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Rural Hospice and Palliative Care – Resources

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

Transitional Palliative Care for Family Caregivers: Outcomes From a Randomized Controlled Trial
Examines the influence of mentoring from a palliative care nurse on family caregivers in rural and medically underserved areas of three states. Analyzes adult caregivers from 2018-2022 after their care recipient who utilized inpatient palliative care was discharged from the hospital. Compares a control group who received only monthly phone calls with an intervention group who received teaching, guidance, and counseling. Discusses importance of both caregiver support and patient wellness.
Author(s): Joan M. Griffin, Jay N. Mandrekar, Catherine E. Vanderboom, et al.
Citation: Journal of Pain and Symptom Management, 68(5), 456-466
Date: 11/2024
Type: Document
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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: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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NHPCO Facts and Figures: 2024 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 data on geographic locations of hospice services and patients.
Date: 09/2024
Type: Document
Sponsoring organizations: National Alliance for Care at Home, National Hospice and Palliative Care Organization
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Palliative Care Challenges and Solutions in Rural U.S. Communities
Policy brief describing the availability of palliative care (PC) services in rural communities compared with urban areas, and identifying novel solutions for providing PC to rural areas. Features statistics including sociodemographic characteristics of urban and rural counties with and without hospitals offering PC as of 2020, and availability of PC in rural hospitals and health systems as of 2022-2023, with breakdowns by large rural, small rural, and isolated rural areas.
Author(s): Natalia V. Oster, Laura-Mae Baldwin, Pat Justis, et al.
Date: 09/2024
Type: Document
Sponsoring organization: WWAMI Rural Health Research Center
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Standing Technical Expert Panel for the Development, Evaluation, and Maintenance of Post-Acute Care (PAC) and Hospice Quality Reporting Program (QRP) Measurement Sets: Summary Report
Describes a December 15, 2023, Technical Expert Panel (TEP) regarding the development of additional cross-setting measures for the Post-Acute Care (PAC) and Hospice Quality Reporting Programs (QRPs), and filling measurement gaps with the Centers for Medicare & Medicaid Services (CMS) Universal Foundation measures. Summarizes TEP comments on adding measures to PAC and Hospice QRPs in four domains: 1) behavioral and mental health, 2) patient experience of care, 3) pain management, and 4) immunization. Covers panelists' discussions on the appropriateness of the existing measure set and potential new measures, setting-specific considerations, data sources, and other topics related to each domain. Includes rural references throughout.
Date: 07/2024
Type: Document
Sponsoring organizations: Abt Associates, Acumen, Centers for Medicare and Medicaid Services
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MedPAC Report to the Congress: Medicare Payment Policy: Hospice Services: Chapter 9
Discusses payment adequacy for hospice and palliative support services. Includes data on average costs by day and aggregate margins by urban and rural status, as well as demographics on Medicare decedents who used hospice during 2010 and between 2018-2022. Compares the actual hospice utilization rates in micropolitan, rural adjacent, rural nonadjacent, and frontier areas to urban hospice utilization rates.
Date: 03/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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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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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 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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Last Updated: 10/21/2024