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Rural Health
Resources by Topic: Hospice and palliative care

Literature Review on Differences in Care Provided in Urban and Rural Nursing Homes in the United States
Summarizes results of a review of peer-reviewed research on differences in rural and urban nursing home care quality. Covers access to mental health services and supports, hospitalizations and in-hospital deaths, and hospice care utilization. Highlights implications for future research.
Author(s): Denise D. Quigley, Leah V. Estrada, Gregory L. Alexander, Andrew Dick, Patricia W. Stone
Citation: Journal of Gerontological Nursing, 47(12), 48-56
Date: 12/2021
Type: Document
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December 2021 MedPAC Meeting Transcript
Transcript from the Medicare Payment Advisory Commission's (MedPAC) December 2021 meeting. Covers payment adequacy and updates for hospital inpatient and outpatient services and the mandated report on changes to the low-volume hospital payment adjustment, physician and other health professional services, ambulatory surgical center services, outpatient dialysis services, and hospice services. Highlights the effect of COVID-19 relief funding on rural hospital margins, rural hospital bypass, and rural hospice payment utilization, among other rural references.
Date: 12/2021
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Developing Successful Palliative Care Teams in Rural Communities: A Facilitated Process
Discusses the importance of palliative care in rural areas. Describes a 3-year initiative led by Stratis Health to guide the development of palliative care services through rural community-based teams in North Dakota, Washington, and Wisconsin. Presents results of the initiative, including initial and follow-up assessments regarding the community's experience and expertise in components of palliative care.
Author(s): Karla Weng, Janelle Shearer, Laura Grangaard Johnson
Citation: Journal of Palliative Medicine
Date: 11/2021
Type: Document
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Medicare Payment Basics: Hospice Services Payment System
Overview of the Medicare hospice and palliative care benefit for beneficiaries who have a life expectancy of six months or less, and Medicare payments to hospice and palliative care providers. Describes the four levels of care of the hospice prospective payment system and payment rates.
Date: 11/2021
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Obstacles Persist for Rural Patients to Access Hospice
Discusses challenges to delivering hospice care in rural areas. Highlights changes to allow providers at Rural Health Centers and Federal Qualified Health Centers to serve as attending physicians for hospice patients. Explores the impact of COVID-19 on the delivery of hospice services, including the use of telehealth services and workforce concerns.
Author(s): Jim Parker
Date: 09/2021
Type: Document
Sponsoring organization: Hospice News
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Rural Disparities in End-of-life Care for Patients with Heart Failure: Are They Due to Geography or Socioeconomic Disparity?
Examines the relationship of rurality, socioeconomic background, and end-of-life care for patients with heart failure in Maine. Includes data on healthcare utilization at end-of-life by age, sex, rurality, insurance type, and area deprivation index.
Author(s): Rebecca N. Hutchinson, Paul K. J. Han, F. Lee Lucas, et al.
Citation: Journal of Rural Health
Date: 05/2021
Type: Document
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Rural Crosswalk: CMS Flexibilities to Fight COVID-19
Lists CMS waivers and flexibilities issued and implemented in response to the COVID-19 Public Health Emergency. Describes the impact of each provision for rural providers and facilities.
Date: 05/2021
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Rural Community-based Palliative Care ECHO Program Summary
Describes a nine-month intervention to support 11 community-based palliative care programs in rural Minnesota using the Extension for Community Healthcare Outcomes (ECHO) Model. Provides an overview of the participants, session topics, technology utilized, and results. Offers insights and lessons learned.
Date: 04/2021
Type: Document
Sponsoring organization: Stratis Health
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Rural Community-based Palliative Care: Improving Health and Reducing Disparities in Access and Services
Toolkit describing a framework for the development of rural community-based palliative care capacity and services. Includes information and links to resources regarding assessing community needs, foundational tools, process development, service implementation.
Date: 04/2021
Type: Document
Sponsoring organization: Stratis Health
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MedPAC Report to the Congress: Medicare Payment Policy, 2021
Annual review of Medicare payment policies, with recommendations to Congress. Includes discussion on Medicare payment policies directly affecting rural providers and beneficiaries. Addresses payment adequacy for healthcare facilities and services, improving Medicare payment for post-acute care, Medicare Advantage, Medicare Part D, and the impact of healthcare provider consolidation. Contains information on the effects of the COVID-19 pandemic on Medicare beneficiary healthcare access, mortality, and service use. Presents an option for Medicare's coverage of telehealth beyond the public health emergency.
Date: 03/2021
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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