Rural Health
Resources by Topic: Hospice and palliative care
Provision of Hospice Services by Critical Access Hospitals: Strengths and Challenges
Describes the characteristics of Critical Access Hospitals (CAHs) that report providing hospice services by analyzing data from the 2021 American Hospital Association (AHA) annual survey. Presents findings from qualitative interviews with seven CAHs who report providing hospice care, including how CAHs provide hospice services, the advantages CAHs may have when providing end-of-life care, and what CAH-specific barriers exist in providing such care.
Author(s): Robert Barclay, Megan Lahr, Hannah MacDougall, Abigail Wenninger
Date: 10/2023
Sponsoring organization: Flex Monitoring Team
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Describes the characteristics of Critical Access Hospitals (CAHs) that report providing hospice services by analyzing data from the 2021 American Hospital Association (AHA) annual survey. Presents findings from qualitative interviews with seven CAHs who report providing hospice care, including how CAHs provide hospice services, the advantages CAHs may have when providing end-of-life care, and what CAH-specific barriers exist in providing such care.
Author(s): Robert Barclay, Megan Lahr, Hannah MacDougall, Abigail Wenninger
Date: 10/2023
Sponsoring organization: Flex Monitoring Team
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Medicare Advantage Value-Based Insurance Design Model Phase II: Second Annual Evaluation Report
Presents findings from an evaluation of Phase II of the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model, which allows participating MA parent organizations to offer supplemental benefits and incentives to beneficiaries, hospice benefits, and wellness and healthcare planning through their MA plans. Summarizes findings from interviews with representatives of participating MA organizations, in-network and out-of-network hospices, and beneficiaries. Covers MA organization and beneficiary implementation experiences, plan enrollment, quality of care, health outcomes, and more, for the VBID Model generally and for the VBID Hospice Benefit Component.
Additional links: Appendices, Findings at a Glance, Hospice Benefit Component Findings at a Glance
Date: 09/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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Presents findings from an evaluation of Phase II of the Medicare Advantage (MA) Value-Based Insurance Design (VBID) Model, which allows participating MA parent organizations to offer supplemental benefits and incentives to beneficiaries, hospice benefits, and wellness and healthcare planning through their MA plans. Summarizes findings from interviews with representatives of participating MA organizations, in-network and out-of-network hospices, and beneficiaries. Covers MA organization and beneficiary implementation experiences, plan enrollment, quality of care, health outcomes, and more, for the VBID Model generally and for the VBID Hospice Benefit Component.
Additional links: Appendices, Findings at a Glance, Hospice Benefit Component Findings at a Glance
Date: 09/2023
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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MedPAC Comment on CMS's Proposed Rule on the Home Health Prospective Payment System for FY 2024
Comments on a July 10, 2023, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments on expanding the Home Health Value-Based Purchasing Model nationwide, wage index adjustments, the Hospice Special Focus Program (SFP), and more.
Date: 08/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Comments on a July 10, 2023, Federal Register proposed rule related to Medicare payment policies for home health agencies. Includes comments on expanding the Home Health Value-Based Purchasing Model nationwide, wage index adjustments, the Hospice Special Focus Program (SFP), and more.
Date: 08/2023
Sponsoring organization: Medicare Payment Advisory Commission
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Palliative Care Needs and Preferences of Older Adults with Advanced or Serious Chronic Illnesses and their Families in Rural Communities of Indiana, USA
Presents the experiences of caregivers in rural Indiana related to palliative care, the needs of older adults with chronic illnesses, and the impacts on their families. Discusses themes such as managing pain, caregiver trust, distance and access to care, managing difficult conversations, caregiver burden, and use of telehealth in rural areas.
Author(s): Nasreen Lalani, Kawther Hamash, Yitong Wang
Citation: Journal of Rural Health, 40(2), 368-375
Date: 08/2023
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Presents the experiences of caregivers in rural Indiana related to palliative care, the needs of older adults with chronic illnesses, and the impacts on their families. Discusses themes such as managing pain, caregiver trust, distance and access to care, managing difficult conversations, caregiver burden, and use of telehealth in rural areas.
Author(s): Nasreen Lalani, Kawther Hamash, Yitong Wang
Citation: Journal of Rural Health, 40(2), 368-375
Date: 08/2023
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Texans' Views and Experiences with End-of-Life Issues
Survey of 2,305 Texans regarding attitudes, experiences, and needs around illness and end-of-life issues. Discusses barriers to access of end-of-life care, race and ethnicity, insurance status, and more. Includes rural data throughout.
