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Rural Hospice and Palliative Care – Resources

Selected recent or important resources focusing on Rural Hospice and Palliative Care.

Implementation Costs of Technology-Enhanced Transitional Palliative Care for Rural Caregivers
Examines the feasibility and sustainability of a family caregiver-focused transitional palliative care intervention that uses telehealth technologies. Presents results of a budget impact analysis of a randomized control trial, community-dwelling rural caregivers of hospitalized patients with a serious, life-limiting illness and receiving palliative care during hospitalization. Describes potential reimbursement mechanisms available to offset health system costs to providing transitional palliative care to support caregivers, including transitional care management and chronic care management service reimbursement.
Author(s): Brystana G. Kaufman, Diane E. Holland, Catherine E. Vanderboom, Cory Ingram, et al.
Citation: American Journal of Hospice and Palliative Care, 41(1), 38-44
Date: 01/2024
Type: Document
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NHPCO Facts and Figures: 2023 Edition
Provides an overview of hospice and palliative care in the United States. Includes information and data on patient characteristics, access to care, reimbursement, barriers and facilitators to care, quality of care, and more. Includes rural references throughout.
Date: 12/2023
Type: Document
Sponsoring organization: National Hospice and Palliative Care Organization
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Evaluation of the Medicare Care Choices Model: Fifth and Final Annual Evaluation Report
Evaluates the Medicare Care Choice Model (MCCM), which tests whether offering eligible Medicare beneficiaries the option to receive supportive services without forgoing payment for treatment of their terminal conditions improved their quality of life and care, increased patient and family satisfaction, and reduced Medicare expenditures. Describes the characteristics of participating hospices and withdrawal of providers over time; beneficiaries who were referred to, eligible for, and enrolled in MCCM; services provided and the quality of service delivery; transitions from MCCM to the Medicare hospice benefit; beneficiary outcomes and effects across subgroups; and key findings. Includes information on rural provider and beneficiary participation in the model and compares rural and urban beneficiary outcomes.
Additional links: Findings at a Glance, Participant Experience & Evaluation Results Video
Date: 11/2023
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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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
Type: Document
Sponsoring organization: Flex Monitoring Team
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Medicare Payment Basics: Hospice Services Payment System
Overview of the Medicare hospice benefit and Medicare payments to hospice providers. Describes the four levels of care of the hospice prospective payment system and payment rates.
Date: 10/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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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
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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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
Type: Document
Sponsoring organization: National Hospice and Palliative Care Organization
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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
Type: Document
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
Type: Document
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MedPAC Report to the Congress: Medicare Payment Policy: Hospice Services: Chapter 10
Discusses payment adequacy for hospice and palliative support services. Includes statistics with breakdowns by urban and rural locations and demographics on Medicare decedents who used hospice during 2010 and between 2017-2021. Compares the actual hospice utilization rates in micropolitan, rural adjacent, rural nonadjacent, and frontier areas to urban hospice utilization rates. Presents data on costs by day, aggregate margins, and the aggregate cap by urban and rural status.
Date: 03/2023
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Last Updated: 2/28/2024