Palliative Care Billing Up for Advanced Cancer

MONDAY, March 17, 2025 (HealthDay News) — For patients with distant-stage cancers, there was an increase in early palliative care (PC) billing from 2010 to 2019, but the level remained low, according to a study published online March 7 in the Journal of Clinical Oncology.

Xin Hu, Ph.D., from the Emory University School of Medicine in Atlanta, and colleagues examined early PC billing, which was identified by diagnosis codes or hospice and palliative medicine (HPM) specialty codes on outpatient claims within the first three months of cancer diagnosis or up to hospice admission date. The study cohort included Medicare Fee-for-Service beneficiaries aged 65.5 years and older diagnosed with distant-stage female breast, colorectal, non-small cell lung, small cell lung, pancreatic, or prostate cancers in 2010 to 2019 with survival of at least six months.

The researchers found that in 2010 to 2019, there was an increase in the percentage with early PC billing among 102,032 patients treated by 18,908 unique physicians, from 1.44 to 10.36 percent. The likelihood of early PC billing was increased in association with treating physician”s early PC referrals in the previous year and organizations” employment of any HPM specialist (3.01 and 4.54 percentage points, respectively). There was a decline seen in between-provider variation in early PC from 51 percent in 2010-2013 to 45.3 percent in 2017-2019. For between-organization variation, patterns were similar.

“Variation across providers and organizations was considerable despite a declining trend in the past decade,” the authors write. “In particular, physician referral patterns and the presence of PC specialists in an organization were key drivers of early PC billing.”

Two authors disclosed ties to MJH Life Sciences and Flatiron Health.

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