Additional links: Research Summary
Date: 06/2023
Sponsoring organizations: Perry Undem, St. David's Foundation
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Survey of 2,305 Texans regarding attitudes, experiences, and needs around illness and end-of-life issues. Discusses barriers to access of end-of-life care, race and ethnicity, insurance status, and more. Includes rural data throughout.
Additional links: Research Summary
Date: 06/2023
Sponsoring organizations: Perry Undem, St. David's Foundation
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NHPCO Pediatric Facts and Figure, 2023 Edition
Provides an overview of pediatric hospice and palliative care in the United States. Includes information and data on patient characteristics, access to care, reimbursement, barriers and facilitators to care, and more. Section 3 compares the number and percentage of metropolitan and non-metropolitan counties with access to pediatric hospice and palliative care.
Date: 06/2023
Sponsoring organizations: National Alliance for Care at Home, National Hospice and Palliative Care Organization
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Provides an overview of pediatric hospice and palliative care in the United States. Includes information and data on patient characteristics, access to care, reimbursement, barriers and facilitators to care, and more. Section 3 compares the number and percentage of metropolitan and non-metropolitan counties with access to pediatric hospice and palliative care.
Date: 06/2023
Sponsoring organizations: National Alliance for Care at Home, National Hospice and Palliative Care Organization
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2023 National Survey on MIH-CP Programs
Results of a February 2023 survey of approximately 400 emergency medical services (EMS) agencies nationwide that have launched mobile integrated healthcare and community paramedicine (MIH-CP) programs. Features statistics on nontraditional services offered, and programs by demographic region served, with breakdowns by 3 levels of population density.
Date: 05/2023
Sponsoring organization: National Association of Emergency Medical Technicians
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Results of a February 2023 survey of approximately 400 emergency medical services (EMS) agencies nationwide that have launched mobile integrated healthcare and community paramedicine (MIH-CP) programs. Features statistics on nontraditional services offered, and programs by demographic region served, with breakdowns by 3 levels of population density.
Date: 05/2023
Sponsoring organization: National Association of Emergency Medical Technicians
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Hospice: CMS Flexibilities to Fight COVID-19
Outlines specific regulatory waivers and Medicare flexibilities for hospice providers issued in response to the COVID-19 pandemic. Includes information on payments for COVID-19 vaccines and therapeutics. Identifies whether each waiver or flexibility has been terminated, will end at the conclusion of the public health emergency, or has become permanent.
Date: 05/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Outlines specific regulatory waivers and Medicare flexibilities for hospice providers issued in response to the COVID-19 pandemic. Includes information on payments for COVID-19 vaccines and therapeutics. Identifies whether each waiver or flexibility has been terminated, will end at the conclusion of the public health emergency, or has become permanent.
Date: 05/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Palliative Care and Healthcare Utilization among Metastatic Breast Cancer Patients in U.S. Hospitals
Examines in-patient palliative care use by hospitalized metastatic breast cancer patients. Analyzes 26,961 female patients from 2010 to 2014 for palliative care use, with patient information further broken down by age, race, income, insurance type, and status of hospital utilized, such as urban teaching, urban nonteaching, or rural.
Author(s): Sun Jung Kim, Isha Patel, Chanhyun Park, Dong Yeong Shin, Jongwha Chang
Citation: Scientific Reports,13, 4358
Date: 03/2023
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Examines in-patient palliative care use by hospitalized metastatic breast cancer patients. Analyzes 26,961 female patients from 2010 to 2014 for palliative care use, with patient information further broken down by age, race, income, insurance type, and status of hospital utilized, such as urban teaching, urban nonteaching, or rural.
Author(s): Sun Jung Kim, Isha Patel, Chanhyun Park, Dong Yeong Shin, Jongwha Chang
Citation: Scientific Reports,13, 4358
Date: 03/2023
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MedPAC Report to the Congress: Medicare Payment Policy, 2023
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; Medicare Advantage (MA), including a mandated report comparing per enrollee spending in the MA program with that of traditional fee-for-service (FFS) Medicare; and Medicare Part D.
Date: 03/2023
Sponsoring organization: Medicare Payment Advisory Commission
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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; Medicare Advantage (MA), including a mandated report comparing per enrollee spending in the MA program with that of traditional fee-for-service (FFS) Medicare; and Medicare Part D.
Date: 03/2023
Sponsoring organization: Medicare Payment Advisory Commission
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