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 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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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
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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
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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
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: 10/2024
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
Sponsoring organizations: National Alliance for Care at Home, National Hospice and Palliative Care Organization
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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: 09/2024
Sponsoring organizations: National Alliance for Care at Home, National Hospice and Palliative Care Organization
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Palliative Care in Rural Communities
Presents the CARE (Complex, Access, Resourceful, Extraordinary) Framework to highlight the challenges and benefits of healthcare delivery in rural communities. Highlights multiple models for palliative care outside acute care settings with consideration for the CARE Framework.
Author(s): Tracy Fasolino, Kathleen Valentine, Megan E. Mayfield, William E. Rosa, Anne Koci
Citation: American Journal of Nursing, 128(4), 50-55
Date: 07/2024
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Presents the CARE (Complex, Access, Resourceful, Extraordinary) Framework to highlight the challenges and benefits of healthcare delivery in rural communities. Highlights multiple models for palliative care outside acute care settings with consideration for the CARE Framework.
Author(s): Tracy Fasolino, Kathleen Valentine, Megan E. Mayfield, William E. Rosa, Anne Koci
Citation: American Journal of Nursing, 128(4), 50-55
Date: 07/2024
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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
Sponsoring organizations: Abt Associates, Acumen, Centers for Medicare and Medicaid Services
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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
Sponsoring organizations: Abt Associates, Acumen, Centers for Medicare and Medicaid Services
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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
Sponsoring organizations: Centers for Medicare and Medicaid Services, Mathematica
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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
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
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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Last Updated: 3/13/2025