Though the numbers are still relatively low, spending on early palliative care rose between 2010 and 2019 for patients with advanced cancers, a recent study found.

Researchers from the Emory University School of Medicine in Atlanta examined early palliative care billing based on diagnosis codes or hospice and palliative medicine (HPM) specialty codes on outpatient claims.

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

The study cohort included Medicare beneficiaries 65 or older who were diagnosed with distant-stage female breast, colorectal, non-small cell lung, small cell lung, pancreatic or prostate cancers between 2010 to 2019 with survival of at least six months.

Early palliative care billing increased to 10.36%, up from 1.44% among 102,032 patients who received treatment from nearly 19,000 unique physicians. The increase was associated with earlier palliative care referrals and providers having a hospice and palliative specialist on staff.

A decline occurred with between-provider variation, 45.3% in 2017 through 2019 compared to 51% in 2010-2013.

Despite these results, more work is necessary to improve access to early palliative care, study authors indicated.

“Despite growth in early PC billing among patients with distant-stage cancers in 2010-2019, its level remained low,” they concluded. “Provider and organizational characteristics such as referral patterns and availability of HPM specialists within the organization may be important drivers for early PC utilization.”