As awareness of hospice care grows, demand continues to rise, as does length of stay.
This is according to Trella Health’s recently released 2025 Post-Acute Industry Trend Report. Hospice admissions have steadily increased since a COVID-related slump in 2020. Annual growth rates have gone up for each fourth quarter reporting period since 2021, the report indicated.
This growth is likely to continue, according to the report.
“These patterns suggest continued upward momentum for hospice admissions as demographic trends drive demand, and hospice benefit awareness continues to increase,” the report showed.
In Q4 2024, hospice utilization topped 50% for the first time since 2019, finally reaching pre-pandemic levels. The proportion of Medicare beneficiaries who died in hospice rose 1% between 2023 Q4 and 2024 Q4, driven by a 2.6% increase in hospice deaths versus a 0.7% rise in total Medicare mortalities.
Average length of stay (ALOS) is also trending upwards. Between Q4 2023 and the same quarter in 2024, ALOS reached 71.9 days, up from 68.3 to 71.9. Hospice median length of stay (MLOS) saw a smaller increase to 21 days in Q4 2024, up from 20 year over year.
“Increases in both ALOS and MLOS indicate earlier adoption of hospice services, suggesting more awareness by both patients and referral partners on the value of the hospice benefit,” the report said. “This awareness is especially prevalent as U.S. health care in general prioritizes value-based care since earlier hospice admission saves a substantial amount in reimbursement.”
Even in light of this growth at the national level, utilization rates continue to vary widely among the states, ranging from 27.2% in New York to 65.5% in Utah in Q4 2024. However, the utilization rate is impacted by the size of the state’s population.
“The wide gap in hospice utilization indicates opportunities for both patient and referral education for the benefits of hospice as nearly half of Medicare mortalities do not take advantage of this extremely valuable care setting,” the report stated. “Markets with hospice utilization lower than the national average should be prioritized for hospice expansion to ensure all Medicare beneficiaries have equal access to the hospice benefit.”
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