Rural Hospice and Palliative Care – Resources
Selected recent or important resources focusing on Rural Hospice and Palliative Care.
MedPAC Report to the Congress: Medicare Payment Policy: Hospice Services: Chapter 10
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 2019-2024. Compares the actual hospice utilization rates in micropolitan, rural adjacent, rural nonadjacent, and frontier areas to urban hospice utilization rates.
Date: 03/2026
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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 2019-2024. Compares the actual hospice utilization rates in micropolitan, rural adjacent, rural nonadjacent, and frontier areas to urban hospice utilization rates.
Date: 03/2026
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NACH Facts and Figures: 2025 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: 02/2026
Sponsoring organization: National Alliance for Care at Home
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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: 02/2026
Sponsoring organization: National Alliance for Care at Home
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Hospice Care Chartbook 2025
Provides an overview of hospice care, including patient demographics, characteristics of live discharges, organizational trends, and Medicare spending for hospice services. Includes charts and graphs throughout, as well as state-by-state data. Slides 16 and 34 highlight the percentage of Medicare decedents that did and did not use hospice in 2024 and the number of hospices between 2019 and 2024 by rurality, respectively.
Date: 12/2025
Sponsoring organizations: KNG Health Consulting, National Alliance for Care at Home, Research Institute for Home Care
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Provides an overview of hospice care, including patient demographics, characteristics of live discharges, organizational trends, and Medicare spending for hospice services. Includes charts and graphs throughout, as well as state-by-state data. Slides 16 and 34 highlight the percentage of Medicare decedents that did and did not use hospice in 2024 and the number of hospices between 2019 and 2024 by rurality, respectively.
Date: 12/2025
Sponsoring organizations: KNG Health Consulting, National Alliance for Care at Home, Research Institute for Home Care
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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: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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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: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Medicare Hospice Use Patterns Among Patients With Alzheimer's Disease or Related Dementias Compared to Those With Other Terminal Diagnoses
Examines hospice use among Medicare enrollees with Alzheimer's disease and related dementias (ADRD) compared to Medicare hospice enrollees with other terminal diagnoses. Explores whether hospice characteristics, including rural status, are associated with hospice length of stay, visit frequency, and live discharge rates among Medicare patients with and without terminal and comorbid ADRD diagnoses.
Date: 09/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Examines hospice use among Medicare enrollees with Alzheimer's disease and related dementias (ADRD) compared to Medicare hospice enrollees with other terminal diagnoses. Explores whether hospice characteristics, including rural status, are associated with hospice length of stay, visit frequency, and live discharge rates among Medicare patients with and without terminal and comorbid ADRD diagnoses.
Date: 09/2025
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Establishing First Age-Friendly Health System Tele-Palliative Care Clinic – Facilitators, Challenges, Lessons Learned to Improve Care for Rural, Older Veterans
Presents a study exploring an age-friendly tele-palliative care clinic for older veterans. Highlights challenges and successes of using telehealth to provide palliative care to older rural veterans in Colorado.
Author(s): Stephanie Hartz, Alexander Garbin, Kathryn Allen Nearing, et al.
Citation: INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 62
Date: 07/2025
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Presents a study exploring an age-friendly tele-palliative care clinic for older veterans. Highlights challenges and successes of using telehealth to provide palliative care to older rural veterans in Colorado.
Author(s): Stephanie Hartz, Alexander Garbin, Kathryn Allen Nearing, et al.
Citation: INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 62
Date: 07/2025
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Palliative Care and Caregiving in the Midwest, Metro and Nonmetro Geographies: Insights from HINTS 2024
Examines characteristics of palliative caregiving in the Midwest. Utilizes 2024 Health Information National Trends Survey (HINTS) data to provide metro versus nonmetro breakdowns on the health of caregivers, knowledge about and perspectives on palliative care, person being cared for, and more.
Author(s): Adee Athiyaman
Date: 07/2025
Sponsoring organization: Illinois Institute for Rural Affairs
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Examines characteristics of palliative caregiving in the Midwest. Utilizes 2024 Health Information National Trends Survey (HINTS) data to provide metro versus nonmetro breakdowns on the health of caregivers, knowledge about and perspectives on palliative care, person being cared for, and more.
Author(s): Adee Athiyaman
Date: 07/2025
Sponsoring organization: Illinois Institute for Rural Affairs
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Study Protocol of Sustaining Home Palliative Care for Patients with Heart Failure (Hf) and Their Family Caregivers in Rural Appalachia: A Mixed Methods Randomized Clinical Trial
Study protocol to examine an integrated nurse-led intervention bundle for patients with heart failure and their family caregivers regarding home supportive end-of-live palliative care in rural West Virginia. Discusses the assessment of the intervention's sustainability with rural stakeholders, visiting volunteers, and the West Virginia Faith Community Nurse Network.
Author(s): Ubolrat Piamjariyakul, Stephanie Young, Angel Smothers, et al.
Citation: BMC Palliative Care, 24(1)
Date: 03/2025
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Study protocol to examine an integrated nurse-led intervention bundle for patients with heart failure and their family caregivers regarding home supportive end-of-live palliative care in rural West Virginia. Discusses the assessment of the intervention's sustainability with rural stakeholders, visiting volunteers, and the West Virginia Faith Community Nurse Network.
Author(s): Ubolrat Piamjariyakul, Stephanie Young, Angel Smothers, et al.
Citation: BMC Palliative Care, 24(1)
Date: 03/2025
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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 2019-2023. Compares the actual hospice utilization rates in micropolitan, rural adjacent, rural nonadjacent, and frontier areas to urban hospice utilization rates.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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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 2019-2023. Compares the actual hospice utilization rates in micropolitan, rural adjacent, rural nonadjacent, and frontier areas to urban hospice utilization rates.
Date: 03/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Rural American Hospice Insights Report: Understanding the Needs of the Rural Family Caregiver
Presents findings from a survey of 400 rural family caregivers regarding their knowledge and perceptions of hospice care. Covers respondents' demographics, communication and learning preferences, awareness of and beliefs about hospice, priorities regarding hospice care, and more. Requires name, organization information, and email address to download.
Date: 12/2024
Sponsoring organizations: National Alliance for Care at Home, Transcend Strategy Group
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Presents findings from a survey of 400 rural family caregivers regarding their knowledge and perceptions of hospice care. Covers respondents' demographics, communication and learning preferences, awareness of and beliefs about hospice, priorities regarding hospice care, and more. Requires name, organization information, and email address to download.
Date: 12/2024
Sponsoring organizations: National Alliance for Care at Home, Transcend Strategy Group
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Last Updated: 3/12/2026